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左侧颧骨软骨母细胞型骨肉瘤:罕见病例报告及文献复习

Chondroblastic osteosarcoma of the left zygomatic bone: Rare case report and review of the literature.

作者信息

Khandekar Shubhangi, Dive Alka, Munde Prashant, Fande Prajakta Zade

机构信息

Department of Oral and Maxillofacial Pathology, Vidya Shikshan Prasarak Mandal's Dental College and Research Centre, Nagpur, Maharashtra, India.

出版信息

J Oral Maxillofac Pathol. 2014 May;18(2):281-5. doi: 10.4103/0973-029X.140791.

Abstract

Chondroblastic osteosarcoma (COS), a subgroup of intramedullary osteosarcoma (OS), is the most common osteosarcoma that occurs in adolescents and early adulthood. The COS has similar clinical and radiological features to those of conventional OS. We present a case of 20-year-old male patient with the chief complaint of pain and swelling in the left zygomatic region. The computed tomography (CT) and three-dimensional (3D) CT face showed erosion, calcific foci, sunray type of spicules suggestive of OS. On fine-needle aspiration cytology (FNAC) examination, initial diagnosis was malignant chondroid lesion, with differential diagnosis of mesenchymal chrondrosarcoma, COS on incisional biopsy and finally COS on excisional biopsy. The patient underwent radical resection of left zygomatic arch, followed by chemotherapy. Although clinically unsuspected in this unusual site, histopathology along with immunohistochemistry (IHC) results confirmed the COS. Because zygomatic location of COS is very rare, this report aimed to discuss clinical, radiographic, histopathologic, IHC findings and diagnostic pitfalls of COS in light of the literature.

摘要

软骨母细胞性骨肉瘤(COS)是髓内骨肉瘤(OS)的一个亚组,是青少年和成年早期最常见的骨肉瘤类型。COS具有与传统OS相似的临床和放射学特征。我们报告一例20岁男性患者,主要症状为左侧颧区疼痛和肿胀。计算机断层扫描(CT)和三维(3D)CT面部成像显示有骨质侵蚀、钙化灶、呈日光放射状的针状骨,提示骨肉瘤。细针穿刺细胞学检查(FNAC)初步诊断为恶性软骨样病变,切开活检时鉴别诊断为间叶性软骨肉瘤、COS,最终切除活检确诊为COS。患者接受了左侧颧弓根治性切除术,随后进行化疗。尽管该病变位于这个不寻常的部位在临床上未被怀疑,但组织病理学及免疫组织化学(IHC)结果证实为COS。由于COS发生于颧部非常罕见,本报告旨在结合文献讨论COS的临床、影像学、组织病理学、IHC表现及诊断陷阱。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e15/4196301/fb18839b8857/JOMFP-18-281-g001.jpg

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