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颌骨促结缔组织增生性纤维瘤:病例系列及文献综述

Desmoplastic Fibroma of the Jaws: A Case Series and Review of Literature.

作者信息

Karimi Abbas, Derakhshan Samira, Moradzadeh Khiavi Monir, Mosavat Farzaneh, Mirjalili Faeze

机构信息

Department of Oral and Maxillofacial Surgery , Dentistry School, Tehran University of Medical Sciences, Tehran, Iran.

Department of Oral and Maxillofacial Pathology , Dentistry School, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Iran J Pathol. 2020 Spring;15(2):134-143. doi: 10.30699/ijp.2020.103833.2049. Epub 2020 Jan 26.

Abstract

Desmoplastic fibroma (DF) is a benign, locally aggressive neoplasm that rarely occurs in the facial skeleton. It usually presents during the first three decades of life. Due to its aggressiveness and high recurrence rate, early diagnosis is imperative, and complete surgical removal of the lesion is the treatment of choice. Herein, we present three cases of DF namely a 2 year-old girl with a mandibular DF, a 9 year-old boy with a maxillary lesion and a 1.5-year old boy with a mandibular DF. Complete clinicopathological information, treatment plan and long-term follow-up of patients are discussed. Histopathologic features of 3 cases revealed non-capsulated spindle cell tumor with fascicular or swirling patterns in incisional biopsy. Immunohistochemical staining was performed to make a definitive diagnosis. Strongly positive nuclear immunoreactivity for β-catenin confirmed the diagnosis of desmoplastic fibroma in 3 cases. Segmental mandibulectomy, partial maxillectomy and hemimandibulectomy were done for the cases. There was no recurrence in our reported cases after 8 and 11 months and 3 years follow up, respectively. It is noteworthy that despite the aggressive nature of DF, young patients often respond well to wide resection treatment.

摘要

促结缔组织增生性纤维瘤(DF)是一种良性、具有局部侵袭性的肿瘤,很少发生于面骨。它通常在生命的头三十年出现。由于其侵袭性和高复发率,早期诊断至关重要,完整手术切除病变是首选治疗方法。在此,我们报告三例DF病例,分别为一名患有下颌骨DF的2岁女孩、一名患有上颌病变的9岁男孩和一名患有下颌骨DF的1.5岁男孩。讨论了患者完整的临床病理信息、治疗方案和长期随访情况。3例病例的组织病理学特征显示,在切开活检中为无包膜的梭形细胞瘤,呈束状或漩涡状排列。进行免疫组织化学染色以做出明确诊断。β-连环蛋白核免疫反应呈强阳性,确诊3例为促结缔组织增生性纤维瘤。对这些病例分别进行了节段性下颌骨切除术、部分上颌骨切除术和半侧下颌骨切除术。在我们报告的病例中,分别经过8个月、11个月和3年的随访后均未复发。值得注意的是,尽管DF具有侵袭性,但年轻患者通常对广泛切除治疗反应良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d42/7081768/61432faa5f68/ijp-15-134-g001.jpg

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