青少年下颌骨骨肉瘤1例并文献复习

Pinky Gupta, Pragati Upasham, Ajinkya Bangar
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摘要

骨肉瘤是高度恶性的骨肿瘤,其特征是存在产生类骨或未成熟骨的恶性间充质细胞。虽然快速生长的骨骼通常会受到影响,如股骨干骺端,但也会发生罕见的颌骨骨肉瘤(JOS);发病率约为百万分之0.7。诊断包括临床放射学和组织学相关。一名14岁男性,以左侧下颌骨肿胀疼痛为主诉15天,经x线检查初步诊断为下颌骨左体肿瘤,病理证实为骨肉瘤。本病例强调了组织病理学在诊断病变中的重要性。考虑到其罕见性,我们提出了这个病例,并试图回顾与该病变相关的文献。骨肉瘤,尤其是颌骨骨肉瘤,需要高度的怀疑,需要及时诊断和治疗,以防止进一步的并发症,因为快速生长的肿瘤可能导致骨生长、面部畸形、气道损害和转移。关键信息:颌骨骨肉瘤是一种罕见的实体,需要临床放射学和组织病理学的早期诊断。与四肢相比较,早期的组织形态学诊断和手术、化疗和放疗的治疗可以带来更好的结果。关键词:骨恶性肿瘤,组织病理学,颌骨骨肉瘤,下颌骨,成骨细胞。
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Osteosarcoma of mandible in a teenager - A case report with review of literature
Osteosarcomas are highly malignant bone tumours characterised by the presence of malignant mesenchymal cells producing osteoid or immature bone. Though rapidly growing bones are commonly affected like metaphysis in the femur, rare cases of Osteosarcoma of jaw (JOS) too occur; with an incidence of approximately 0.7 per million. The diagnosis involves clinico-radiological and histological correlation. A 14-year old male presented with the chief complaints of swelling and pain in his lower jaw on left side for 15 days and was given a provisional diagnosis of neoplasia of left body of mandible on radiography which was confirmed as osteosarcoma in histopathology. The case presented here highlight the importance of histopathology in diagnosing the lesion. Considering its rarity we present the case and attempt to review the literature associated with this lesion. Osteosarcoma especially of jaw requires a high degree of suspicion and need to be diagnosed and treated promptly to prevent further complications as rapidly growing tumour could predispose to bony outgrowth, facial deformity, airway compromise and metastasis. Key message: Jaw osteosarcoma is a rare entity requiring clinico-radiological and histopathological corelation for early diagnosis.With a clinically distinct profile as compared to its extremity counterpart, early histomorpholgical diagnosis and management with surgery, chemotherapy and radiotherapy can lead to better outcome. Keywords: Bone malignant tumour, Histopathology, Jaw osteosarcoma, Mandible, Osteoblastic.
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