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口腔肌内脂肪瘤与小叶状毛细血管瘤并存:一例罕见病例报告。

Co-existence of oral intra-muscular lipoma and lobular capillary hemangioma: A rare case report.

作者信息

Kini Yogesh, Kamat Anish, Navalkha Komal, Nayan Swapna, Mandlik Geetanjali, Gupta Damini

机构信息

OMFS, D.Y. Patil University School of Dentistry, Navi Mumbai, Sector 7, Highway Road, Dy Patil Vidyanagar, Nerul East, Navi Mumbai 400706, India.

OMFS, D.Y. Patil University School of Dentistry, Navi Mumbai, Sector 7, Highway Road, Dy Patil Vidyanagar, Nerul East, Navi Mumbai 400706, India.

出版信息

Int J Surg Case Rep. 2020;77:704-707. doi: 10.1016/j.ijscr.2020.11.057. Epub 2020 Nov 12.

Abstract

INTRODUCTION

Intramuscular lipoma are benign mesenchymal soft tissue neoplasm of mature adipocytes that arises within the muscle. Oral intramuscular lipoma are more commonly seen on tongue. Lobular capillary hemangioma (LCH) on the other hand are common benign vascular neoplasms which are often confused with pyogenic granuloma.

PRESENTATION OF CASE

In this paper we present a rare case of co-existence of oral intramuscular lipoma with LCH. A 65 year old male complains of swelling on the left chin region from past 4-5 years. On complete intraoral examination another mass was noted on ventral surface of tongue. After performing USG and FNAC of the swelling in the chin region, an excisional biopsy was done and was sent for histopathological examination which showed thin connective tissue septa separating lobules of mature adipocytes. Histopathological examination of tongue mass revealed a benign tumor composed of blood vessels comprising of small capillary sized vascular channels. After a follow-up of 1 year patient showed no signs of recurrence.

DISCUSSION

According to the literature recurrences are seen in case of intramuscular lipoma due to difficulty in total excision of the lesion. Immunohistochemistry plays a crucial role in distinguishing LCH from pyogenic granuloma. Intraoral LCH should be properly excised after understanding the vascularity of the lesion.

CONCLUSION

In literature, the co-existence of intraoral lipoma with other lesions have been encountered hence for a surgeon a complete examination of oral cavity plays a crucial role to rule out such co-existence.

摘要

引言

肌内脂肪瘤是一种由成熟脂肪细胞构成的良性间叶性软组织肿瘤,起源于肌肉内部。口腔肌内脂肪瘤多见于舌部。另一方面,小叶状毛细血管瘤(LCH)是常见的良性血管肿瘤,常与化脓性肉芽肿相混淆。

病例介绍

本文报告一例罕见的口腔肌内脂肪瘤与LCH并存的病例。一名65岁男性主诉左下颌区域肿胀4至5年。口腔全面检查时,在舌腹面发现另一肿物。对下颌区域肿物进行超声检查(USG)和细针穿刺抽吸活检(FNAC)后,进行了切除活检并送组织病理学检查,结果显示有薄的结缔组织间隔分隔成熟脂肪细胞小叶。舌部肿物的组织病理学检查显示为一个由小毛细血管大小的血管通道组成的良性肿瘤。随访1年后,患者无复发迹象。

讨论

根据文献,由于病变难以完全切除,肌内脂肪瘤会出现复发情况。免疫组织化学在区分LCH与化脓性肉芽肿方面起着关键作用。了解口腔LCH病变的血管情况后,应适当切除。

结论

文献中曾有口腔脂肪瘤与其他病变并存的情况,因此对于外科医生来说,全面检查口腔对于排除这种并存情况起着关键作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c219/7711181/c94130b1f3b0/gr1.jpg

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