Yamamoto-Silva Fernanda Paula, Silva Brunno Santos de Freitas, Batista Aline Carvalho, Mendonça Elismauro Francisco de, Pinto-Júnior Décio Dos Santos, Estrela Carlos
Universidade Federal de Goiás, Departamento de Ciências Estomatológicas, Goiânia, GO, Brasil.
Centro Universitário de Anápolis, Departamento de Medicina Oral, Anápolis, GO, Brasil.
J Appl Oral Sci. 2017 Jul-Aug;25(4):455-461. doi: 10.1590/1678-7757-2016-0424.
The present report describes a case of chondroblastic osteosarcoma in the periapical region of teeth #29, #30, and #31 of an 18-year-old male. Clinical history showed self-reported discomfort in the right posterior gingiva for over a month. Physical examination showed a small expansion and redness of the right mandibular buccal and lingual cortical plates, but no signs of pain or inflammation were observed. All the teeth responded positively to pulp sensibility. Periapical and panoramic radiographs showed slight periapical radiolucency in the roots of teeth #29 and #30, clear periodontal ligament space widening, and evident loss of lamina dura. Incisional biopsy was performed, and based on microscopic findings the diagnosis of chondroblastic osteosarcoma was confirmed.
Non-endodontic diseases associated with tooth root apex, such as chondroblastic osteosarcoma, should be included in differential diagnosis of jaw lesions that resemble periapical abscess.
本报告描述了一名18岁男性在29、30和31号牙根尖区发生的软骨母细胞性骨肉瘤病例。临床病史显示,患者自述右后牙龈不适超过一个月。体格检查发现右下颌颊侧和舌侧皮质板轻度膨隆及发红,但未观察到疼痛或炎症迹象。所有牙齿牙髓感觉测试均呈阳性反应。根尖片和全景片显示29和30号牙根尖区有轻微的根尖周透射影,牙周膜间隙明显增宽,骨硬板明显消失。进行了切开活检,根据显微镜检查结果确诊为软骨母细胞性骨肉瘤。
与牙根尖相关的非牙髓疾病,如软骨母细胞性骨肉瘤,应纳入类似根尖周脓肿的颌骨病变的鉴别诊断中。