Slootweg P J, Müller H
Oral Surg Oral Med Oral Pathol. 1983 Jul;56(1):61-70. doi: 10.1016/0030-4220(83)90057-9.
Discerning desmoplastic fibroma from odontogenic fibroma may present considerable diagnostic difficulty. In the present article five cases of jaw fibroma serve to emphasize the various problems. Two cases represented desmoplastic fibroma. Both were treated by curettage, which was successful in one case but failed to provide a cure in the other. Factors responsible for this differing clinical course are discussed. A third case of desmoplastic fibroma proved to have been misdiagnosed, being a low-grade fibrosarcoma that subsequently showed dedifferentiation, and two cases were diagnosed as central odontogenic fibroma. After a discussion of the various histologic aspects of the reported cases, it is concluded tha desmoplastic fibroma is a well-delineated entity. Odontogenic fibroma, on the contrary, can exhibit a varying histomorphology, perhaps because of the existence of different entities that at present are taken together. To prevent the uncertainties concerning the odontogenic fibroma from making the definition of desmoplastic fibroma also indistinct, it is proposed that a central jaw fibroma that does not show the typical morphology of a desmoplastic fibroma should be considered an odontogenic fibroma.
鉴别促结缔组织增生性纤维瘤与牙源性纤维瘤可能存在相当大的诊断困难。在本文中，五例颌骨纤维瘤病例用于强调各种问题。其中两例为促结缔组织增生性纤维瘤。两例均采用刮除术治疗，一例成功，另一例未治愈。文中讨论了导致这种不同临床病程的因素。第三例促结缔组织增生性纤维瘤被证明误诊，实际是一例低级别纤维肉瘤，随后出现去分化，另外两例被诊断为中央性牙源性纤维瘤。在对报告病例的各种组织学方面进行讨论后，得出结论：促结缔组织增生性纤维瘤是一个界限明确的实体。相反，牙源性纤维瘤可能表现出不同的组织形态，这可能是因为目前将不同的实体归在一起。为防止牙源性纤维瘤的不确定性导致促结缔组织增生性纤维瘤的定义也不明确，建议不表现出促结缔组织增生性纤维瘤典型形态的中央性颌骨纤维瘤应被视为牙源性纤维瘤。
