下颌骨促纤维结缔组织增生性纤维瘤1例报告及文献复习

摘要/Abstract

摘要：

促纤维结缔组织增生性纤维瘤（DF）是一种罕见的良性颌骨肿瘤性疾病，其无明显特异性，临床上常难以与其他疾病相鉴别，因此常导致疗效不佳，增加治疗复杂性。本文作者报道了1例老年DF患者的诊疗经过，为DF的诊断和治疗提供参考。患者，女性，66岁，因左下颌后牙区反复肿胀不适20余年入院。体格检查见左下颌后部骨膨隆质硬，有压痛；曲面断层和锥形束计算机断层扫描（CBCT）检查见边界不清的低密度影，大小为1.5 cm ×1.8 cm，以及骨质破坏；为明确诊断，进行术前病理学活检，结果显示为梭形细胞病变，视野背景见大量的纤维结缔组织；综合以上检查，确诊为下颌骨DF。鉴于DF具有侵袭性，采用下颌骨部分切除术切除病灶，并通过重建夹板内固定术以及下颌下腺瓣修复术修复缺损；术后病理检查可见致密的纤维结缔组织，其中部分细胞成分具有异型性，也可见部分肥大细胞，符合DF的病理学特征。术后随访1年，暂时未见术后并发症以及复发。DF无明显特异性，常导致诊断和治疗的困难，需综合借助影像学和病理学检查进行辅助诊断，采用扩大切除边界的手术方式进行治疗；DF常为良性，但具有侵袭性，患者术后需要进行观察随访。

关键词: 下颌骨, 促纤维结缔组织增生性纤维瘤, 下颌骨部分切除术, 下颌骨良性肿瘤, 皮瓣修复

Abstract:

Desmoplastic fibroma （DF） is an extremely rare benign tumor of the jaw bone. Due to its lack of distinct specific features， it is often difficult to distinguish clinically from other diseases， which can lead to suboptimal therapeutic outcomes and increased treatment complexity. This article reportsed the clinical features of an elderly patient with DF to provide the reference for its diagnosis and treatment. The patient， a 66-year-old female， was admitted to the hospital due to recurrent swelling and discomfort in the left posterior mandibular region for over 20 years. The physical examination results showed a hard， tender bony expansion in the left posterior mandible. The panoramic radiography and cone-beam computed tomography （CBCT） results showed an ill-defined radiolucent shadow， about 1.5 cm×1.8 cm， and bone destruction. To confirm the diagnosis， a preoperative pathological biopsy was performed， which showed a spindle cell lesion with a background of abundant fibrous connective tissue. Based on the above findings， a definitive diagnosis of mandibular DF was made. Given the aggressive nature of DF， the lesion was resected via partial mandibulectomy. The defect was repaired using a reconstruction plate for internal fixation and a submandibular gland flap. The postoperative pathological examination results showed dense fibrous connective tissue， with some cellular components exhibiting atypia and the presence of some mast cells， consistent with the pathological characteristics of DF. No postoperative complications or recurrence were observed during the 1-year follow-up period. DF often lacks specific features， to result in the difficulties in diagnosis and treatment. Comprehensive diagnosis requires the integration of imaging and pathological examinations， and treatment involves surgical resection with wide margins. Although DF is typically benign， it exhibits local aggressiveness， necessitating postoperative observation and follow-up for the patients.

Key words: Mandible, Desmoplastic fibroma, Partial mandibulectomy, Benign tumor of mand, Flap repair

中图分类号:

R739.82

李双季,时赫,秦一文,李想,李裕洋,刘炜炜,李佳. 下颌骨促纤维结缔组织增生性纤维瘤1例报告及文献复习[J]. 吉林大学学报(医学版), 2025, (): 1-6.

Shuangji LI,He SHI,Yiwen QIN,Xiang LI,Yuyang LI,Weiwei LIU,Jia LI. Desmoplastic fibroma of mandible: A case report and literature review[J]. Journal of Jilin University(Medicine Edition), 2025, (): 1-6.

图/表 4

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