Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.
Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.
Int J Oral Maxillofac Surg. 2021 Aug;50(8):1023-1026. doi: 10.1016/j.ijom.2020.10.010. Epub 2020 Dec 6.
Adamantinoma is an extremely rare tumour originating from bone that can be divided into classical and osteofibrous dysplasia (OFD)-like adamantinoma. This low-grade malignancy almost exclusively occurs in long bones, and only few cases of mandibular adamantinoma have been reported. Here, we report the case of a 30-year-old female with a 2-year history of right mandible tenderness. Radiological examinations showed a lytic lesion involving the right mandible without a well-defined margin. Biopsy confirmed the diagnosis of adamantinoma. She underwent a segmental mandibulectomy and reconstruction with a fibula flap. The definitive diagnosis was OFD-like adamantinoma. However, the tumour recurred after 5 years. The residual mandible and fibula flap were widely involved. A total mandibulectomy was performed. Five years later, there is no evidence of recurrence or metastasis. We recommend that adamantinoma be treated by radical resection with clear margins, and long-term surveillance is necessary due to the likely high local recurrence rate and the potential for late tumour metastasis.
造釉细胞瘤是一种源自骨的极罕见肿瘤,可分为经典型和骨纤维发育不良(OFD)样造釉细胞瘤。这种低度恶性肿瘤几乎仅发生于长骨,仅有少数下颌造釉细胞瘤的病例报道。本文报告了 1 例 30 岁女性,右侧下颌骨疼痛 2 年。影像学检查显示累及右侧下颌骨的溶骨性病变,边界不清晰。活检证实为造釉细胞瘤。患者接受了下颌骨节段切除术和腓骨瓣重建。明确诊断为 OFD 样造釉细胞瘤。然而,5 年后肿瘤复发。残余下颌骨和腓骨瓣广泛受累。行全下颌骨切除术。5 年后,未见复发或转移的证据。我们建议通过有明确切缘的根治性切除术来治疗造釉细胞瘤,由于可能存在较高的局部复发率和肿瘤转移的潜在风险,需要长期监测。