Successful Treatment of Huge Juvenile Ossifying Fibroma in Mandible by Conservative Enucleation-A Case Report

以保守性剜出術成功治療下顎骨巨大年輕型骨化纖維瘤－病例報告

陳里奈(Li-Nai Chen) ； 李正喆(Jang-Jaer Lee)

《臺灣口腔顎面外科學會雜誌》 32卷2期 (2021/06) Pp. 96-105

摘要

Fibro-osseous lesions of the jaws are the lesions containing fibrous tissue transformed from bone marrow, and they may consist of mineralized materials of different forms. Fibro-osseous lesions include fibrous dysplasia, ossifying fibroma, and osseous dysplasia. Among them, the incidence rate of ossifying fibroma is the lowest. Juvenile ossifying fibroma is a subtype of ossifying fibroma, with largely different features. It is rapid growing and aggressive, with the prevalence among patients in the first or second decades of age. Based on different clinical features and histological type, it is divided into two variants, juvenile trabecular ossifying fibroma and juvenile psammomatoid ossifying fibroma. In our case, an 11-year-old girl experienced the first time of recurrence after marsupialization, and the second time of recurrence after bone contouring at other hospitals. Due to young age of the patient, we decided to perform enucleation instead of resection. After conservative enucleation with curettage, no recurrence had occurred so far.

關鍵字

Benign fibro-osseous lesions ； Juvenile ossifying fibroma

並列摘要

顎骨纖維骨質病灶為含有由骨髓轉化為纖維組織之病灶，其礦化成分各有不同形態。纖維骨質病灶包括纖維性再生不良、骨化纖維瘤，以及骨性再生不良。這些種類當中，最少見的是骨化纖維瘤。年輕型骨化纖維瘤是骨化纖維瘤的亞型，擁有很大不同的特徵。它生長快速且侵略性高，通常發生於0-10歲或10-20歲。根據組織學與臨床特徵，分為兩類：年輕型骨小樑骨性再生不良和年輕型沙瘤樣骨性再生不良。此病例為一11歲女性患者，分別在不同外院於造袋術後經歷第一次復發，於骨修型後第二次復發。考慮患者年紀，我們決定進行剜除術而非下顎骨切除。患者在剜除合併刮除術後至今未復發。

並列關鍵字

良性纖維骨性病灶 ； 年輕型骨化纖維瘤