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颌骨动脉瘤样骨囊肿:19例回顾性分析

Aneurysmal Bone Cyst of the Jaws: A Retrospective Analysis of 19 Cases.

作者信息

Zhang Yiwen, Zhang Chunye, Liu Jiannan, Han Jing

机构信息

Department of Oral and Maxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China.

Department of Oral Pathology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

Int Dent J. 2025 Jun;75(3):1988-1998. doi: 10.1016/j.identj.2025.01.006. Epub 2025 Jan 26.

Abstract

OBJECTIVE

To analyse the clinical, radiographic, and pathological characteristics of aneurysmal bone cyst of the jaws (JABCs), and to provide reference for clinical diagnosis and treatment.

MATERIALS AND METHODS

A retrospective study was conducted on 19 patients with JABC diagnosed from 2018 to 2022.

RESULTS

Of the 19 JABC patients (5 males, 14 females, aged 7-53 years, mean 23.7), 94.7% of the lesions were in the mandible, with only 5.3% in the maxilla. Painless swelling was the most common symptom. CT typically showed bone expansion with either a unilocular or multilocular appearance and visible intracystic septa. MRI revealed characteristic 'fluid-fluid' levels within the lesion. Microscopically, most cases were unilocular or multilocular; 10.5% were cystic-solid, and USP6 gene disruption was detected in 44.4% of tested cases (4/9). All the cases were treated surgically, ranging from curettage to extensive excision. The follow-up data of 16 patients were obtained, most of them had a good prognosis, with one patient relapsed 9 months after surgery.

CONCLUSION

JABC commonly occurs in the mandible, with a higher incidence in women. Swelling is the most common symptom. Radiographic findings were mostly unilocular or multilocular lesions with clear boundaries, and the characteristic multiple 'fluid-fluid' level could be used as an important basis for diagnosis. Smaller lesions can achieve good therapeutic effects through curettage, while larger ones often require radical excision followed by autologous bone graft reconstruction simultaneously. Prognosis is favourable in most cases.

CLINICAL RELEVANCE

JABC are rare but clinically significant, requiring accurate diagnosis and timely treatment. This study analyses 19 cases, highlighting their diverse clinical, imaging, and histological features. Early detection and personalized treatment, including surgery, are crucial to prevent recurrence and preserve function. Long-term follow-up is essential for monitoring outcomes. These findings enhance the understanding of JABC, guiding clinicians in management for better patient outcomes.

摘要

目的

分析颌骨动脉瘤样骨囊肿(JABC)的临床、影像学及病理特征,为临床诊断与治疗提供参考。

材料与方法

对2018年至2022年确诊的19例JABC患者进行回顾性研究。

结果

19例JABC患者(男性5例,女性14例,年龄7 - 53岁,平均23.7岁)中,94.7%的病变位于下颌骨,仅5.3%位于上颌骨。无痛性肿胀是最常见症状。CT典型表现为骨质膨胀,呈单房或多房状,可见囊内分隔。MRI显示病变内特征性的“液 - 液”平面。显微镜下,多数病例为单房或多房;10.5%为囊实性,44.4%(4/9)的检测病例中检测到USP6基因破坏。所有病例均接受手术治疗,范围从刮除术到广泛切除术。获得了16例患者的随访数据,大多数患者预后良好,1例患者术后9个月复发。

结论

JABC常见于下颌骨,女性发病率较高。肿胀是最常见症状。影像学表现多为边界清晰的单房或多房病变,特征性的多个“液 - 液”平面可作为重要诊断依据。较小病变通过刮除术可取得良好治疗效果,而较大病变通常需要根治性切除并同期进行自体骨移植重建。多数病例预后良好。

临床意义

JABC虽罕见但具有临床重要性,需要准确诊断和及时治疗。本研究分析了19例病例,突出了其多样的临床、影像学和组织学特征。早期发现和包括手术在内的个体化治疗对于预防复发和保留功能至关重要。长期随访对于监测预后至关重要。这些发现增进了对JABC的理解,指导临床医生进行管理以获得更好的患者预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/216f/12142750/5a74e4da43bf/gr1.jpg

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