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上颌前部骨肉瘤误诊为根尖周病变:一例报告

Osteosarcoma of the anterior maxilla mimicking a periapical pathology: A case report.

作者信息

Pires Mariana Domingos, Martins Jorge N R, Dias Gonçalo Seguro, Doutel Delfim, Ordinola-Zapata Ronald

机构信息

Faculdade de Medicina Dentaria, Universidade de Lisboa, Lisboa, Portugal.

Serviço de Anatomia Patológica (SAP), Instituto Português de Oncologia (IPO), Lisboa, Portugal.

出版信息

Aust Endod J. 2021 Dec;47(3):656-663. doi: 10.1111/aej.12491. Epub 2021 Feb 18.

Abstract

Osteosarcomas of the jaws (OSJ) are difficult to diagnose, rare malignant lesions, with uncharacteristic radiographic and clinical presentation. Early diagnosis and treatment are essential to improve long-term prognosis. The current report presents a rare case of a primary conventional osteoblastic osteosarcoma of the anterior maxilla in a 25-year-old female. She presented to a private dental clinic after developing pain, facial oedema and palpation tenderness of a mass associated with the upper right lateral incisor. The signs and symptoms mimicked very closely a regular radiolucent and symptomatic periapical pathology, and the definitive diagnosis was only possible through a combination of clinical, radiographic and histopathological findings. The patient was referred to an oncology facility, where she was submitted to radical excision surgery through a hemi-maxillectomy. Although other pathologies are uncommon, the differential diagnosis of lesions compatible with odontogenic periapical pathology should not be neglected.

摘要

颌骨骨肉瘤(OSJ)难以诊断,是罕见的恶性病变,其影像学和临床表现不典型。早期诊断和治疗对于改善长期预后至关重要。本报告介绍了一例罕见的原发性常规成骨细胞型骨肉瘤病例,患者为一名25岁女性,肿瘤位于上颌前部。她因右上侧切牙处出现疼痛、面部水肿以及可触及的肿物压痛而前往一家私人牙科诊所就诊。这些症状和体征与典型的透射性根尖周病变极为相似,只有通过临床、影像学和组织病理学检查结果相结合才能做出明确诊断。该患者被转诊至肿瘤治疗机构,在那里接受了半侧上颌骨切除术的根治性切除手术。尽管其他病理情况并不常见,但与牙源性根尖周病变相符的病变的鉴别诊断也不应被忽视。

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