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婴儿鼻窦黏液瘤:关于其独特性的观察以及关于作为婴儿骨内黏液样硬纤维瘤病进行潜在重新分类的讨论。

Sinonasal Myxoma in an Infant: Observations on Its Distinctiveness and a Discussion on Potential Reclassification As Infantile Intraosseous Myxoid Desmoid Fibromatosis.

作者信息

Kashiwagi Ryoichiro, Maruguchi Hayato, Ken-Ichi Nibu, Terashi Hiroto, Nomura Tadashi

机构信息

Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe, JPN.

Department of Plastic Surgery, Maruguchi Skin Clinic, Kobe, JPN.

出版信息

Cureus. 2024 Aug 1;16(8):e65933. doi: 10.7759/cureus.65933. eCollection 2024 Aug.

Abstract

Myxomas, when they manifest in the paranasal sinuses and/or maxillae of infants, are classified as sinonasal myxomas (SNMs). We present a case of SNM in the maxilla of a 15-month-old infant. Following the initial surgical intervention, the patient unfortunately experienced a recurrence of the condition. However, a subsequent surgery employing marginal excision was performed, and since then, no further recurrence has been reported. SNM exhibits consistent clinical features and histological characteristics that are distinct from those of odontogenic myxomas. Furthermore, in this case, immunohistochemical staining was positive for β-catenin, whereas odontogenic myxomas are generally negative for β-catenin staining. Another study reported that SNMs share genetic mutations with desmoid tumors, which are not observed in odontogenic myxomas. This suggests that this entity is distinct from odontogenic myxomas, leading us to propose that it may indeed represent a separate disease entity. This fact may lead to the reclassification of the disease and, ultimately, to changes in treatment strategies.

摘要

黏液瘤若出现在婴儿的鼻窦和/或上颌骨中,会被归类为鼻窦黏液瘤(SNM)。我们报告一例15个月大婴儿上颌骨的SNM病例。在首次手术干预后,不幸的是,该患者病情复发。然而,随后进行了边缘性切除手术,自那以后,未再有复发报告。SNM具有一致的临床特征和组织学特征,与牙源性黏液瘤不同。此外,在本病例中,免疫组化染色β-连环蛋白呈阳性,而牙源性黏液瘤β-连环蛋白染色通常为阴性。另一项研究报告称,SNM与硬纤维瘤存在共同的基因突变,而牙源性黏液瘤中未观察到这种情况。这表明该实体与牙源性黏液瘤不同,促使我们提出它可能确实代表一种独立的疾病实体。这一事实可能导致该疾病的重新分类,并最终导致治疗策略的改变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a922/11365093/be8ea16fa798/cureus-0016-00000065933-i01.jpg

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