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中华口腔医学研究杂志(电子版) ›› 2025, Vol. 19 ›› Issue (06) : 400 -404. doi: 10.3877/cma.j.issn.1674-1366.2025.06.008

病例分析

巨大骨化纤维瘤合并动脉瘤样骨囊肿1例
侯承素1, 张野1, 王健1, 史敬存2, 殷玉兰1, 王磊1,2,()   
  1. 1上海市奉贤区奉城医院口腔颌面-头颈肿瘤科,上海 201411
    2上海交通大学医学院附属第九人民医院口腔颌面-头颈肿瘤科,上海交通大学口腔医学院,国家口腔医学中心,口腔疾病国家临床医学研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,上海 200011
  • 收稿日期:2025-06-21 出版日期:2025-12-01
  • 通信作者: 王磊

Case analysis of huge ossified fibroma combined with aneurysmal bone cyst

Chengsu Hou1, Ye Zhang1, Jian Wang1, Jingcun Shi2, Yulan Yin1, Lei Wang1,2,()   

  1. 1Department of Oromaxillofacial Head and Neck Oncology, Fengcheng Hospital, Shanghai 201411, China
    2Department of Oromaxillofacial 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 200011, China
  • Received:2025-06-21 Published:2025-12-01
  • Corresponding author: Lei Wang
  • Supported by:
    Scientific Research Project of Shanghai Municipal Health Commission(202340135)
引用本文:

侯承素, 张野, 王健, 史敬存, 殷玉兰, 王磊. 巨大骨化纤维瘤合并动脉瘤样骨囊肿1例[J/OL]. 中华口腔医学研究杂志(电子版), 2025, 19(06): 400-404.

Chengsu Hou, Ye Zhang, Jian Wang, Jingcun Shi, Yulan Yin, Lei Wang. Case analysis of huge ossified fibroma combined with aneurysmal bone cyst[J/OL]. Chinese Journal of Stomatological Research(Electronic Edition), 2025, 19(06): 400-404.

本病例报道了1例罕见的、累及范围广泛的青少年巨大下颌骨骨化纤维瘤(OF),继发显著的动脉瘤样骨囊肿(ABC)形成。其临床表现典型(颌面变形、神经损伤),影像学及病理诊断明确。通过精心的术前栓塞和复杂的根治性切除联合显微血管吻合的游离皮瓣重建,患者获得了良好的近期治疗效果。

This case report describes a rare and widespread ossifying fibroma of the mandible in adolescents, secondary to significant aneurysmal bone cyst formation. Its clinical manifestations are typical (maxillofacial deformity, nerve injury), and the imaging and pathological diagnoses are clear. Through meticulous preoperative embolization and complex radical resection combined with microvascular anastomosis for free flap reconstruction, the patient achieved a good short-term therapeutic outcome.

图1 巨大骨化纤维瘤(OF)合并动脉瘤样骨囊肿(ABC)患者术前照片 A:侧面照;B:手术切口设计。
图4 巨大骨化纤维瘤(OF)合并动脉瘤样骨囊肿(ABC)患者手术过程照片 4A:术中;4B:手术切除的原发灶;4C:缝合后正面观。
图5 巨大骨化纤维瘤(OF)合并动脉瘤样骨囊肿(ABC)患者病理及免疫组化结果 A:肿物标本镜下观(苏木精-伊红);B:CD31阴性(免疫组化);C:EST相关基因(ERG)阳性(免疫组化);D:平滑肌肌动蛋白(SMA)阳性(免疫组化);E:CD34阳性(免疫组化);F:葡萄糖磷酸变位酶1(PGM1)阳性(免疫组化)。
图6 巨大骨化纤维瘤(OF)合并动脉瘤样骨囊肿(ABC)患者术后随访图像资料 A:术后2周正面像;B:术后3个月复查正面像;C:术后半年复查正面像;D:术后1年复查正面像;E:术后1年复查磁共振影像。
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