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腓骨游离皮瓣骨移植后成釉细胞瘤复发:病例报告及文献复习。

Recurrence of ameloblastoma in bone grafts of a fibula free flap: A case report and literature review.

机构信息

Oral and maxillofacial surgery, Tangshan Cancer Hospital, Tangshan, China.

Department of Pathology, North China University of Science and Technology, Tangshan, China.

出版信息

J Stomatol Oral Maxillofac Surg. 2022 Nov;123(6):663-665. doi: 10.1016/j.jormas.2022.06.007. Epub 2022 Jun 10.

Abstract

Ameloblastoma is a benign odontogenic tumor with high recurrence rate. It can cause severe abnormalities of the face and jaw, leading to severe disfiguration and impaired jaw and airway functions. Wide local excision and reconstruction are required for ameloblastoma. Recurrence in the free bone graft is rare, especially in the fibula free flap. A 67-year-old man had a history of ameloblastoma of the left mandible resected 16 years ago with reconstruction using the fibula free flap. Three years ago, radiologic examination suggested a possible tumor recurrence in the fibula free flap. Because of the left facial swelling with hard, painless, and elastic tumor extending in the mandibular, he was admitted to the hospital and underwent segmental mandibulectomy. Ameloblastoma in the fibula was confirmed by pathological examination meanwhile not invasion in soft tissue nor bone margin. At the 24-month follow-up, no recurrence was detected. As the strong tendency for recurrence, especially in cases of large tumor size and soft tissue involvement, the radical resection and long-term follow-up are recommended.

摘要

成釉细胞瘤是一种良性牙源性肿瘤,复发率高。它可导致面部和颌骨严重畸形,严重毁容,并影响颌骨和气道功能。成釉细胞瘤需要广泛的局部切除和重建。游离骨移植后复发罕见,特别是腓骨游离皮瓣。一名 67 岁男性,16 年前因左下颌骨成釉细胞瘤接受了腓骨游离皮瓣重建手术。三年前,影像学检查提示腓骨游离皮瓣可能有肿瘤复发。由于左侧面部肿胀,触及坚硬、无痛、有弹性的肿瘤,沿下颌骨延伸,他被收治入院并接受了下颌骨节段切除术。病理检查证实为腓骨内的成釉细胞瘤,同时无软组织和骨缘侵犯。24 个月随访时,未发现复发。由于强烈的复发倾向,特别是在肿瘤体积大且累及软组织的情况下,建议进行根治性切除和长期随访。

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