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罕见部位的罕见病变:外科医生的难题。

A Rare Lesion at Rare Location: A Surgeon's Enigma.

作者信息

Bansal Vishal, Bansal Rani, Thapliyal Sanchita, Mowar Apoorva, Dubey Prajesh

机构信息

Department of Oral and Maxillofacial Surgery, Subharti Dental College, Swami Vivekanand Subharti University, NH-58, Delhi-Haridwar, Meerut Bypass Road, Meerut, Uttar Pradesh 250005 India.

Department of General Pathology, Subharti Medical College, Swami Vivekanand Subharti University, Meerut, India.

出版信息

J Maxillofac Oral Surg. 2022 Mar;21(1):73-77. doi: 10.1007/s12663-020-01364-5. Epub 2020 Apr 16.

Abstract

Leiomyosarcoma of palate is a rare malignant spindle cell tumour in oral cavity. It is often misdiagnosed with other benign lesions like nodular fasciitis, clinical and histological similarity of rapid growth, rich cellularity, as the pathogenesis is unknown, which can make diagnosis and management challenging. The non-specific clinical, radiologic and pathological presentation of spindle cell tumours causes diagnostic difficulty due to similarities to granulation tissue, benign or malignant lesions in histologic and imaging features. Nevertheless, differentiation is important because the prognosis and treatment varies according to the type of tumor. NF is frequently evaluated by biopsy and also immunohistochemistry (IHC) which is very essential in cases of non-regressing lesions after biopsy. The present case report highlights the clinical and histopathologic challenges in a rare case of nodular fasciitis in the palate which initially diagnosed as granulation tissue and later confirmed as Grade l leiomyosarcoma on IHC.

摘要

腭部平滑肌肉瘤是口腔中一种罕见的恶性梭形细胞瘤。它常被误诊为其他良性病变,如结节性筋膜炎,其临床和组织学表现为生长迅速、细胞丰富,由于发病机制不明,这使得诊断和治疗具有挑战性。梭形细胞瘤非特异性的临床、放射学和病理学表现,因其在组织学和影像学特征上与肉芽组织、良性或恶性病变相似,导致诊断困难。然而,鉴别诊断很重要,因为根据肿瘤类型的不同,预后和治疗方法也有所不同。结节性筋膜炎通常通过活检以及免疫组织化学(IHC)进行评估,这在活检后病变不消退的病例中非常关键。本病例报告强调了腭部罕见的结节性筋膜炎在临床和组织病理学方面面临的挑战,该病例最初被诊断为肉芽组织,后来经免疫组织化学证实为I级平滑肌肉瘤。

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