复发性颌骨成釉细胞瘤伴双肺转移1例及文献复习

Recurrent ameloblastoma accompanied metastasis to the lung:A case report and literatures review

目的:探讨颌面部复发性成釉细胞瘤伴肺转移临床、影像、病理分类综合诊断机制。方法:回顾我院收治的1例复发性成釉细胞瘤伴肺转移病例,对其多学科诊断及治疗预后进行综合分析。结果:该例患者成釉细胞瘤多次治疗,颌面部骨组织及软组织多处反复复发,影像学提示颅底侵犯并出现肺部多发转移,组织病理显示细胞生长活跃,免疫组化显示:PCNA(+),nm23(-)。结论:多次复发的成釉细胞瘤细胞生长活跃,易浸润周围组织,可侵犯颌面部多处组织,甚至发生远处转移,其复发及转移与PCNA高表达和nm23低表达可能有一定相关性。

Objective： To study the clinic features,radiology,pathology,and diagnosis of recurrent ameloblastoma accompanied metastasis to the lung.Methods： A case of recurrent ameloblastoma accompanied metastasis to the lung was retrospected,the comprehensive diagnosis,treatment and prognosis were analyzed.Results： The patient suffered from recurrent ameloblastoma for several times,extensive maxillofacial bone and soft tissues were involved.The radiology showed involvement of fundus cranii and metastasis to the lung.The pathology showed rapid growth of ameloblasts.The immunohistology results demonstrateded PCNA（＋）and nm23（-）.Conclusion： The pathology of recurrent amelobalstoma shows rapid growth of ameloblasts and infiltration of peripheral tissues,extensive maxillofacial regions are involved and even metastasis could be found,the high expression of PCNA and low expression of nm23 may relate to recurrence and metastasis.