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三维成像在软骨母细胞性骨肉瘤早期诊断中的重要性。

Importance of 3-dimensional imaging in the early diagnosis of chondroblastic osteosarcoma.

作者信息

Cuschieri Laura Althea, Schembri-Higgans Rebecca, Bezzina Nicholas, Betts Alexandra, Cortes Arthur Rodriguez Gonzalez

机构信息

Department of Dental Surgery, Faculty of Dental Surgery, University of Malta, Msida, Malta.

出版信息

Imaging Sci Dent. 2023 Sep;53(3):247-256. doi: 10.5624/isd.20220223. Epub 2023 Aug 2.

Abstract

The aim of this report is to present a case of chondroblastic osteosarcoma located in the right maxillary premolar region of a 17-year-old female patient. The initial clinical presentation and 2-dimensional (2D) radiographic methods proved inadequate for a definitive diagnosis. However, a cone-beam computed tomography scan revealed a hyperdense, heterogeneous lesion in the right maxillary premolar region, exhibiting a characteristic "sun-ray" appearance. To assess soft tissue involvement, a medical computed tomography scan was subsequently conducted. A positron emission tomography scan detected no metastasis or indications of secondary tumors. T1- and T2-weighted magnetic resonance imaging showed signal heterogeneity within the lesion, including areas of low signal intensity at the periphery. A histological examination conducted after an incisional biopsy confirmed the diagnosis of high-grade chondroblastic osteosarcoma. The patient was then referred to an oncology department for chemotherapy before surgery. In conclusion, these findings suggest that early diagnosis using 3-dimensional imaging can detect chondroblastic osteosarcoma in its early stages, such as before metastasis occurs, thereby improving the patient's prognosis.

摘要

本报告旨在介绍一例位于17岁女性患者右上颌前磨牙区的软骨母细胞性骨肉瘤病例。最初的临床表现和二维(2D)影像学方法不足以做出明确诊断。然而,锥形束计算机断层扫描显示右上颌前磨牙区有一个高密度、不均匀的病变,呈现出典型的“日光射线”外观。为评估软组织受累情况,随后进行了医学计算机断层扫描。正电子发射断层扫描未检测到转移或继发性肿瘤迹象。T1加权和T2加权磁共振成像显示病变内信号不均匀,包括周边低信号强度区域。切开活检后的组织学检查证实为高级别软骨母细胞性骨肉瘤。该患者随后被转诊至肿瘤科在手术前进行化疗。总之,这些发现表明使用三维成像进行早期诊断可以在软骨母细胞性骨肉瘤的早期阶段,如转移发生之前检测到该疾病,从而改善患者的预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a36a/10548150/a3244087cd5f/isd-53-247-g001.jpg

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