Lan Tianjun, Liu Xin, Liang Pei-Sheng, Tao Qian
Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong 510055, P.R. China.
Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong 510055, P.R. China.
Oncol Lett. 2019 Sep;18(3):2270-2277. doi: 10.3892/ol.2019.10537. Epub 2019 Jun 27.
Osteochondroma (OC) is considered the most common tumor of the axial skeleton, although it is relatively uncommon in the craniofacial region. The present study describes an atypical case of OC of the coronoid process. A 34-year-old woman presented with severely limited mouth opening (5 mm) and swelling of the right zygoma. Cone-beam computed tomography (CBCT) revealed a mushroom-shaped outgrowth from the coronoid process to the inner surface of the zygomatic arch, forming a pseudojoint. The patient was treated with coronoidectomy via an intraoral approach. Histopathological examination revealed features suggestive of OC. Subsequently, the patient was able to open their mouth, and there was no evidence of recurrence or post-operative complications in the 21-month follow-up. A review of the literature revealed only 38 histologically proven cases of coronoid OC in the past 30 years (1989-2018). The incidence of the disease was higher in men compared with that in women (male:female, 2.17:1), and the median age at onset was 28.7 years, with a range of 5-57 years. Gradual limitation of mouth opening and facial asymmetry are the most noticeable symptoms. Water's view and submentovertex projection of the zygomatic arch may be useful in identifying the tumor and its association with the zygoma, while CT and CBCT permit a detailed visualization of the location and density of the tumor. Coronoidectomy is the preferred treatment option, and the prognosis is excellent, with no evidence of recurrence or malignant transformation.
骨软骨瘤(OC)被认为是中轴骨骼最常见的肿瘤,尽管在颅面部相对少见。本研究描述了一例冠突骨软骨瘤的非典型病例。一名34岁女性出现严重张口受限(5毫米)及右侧颧骨肿胀。锥形束计算机断层扫描(CBCT)显示从冠突向颧弓内表面有一个蘑菇状突出物,形成一个假关节。患者通过口内入路接受了冠突切除术。组织病理学检查显示有骨软骨瘤的特征。随后,患者能够张口,在21个月的随访中没有复发或术后并发症的迹象。文献回顾显示,在过去30年(1989 - 2018年)中,仅有38例经组织学证实的冠突骨软骨瘤病例。该疾病的发病率男性高于女性(男:女,2.17:1),发病年龄中位数为28.7岁,范围为5 - 57岁。张口逐渐受限和面部不对称是最明显的症状。华氏位和颧弓的下颌顶位投照可能有助于识别肿瘤及其与颧骨的关系,而CT和CBCT能详细显示肿瘤的位置和密度。冠突切除术是首选的治疗方法,预后良好,没有复发或恶变的迹象。