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眼眶骨化性纤维瘤——病例报告及文献综述

Orbit ossifying fibroma - Case report and literature review.

作者信息

Rabelo Nicollas, da Silva Vinicius Trindade Gomes, do Espírito Santo Marcelo Prudente, Solla Davi, Oberman Dan Zimelewicz, da Costa Bruno Sisnando, Frassetto Fernando Pereira, Teixeira Manoel Jacobsen, Figueiredo Eberval Gadelha

机构信息

Departments of Neurosurgery, University of São Paulo, São Paulo, Brazil.

Department of Neurosurgery, Air Force Galeão Hospital, Rio de Janeiro, Brazil.

出版信息

Surg Neurol Int. 2020 Feb 28;11:35. doi: 10.25259/SNI_492_2019. eCollection 2020.

Abstract

BACKGROUND

Ossifying fibroma (OF) is benign bone lesions, most frequent in young children, more common in the maxillary sinus and mandible (75-89%), the pathogenesis of the tumor is not clear, there are many subtypes of OF. This paper aims to report an OF a case and literature review.

CASE DESCRIPTION

Male, 19 years old, with a progressive history proptosis since 2012, diagnosed as a right supraorbital lesion at an external service and assigned to conservative management. Then, he evolved with double vision, which worsened in February of 2018, associated with a moderate headache. On admission: proptosis and downward deviation of the right orbit was noticed on the physical exam and with exception of limited right upgaze, external ocular movements were maintained. Head computed tomography showed a multiloculate expansive osteolytic lesion at the right orbital roof. On magnetic resonance imaging, the lesion had an inner content with septations, T1-weighted imaging heterogeneous signal, T2-weighted imaging high signal intensity, and peripheral contrast enhancement. The patient underwent a right frontal craniotomy with a gross total resection and the postoperative follow-up was uneventful. Menzel reported the first case in 1782. The clinical findings depend on localization. There are five subtypes. In general, the lesions have a radiological appearance with hyperdense boundary and cause deformity and destruction in bones with high recurrence risk. Radical resection is curative.

CONCLUSION

As a result, the correlation of clinical, radiologic, and pathologic data is significant while going for a specific diagnosis in cases of craniofacial fibrous lesions. Total excision is the best treatment, but it can recur.

摘要

背景

骨化性纤维瘤(OF)是一种良性骨病变,在幼儿中最为常见,在上颌窦和下颌骨中更为常见(75-89%),肿瘤的发病机制尚不清楚,OF有许多亚型。本文旨在报告1例OF病例并进行文献复习。

病例描述

男性,19岁,自2012年起有渐进性眼球突出病史,在外院被诊断为右侧眶上病变并接受保守治疗。随后,他出现复视,在2018年2月加重,伴有中度头痛。入院时:体格检查发现右眼突出及右眼眶向下移位,除右眼上视受限外,眼球外运动正常。头部计算机断层扫描显示右侧眶顶有一个多房性膨胀性溶骨性病变。磁共振成像显示,该病变内部有分隔,T1加权成像呈不均匀信号,T2加权成像呈高信号强度,周边有对比增强。患者接受了右额开颅手术并进行了全切,术后随访情况良好。门泽尔于1782年报告了首例病例。临床表现取决于病变部位。有五种亚型。一般来说,病变在影像学上表现为边界高密度,可导致骨骼畸形和破坏,复发风险高。根治性切除可治愈。

结论

因此,在诊断颅面纤维性病变时,临床、放射学和病理学数据之间的相关性对于明确诊断具有重要意义。全切是最佳治疗方法,但可能会复发。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e30/7110299/a944c6703518/SNI-11-35-g001.jpg

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