Giant Cell Bone Tumor of the Maxilla-Report of a Rare Case

上顎骨巨大細胞瘤－罕見病例報告

何翊芸(Yi-Yun Ho) ； 羅文良(Wen-Liang Lo)

《臺灣口腔顎面外科學會雜誌》 29卷2期 (2018/06) Pp. 105-114

摘要

Giant cell bone tumor (GCBT) of the head and neck are extremely rare. Although GCBT is generally regards as a benign tumor, however, it can clinically behave aggressively, resulting in lytic lesion, local recurrence and even developing distant metastasis to lung. A 60-year-old female had medical history of lupus nephritis complicated with chronic renal failure receiving regular hemodialysis. She was presented with a left premaxilla painless swelling of two months duration. Radiological investigation revealed a 2×1.9×1.8 cm expansible and well defiried lytic lesion arising from the inferior aspect of the left premaxilla without intralesional calcification. The mass was excised via En bloc methods under general anesthesia. The final pathology proved GCBT. Although GCBT occur in jaw is rare, it is should be included in the differential diagnoses in the patients with maxillary swelling. The adequate surgical excision with long-term close follow-up should be the treatment of choice for managing giant cell tumor of the maxilla.

關鍵字

Giant cell tumor of bone ； Giant cell lesion of jaw ； Osteolytie lesion of jaw ； Maxillary swelling ； Chronic renal failure ； Hemodialysis

並列摘要

頭頸部區域的骨巨大細胞瘤極爲罕見。骨巨大細胞瘤被認爲是一種良性腫瘤，但其腫瘤行爲具有侵略性，會導致病灶處骨頭溶解性病變，局部復發，甚至造成遠端轉移至肺部。一名60歲的女性過去病史患有狼瘡性腎炎合併慢性腎衰竭，並接受血液透析治療。一開始來求診主要是左側前上顎骨腫脹將近兩個月的時間。放射學檢查顯示在左側前上顎骨處，有一個大小爲2×1.9×1.8公分，向周圍骨膨脹，明確界限的骨溶解病變病灶内沒有鈣化區域。在全身麻醉下，我們以En-b1oc方法切除病患之左側上頷骨之病灶。最終的病理診斷證實爲骨巨大細胞瘤。儘管上頜骨發生骨巨大細胞瘤非常罕見，但它仍應被列爲患者上頜骨腫脹的鑑別診斷之一。充分範圍的腫瘤切除手術和長期的追蹤應爲治療上頜骨巨大細胞瘤病變的首選治療。

並列關鍵字

巨大細胞瘤 ； 顎骨巨大細胞病灶 ； 顎骨蝕骨性病灶 ； 上顎骨腫脹 ； 慢性腎衰竭 ； 血液透析