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上颌部恶性外周神经鞘瘤:病例报告及文献复习,重点探讨其不良预后。

Malignant peripheral nerve sheath tumor of the maxilla: Case report and review of the literature with emphasis on its poor prognosis.

机构信息

Department of Oral Pathology, College of Dentistry, Dankook University, Cheonan, Republic of Korea.

Department of Oral Pathology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea.

出版信息

Oral Oncol. 2022 Dec;135:106211. doi: 10.1016/j.oraloncology.2022.106211. Epub 2022 Oct 17.

Abstract

Malignant peripheral nerve sheath tumor (MPNST) is a spindle cell sarcoma with poor prognosis. Although patients with neurofibromatosis type 1 (NF1) have a higher risk of MPNST, it can also occur in the sporadic setting and may rarely arise centrally within bone. In this study, we present an extremely rare case of intraosseous MPNST of the maxilla arising in a 38-year-old female with no history of NF1. Despite radical surgery and postoperative radiotherapy, the patient died due to multiple distant metastases 1 year after treatment. According to the results of the literature analysis performed in this study, maxillary MPNST cases have worse clinical outcomes than general MPNSTs. In addition, it seems that NF1 and histological necrosis are poor prognostic indicators in patients with maxillary MPNST.

摘要

恶性外周神经鞘瘤(MPNST)是一种预后不良的梭形细胞肉瘤。虽然神经纤维瘤病 1 型(NF1)患者发生 MPNST 的风险更高,但它也可发生在散发性病例中,并且在骨内罕见发生于中央部位。在本研究中,我们报告了一例非常罕见的 38 岁女性上颌骨骨内 MPNST 病例,该患者无 NF1 病史。尽管进行了根治性手术和术后放疗,但该患者在治疗 1 年后因多发远处转移而死亡。根据本研究中的文献分析结果,上颌骨 MPNST 病例的临床结局比一般 MPNST 更差。此外,NF1 和组织坏死似乎是上颌骨 MPNST 患者的预后不良指标。

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