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表现为非特异性良性病变的下颌骨内丛状神经鞘瘤:我们能有多准确?一例病例报告并文献复习

Intramandibular plexiform schwannoma presenting as a nonspecific benign lesion: How specific can we be? A case report with a review of the literature.

作者信息

Bhandarkar Gowri Pandarinath, Shetty Kushal Vasanth, Desai Dinkar

机构信息

Department of Oral Medicine and Radiology, A. J. Institute of Dental Sciences, Mangalore, Karnataka, India.

Department of Pedodontia, A. J. Institute of Dental Sciences, Mangalore, Karnataka, India.

出版信息

J Cancer Res Ther. 2020 Apr-Jun;16(3):641-646. doi: 10.4103/jcrt.JCRT_393_19.

DOI:10.4103/jcrt.JCRT_393_19
PMID:32719282
Abstract

Schwannoma, a benign nerve sheath tumor, is quite rare and more so in jawbones. We report a rare case of a plexiform variant of mandibular schwannoma in a 12-year-old female with a swelling in the left mandible. Clinical features were suggestive of dentigerous cyst as a result of missing premolars and canine. Occlusal and panoramic radiography revealed an osteolytic lesion with scalloping margins, bicortical plate expansion, and agenesis of several teeth. Odontogenic keratocyst, central giant cell granuloma, odontogenic myxoma, and ameloblastic fibroma were given as radiological differential diagnoses. Histopathological examination revealed features of plexiform schwannoma which was given as the final diagnosis. The lesion was treated with surgical excision. Although odontogenic cysts/tumors are often thought of in differential diagnosis whenever well-defined radiolucencies in the jaw are encountered, it is prudent to include schwannoma. This exceptional case adds light to the fact that schwannoma should not be overlooked though it is a rare possibility and must be included in differential diagnosis of odontogenic cysts/tumors.

摘要

神经鞘瘤是一种良性神经鞘肿瘤,非常罕见,在颌骨中更为少见。我们报告一例罕见的下颌神经鞘瘤丛状变型病例,患者为一名12岁女性,左下颌出现肿胀。临床特征提示因前磨牙和尖牙缺失导致含牙囊肿。咬合片和全景片显示溶骨性病变,边缘呈扇贝样,双层皮质板扩张,多颗牙齿发育不全。牙源性角化囊肿、中央巨细胞肉芽肿、牙源性黏液瘤和成釉细胞纤维瘤被列为影像学鉴别诊断。组织病理学检查显示丛状神经鞘瘤特征,最终确诊为此病。该病变通过手术切除进行治疗。尽管每当在颌骨中遇到边界清晰的透射区时,牙源性囊肿/肿瘤通常会被纳入鉴别诊断,但谨慎起见也应将神经鞘瘤考虑在内。这个特殊病例表明,尽管神经鞘瘤可能性很小,但不应被忽视,必须纳入牙源性囊肿/肿瘤的鉴别诊断中。

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