下顎骨年輕型牙骨質骨化纖維瘤－病例報告

Juvenile Cemento-ossifying Fibroma of Mandible-Case Report

蔡國陽(Kuo-Yang Tsai) ； 張文乾(Wen-Chien Chang) ； 林永和(Yun-Ho Lin) ； 林宏雅(Hong-Yea Lin)

《中華民國口腔顎面外科學會雜誌》 8卷2期 (1997/09) Pp. 77-85

https://doi.org/10.7104/CJOMS.199709.0077

摘要

牙骨質骨化纖維瘤是牙胚源性腫瘤，屬纖維骨性病變之一種，而顎骨纖維骨性病變主要指骨頭組織被良性纖維組織取代且其間可能散布著不等量的鈣化組織，列屬於發育性的、反應性的、或是贅瘤性的，雖不容易區分，但正確歸類有助於診斷、手術方式的選擇及預後的評估。
本篇報告一位十四歲女孩在右下顎骨體區自八個月前即有不明原因的腫脹，最近數週更感覺到兩邊臉形不對稱；口内觀，發現頰側及舌側皮質的骨板膨脹，且右下後牙舌側傾斜。經手術挖除，追蹤半年，並無再發現象。由於雙顆牙骨質骨化纖維瘤並發生在青春期階段，相當罕見特予提報，其診斷須要綜合臨床特性、放射線特徵及病理組織檢查才可，並討論相關纖維性發育不良及纖維骨性腫瘤之鑑別診斷及治療方法。

關鍵字

牙骨質骨化纖維瘤 ； 纖維骨性病變 ； 下顎骨體區 ； 纖維骨性腫瘤

並列摘要

Cemento-ossifyingibroua of jaw is one of odontogenic tumors and belong to fibro-osseous lesions. A common denominator to fibro-osseous lesions of jaw is the replacement of the bone tissue with a benign fibrous tissue containing various amounts of mineralized (calcified) structures. It is often quite a challenge to establish a reasonable biologic behavior for these disorders in terms of whether the lesions in question are turely developmental, reactive or neoplastic processes. A 14 year-old girl found her right mandbular body area expansion 8 months ago but she did not care. Recently, due to facial asymmetry, she went to our hospital for help. After examination, we noted the buccal & lingual cortical plate expansion and the right lower posterior teeth tipped lingually. We treated this case by curettage of the bony lesions and it did not recur after followed up half a year. Last, we review the literature and make the discussion in differential diagnosis of monostic fibrous dysplasia and fibro-osseous neoplasms.