Kuratsu J, Nakayama T, Matsukado Y
No Shinkei Geka. 1985 Nov;13(11):1223-6.
A case of ossifying fibroma of the cranial vault is described. Several reports emphasized the rare existence of this lesion limiting in the cranial vault. The patient was a 76-year-old woman who suffered mild headache in the parietal region after a trivial head trauma. Physical and neurological examination were normal. Plain skull X-P revealed irregularly bordered, 4 X 4 cm sized radiolucent area in the left temporal bone. The bone scintigraphy using 99mTc-MDP showed an abnormal uptake like a doughnut. Levels of serum P, Ca and alkaline phosphatase were within normal range. A tumor was softer than normal skull, and undertaken piecemeal removal. The dura was normal. After the total removal of the tumor, cranioplasty using Resin plate was performed. Microscopically the lesion was composed immature, irregular spicules of bone and fibrous tissue. Abundant fibroblasts were arranged in a random fashion in the stroma. Characteristically, the spicules of bone surrounded by rimming of osteoblasts. Ossifying fibroma is a benign fibroosseous tumor. Although this tumor is typically found in the maxillary sinus and mandible, it has also been reported in the paranasal sinuses, frontal, ethmoid, sphenoid bone and orbital roof of the young adult. But previously reported cases involving the cranial vault alone were only 7 cases. Etiology of ossifying fibroma is almost unknown.
本文描述了一例颅顶骨化性纤维瘤病例。多篇报道强调了这种局限于颅顶的病变罕见。患者为一名76岁女性,在轻微头部外伤后出现顶叶区域轻度头痛。体格检查和神经系统检查均正常。颅骨X线平片显示左侧颞骨有一个边界不规则、大小为4×4 cm的透光区。使用99mTc-MDP进行的骨闪烁显像显示有类似甜甜圈样的异常摄取。血清磷、钙和碱性磷酸酶水平在正常范围内。肿瘤比正常颅骨软,遂行分块切除。硬脑膜正常。肿瘤全切后,使用树脂板进行颅骨成形术。显微镜下,病变由不成熟、不规则的骨小梁和纤维组织组成。大量成纤维细胞随机排列于间质中。其特征是骨小梁被成骨细胞环绕。骨化性纤维瘤是一种良性纤维骨性肿瘤。虽然这种肿瘤通常见于上颌窦和下颌骨,但也有报道见于年轻成人的鼻窦、额骨、筛骨、蝶骨和眶顶。但此前仅报道过7例单独累及颅顶的病例。骨化性纤维瘤的病因几乎不明。