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牙源性黏液瘤保守性手术治疗后的长期随访:一例报告及文献综述

Long-Term Follow-Up after Conservative Surgical Treatment of Odontogenic Myxoma: A Case Report and Literature Review.

作者信息

Sato Hitoshi, Kurihara Yuji, Shiogama Sunao, Saka Kotaro, Kurasawa Yuya, Itose Masakatsu, Yaso Atsutoshi, Shirota Tatsuo

机构信息

Department of Oral and Maxillofacial Surgery, School of Dentistry, Showa University, 2-1-1 Kitasenzoku, Ota-ku, Tokyo 145-8515, Japan.

出版信息

Case Rep Dent. 2019 Feb 11;2019:1634842. doi: 10.1155/2019/1634842. eCollection 2019.

Abstract

Odontogenic myxoma (OM) is a relatively rare, benign odontogenic tumor with locally aggressive behavior, but it is a nonmetastasizing neoplasm of the jaw bones. Although radical resection with an appropriate surgical margin is recommended, emerging evidence has suggested that a more conservative approach will result in acceptable recurrence rates with less morbidity if careful long-term follow-up is provided. A 56-year-old Japanese man with odontogenic myxoma of the left mandible was conservatively treated by surgical enucleation and curettage because he desired functional and cosmetic preservation. During a follow-up period of 100 months, the patient has remained clinically and radiologically free of recurrence. As far as we can ascertain, 20 reports published after 1990 described 37 patients with mandibular OM that had been treated by conservative surgery. Tumors recurred during a mean follow-up of 49.2 ± 42.8 months in 7 (18.9%) patients, and only one of five patients who were followed up for over 100 months developed recurrence. The rate of recurrence decreased from 24.0% to 8.3% when follow-up exceeded 60 months. Although enucleation and curettage have proven effective, the risk of recurrence remains considerable and long-term follow-up is indispensable. More evidence of long-term outcomes after conservative surgery for OM is needed.

摘要

牙源性黏液瘤(OM)是一种相对罕见的良性牙源性肿瘤,具有局部侵袭性,但它是颌骨的非转移性肿瘤。尽管建议采用具有适当手术切缘的根治性切除,但新出现的证据表明,如果进行仔细的长期随访,更保守的方法将导致可接受的复发率,且发病率更低。一名56岁的日本男性患有左下颌骨牙源性黏液瘤,由于他希望保留功能和美观,因此接受了手术摘除和刮除的保守治疗。在100个月的随访期内,患者在临床和影像学上均未复发。据我们所知,1990年后发表的20篇报告描述了37例接受保守手术治疗的下颌骨OM患者。7例(18.9%)患者在平均49.2±42.8个月的随访期内复发,在随访超过100个月的5例患者中,只有1例出现复发。当随访超过60个月时,复发率从24.0%降至8.3%。尽管摘除和刮除已被证明有效,但复发风险仍然相当大,长期随访必不可少。需要更多关于OM保守手术后长期结果的证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b01a/6388332/289571a409fa/CRID2019-1634842.001.jpg

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