Anan Kentaro, Kadota Hideki, Oryoji Chikafumi
Department of Plastic and Reconstructive Surgery, Kyushu University Hospital, Fukuoka, Japan.
J Craniofac Surg. 2024 Oct 1;35(7):e649-e651. doi: 10.1097/SCS.0000000000010413. Epub 2024 Jun 13.
Rapid ossification due to a subperiosteal hematoma in extremities has occasionally been documented in patients with neurofibromatosis type 1, but it has not been reported in the maxillofacial region. The authors present the first case of a subperiosteal hematoma in the forehead. A 36-year-old man presented with a rapidly swelling firm, fixed, 8×10 cm forehead mass. It became evident shortly after a fine-needle aspiration biopsy. Computed tomography imaging 2 months after the biopsy showed a hematoma that was encapsulated by a surrounding layer of ossification. Magnetic resonance imaging displayed a fluid-fluid level under the ossified area. These characteristic images led us to diagnose this rare lesion as a subperiosteal hematoma with ossification. Rapid ossification is a characteristic imaging finding of subperiosteal hematoma, which makes definitive diagnosis easy. It becomes imperative to underscore the potential risks of fine-needle aspiration in proximity to the periosteum in patients with neurofibromatosis type 1.
1型神经纤维瘤病患者四肢因骨膜下血肿导致的快速骨化偶有文献记载，但上颌面部区域尚未见报道。作者报告了首例前额骨膜下血肿病例。一名36岁男性患者前额出现一个迅速肿胀、质地坚硬、固定的8×10厘米肿块。细针穿刺活检后不久就明显出现了这种情况。活检2个月后的计算机断层扫描成像显示有一个被周围骨化层包裹的血肿。磁共振成像显示在骨化区域下方有液-液平面。这些特征性图像使我们将这个罕见病变诊断为骨化性骨膜下血肿。快速骨化是骨膜下血肿的一个特征性影像学表现，这使得明确诊断变得容易。强调1型神经纤维瘤病患者在靠近骨膜处进行细针穿刺的潜在风险变得势在必行。
