Ribeiro Igor Lerner Hora, Vasconcelos Mariana de Lyra, Panjwani Camila Maria Beder Ribeiro Girish, Silva Hugo Leonardo Madeiro Arcanjo, da Hora Sales Pedro Henrique, Andrade Clarisse Samara de
Santa Casa de Misericórdia Hospital of São Miguel dos Campos, São Miguel dos Campos.
Private Practice in Oral Surgery.
J Craniofac Surg. 2020 Jul-Aug;31(5):e445-e448. doi: 10.1097/SCS.0000000000006382.
Hemangiomas are benign vascular lesions characterized by endothelial vascular proliferation and may demonstrate aggressive clinical features. Intraosseous hemangiomas are uncommon and the maxillary location rare, with few cases described in the literature. The treatment of these lesions varies, however they have a better prognosis when a surgical treatment through resection is performed. The aim of this study is to report a case of right maxillary cavernous intraosseous hemangioma treated by surgical resection with previous embolization. The diagnosis was made through incisional biopsy and immunohistochemical examination. An aggressive lesion profile was observed through the Ki67 marker. During surgery, a temporary ipsilateral external carotid artery ligation was performed to minimize possible bleeding. Weber-Fergson surgical access was performed and total surgical resection through hemi-maxillectomy. The patient is stable after 30 months of follow-up without relapses. In suspected cases of intraosseous hemangiomas, accurate diagnosis and total surgical resection of the lesion is essential. The use of therapeutic mammoths that minimize sagging during and after the procedure such as embolization and arteriography should always be performed.
血管瘤是一种以血管内皮细胞增生为特征的良性血管病变，可能表现出侵袭性的临床特征。骨内血管瘤并不常见，发生于上颌骨的情况更为罕见，文献中报道的病例较少。这些病变的治疗方法各不相同，但通过手术切除进行治疗时预后较好。本研究的目的是报告一例经术前栓塞后手术切除治疗的右上颌骨海绵状骨内血管瘤病例。通过切开活检和免疫组化检查做出诊断。通过Ki67标记物观察到侵袭性病变特征。手术过程中，进行了同侧颈外动脉临时结扎以尽量减少可能的出血。采用了Weber-Fergson手术入路，并通过半上颌骨切除术进行了完整的手术切除。经过30个月的随访，患者情况稳定，无复发。在怀疑骨内血管瘤的病例中，准确诊断和完整切除病变至关重要。应始终采用在手术期间和术后尽量减少下垂的治疗手段，如栓塞和动脉造影。
