牙源性粘液瘤的临床、X线及病理分析

A clinico pathological study of odontogenic myxoma

目的 总结牙源性粘液瘤的临床、 Ｘ 线及病理基本特征。方法 取患者６４ 例，男女各３２ 例，平均年龄２００ 岁；病变位于颌骨３０ 例，下颌骨３４ 例，进行临床、 Ｘ 线及病理分析。结果 临床表现以前磨牙区和磨牙区常见，多以颌骨局部缓慢膨胀就诊。 Ｘ 线检查见病变呈单房或多房透光影，以牙发生区为中心。镜下以淡兰色、疏松细丝网状粘液样基质及散在其间的星芒状细胞构成，含多少不等的纤维成分，可分为纤维粘液瘤型（４７ 例） 和粘液纤维瘤型（１７ 例） 两型。结论 通过讨论该病的组织来源、诊断与鉴别诊断，生物学行为及多发原因，认识到该病多发主要因手术方式选择不当所致。

Objective To study the clinical, radiological and histopathological characteristics of odontogenic myxoma (OM).Methods Sixty-four cases were studied, including 32 male and 32 female cases with their mean age 20 years old. The myxoma in 30 cases was located in the maxilla and in 34 in the mandible. Results The premolar and molar regions were the common sites of the tumor. A slowly growing mass of the jaws was the most frequent chief complaint. Radiographs showed unilocular or multilocular radiolucency, which mainly developed around the tooth roots. Under the microscope, the tumor was composed of a pale basophilic mucoid stroma with a loose arrangement of spindle, cuneiform, or stellate-shaped cells and long slender anastomosing cytoplasmic processes. According to the amount of collagen, the tumor was subdivided into fibromyxoma in 47 cases and myxofibroma in 17 cases. Ten cases recurred due to improper treatment, and among them, 9 were fibromyxomas, and 1 myxofibroma. Conclusion Based on the discussion of the histogenesis, diagnosis, differential diagnosis, biobehavior and the reason of recurrence of the tumor, it is considered that the recurrence is mainly related to the improper selection of surgical procedure.