Adachi Masatoshi, Miyata Yusuke, Ito Yuki
Oral and Maxillofacial Surgery, Nippon Dental University Hospital, Tokyo, Japan
Oral and Maxillofacial Surgery, Nippon Dental University Hospital, Tokyo, Japan.
J Surg Case Rep. 2016 Feb 10;2016(2):rjw013. doi: 10.1093/jscr/rjw013.
Serious symptoms caused by intra-cystic bleeding are very rare. We describe a case of a maxillary cyst presenting with mid-facial deformity in a Japanese woman. She underwent bilateral Caldwell-Luc procedure 21 years earlier and suffered left cheek trauma 4 years earlier. She presented soon after the trauma complaining of left mid-facial deformity, and computed tomography showed a trilocular cystic lesion in the left maxilla. We performed facial osteotomy concurrent with cyst enucleation with lateral rhinotomy. Serosanguineous fluid filled the cyst cavity just below the face; however, additional cyst cavities contained straw-coloured fluid. She showed no signs of recurrence at the end of a 20-month follow-up, and her postoperative appearance was excellent. Histopathological examination showed that all cyst walls were lined by ciliated columnar epithelium, which was consistent with surgical ciliated cyst. We consider that the increased intra-cystic pressure caused by traumatic haemorrhage induced expansion of the pre-existing surgical ciliated cyst.
囊内出血引起的严重症状非常罕见。我们描述了一例日本女性上颌囊肿伴面部中部畸形的病例。她21年前接受了双侧柯-陆氏手术,4年前左侧脸颊受过外伤。外伤后不久,她因左侧面部中部畸形前来就诊,计算机断层扫描显示左上颌有一个三室囊性病变。我们通过鼻侧切开术同时进行面部截骨术和囊肿摘除术。在面部下方的囊肿腔内充满了血性浆液;然而,其他囊肿腔内含有稻草色液体。在20个月的随访结束时,她没有复发迹象,术后外观良好。组织病理学检查显示,所有囊肿壁均内衬纤毛柱状上皮,这与手术性纤毛囊肿一致。我们认为,创伤性出血导致囊内压力升高,促使原有的手术性纤毛囊肿扩张。