Takayama H, Koyama H, Iwata T, Murase I, Mukai M, Murakami H
No Shinkei Geka. 1985 Jun;13(6):669-73.
A 23-year-old woman was admitted to our hospital because of a soft, painful mass in the right parietal region for a month. Neurological examination revealed no abnormality. Laboratory data including serum Ca, P and alkaline phosphatase were normal. Skull x-ray film showed a partially osteolytic, not well circumscribed lesion in the right frontal, parietal and occipital bone. No remarkable sclerotic area was seen in the lesion. CT scan showed that the lesion was located in the diploë, destroying both inner and outer tables of the bone. Right external carotid angiogram revealed that the lesion is supplied by the branches of superficial temporal artery and middle meningeal artery. 99mTc bone scan showed increased uptake in the lesion. The patient underwent a right parietal craniectomy. The skull bone was invaded by the tumor, which was yellow-brown in color, thickened and fragile. We could easily perforate it through. The tumor didn't invade the dura mater or periosteum. It was extensively removed with an airtome and rongeurs. A cranioplasty was carried out using a plastic resin. The pathological specimen showed that the tumor was mainly composed of mature, regularly-aligned bone and intermingled fibrous tissue. Neither mitosis nor atypical cellular features was seen. These findings were compatible with the diagnosis of ossifying fibroma. The postoperative course was uneventful and the patient was discharged in a good condition. There was no evidence of local recurrence 10 months later. Ossifying fibroma is a rare, benign bone tumor that mainly involves the craniofacial bone. The differential diagnosis of ossifying fibroma versus fibrous dysplasia is difficult. These diseases can be differentiated on combined clinical, radiological and morphological grounds.
一名23岁女性因右侧顶叶区域出现一个柔软、疼痛的肿块1个月而入住我院。神经系统检查未发现异常。包括血清钙、磷和碱性磷酸酶在内的实验室检查数据均正常。颅骨X线片显示右侧额骨、顶骨和枕骨有一个部分溶骨性、边界不清的病变。病变内未见明显的硬化区。CT扫描显示病变位于板障，破坏了颅骨的内板和外板。右侧颈外动脉血管造影显示病变由颞浅动脉和脑膜中动脉的分支供血。99mTc骨扫描显示病变部位放射性摄取增加。患者接受了右侧顶骨颅骨切除术。颅骨被肿瘤侵犯，肿瘤呈黄棕色，增厚且易碎。我们可以很容易地将其穿透。肿瘤未侵犯硬脑膜或骨膜。使用气动钻和咬骨钳将其广泛切除。使用塑料树脂进行了颅骨成形术。病理标本显示肿瘤主要由成熟的、排列规则的骨组织和交织的纤维组织组成。未见有丝分裂或非典型细胞特征。这些发现与骨化性纤维瘤的诊断相符。术后过程顺利，患者状况良好出院。10个月后无局部复发迹象。骨化性纤维瘤是一种罕见的良性骨肿瘤，主要累及颅面骨。骨化性纤维瘤与骨纤维异常增殖症的鉴别诊断困难。这些疾病可根据临床、影像学和形态学综合判断进行鉴别。
