颌骨动脉瘤样骨囊肿的临床分析

Clinical analysis of aneurysmal bone cyst in jaw bone

目的探讨颌骨动脉瘤样骨囊肿的临床表现、治疗方法及预后特点。方法收集8例颌骨动脉瘤样骨囊肿患者的临床资料,包括性别、年龄、病程、症状、影像学检查、治疗及预后等,并对患者的临床资料进行回顾性分析。结果 8例患者中,女性5例,男性3例,年龄5~48岁;发生于上颌骨3例,下颌骨5例,均为原发性病变;颌骨CT扫描显示为多囊性膨胀性占位病变,内见分隔、残留骨嵴及液-液平面形成,增强后病灶周围可显示迂曲扩张的小血管影。所有患者均经病理检查明确诊断,光镜下观察,可见囊壁由梭形纤维细胞、组织细胞、破骨样多核巨细胞及慢性炎症细胞构成,呈飘带样结构,囊腔由含骨及类骨碎片的纤维组织分隔,见有出血及含铁血黄素沉积。8例患者均以病灶根治性切除为主要治疗手段。经1~6年的随访,均无复发。结论颌骨动脉瘤样骨囊肿的影像学表现具有其自身特点,确诊依靠病理诊断,治疗以病灶根治性切除为主。多数病例在病灶彻底切除后能够获得较好的预后。

Objective To investigate aneurysmal bone cyst（ABC） in oral and maxillofacial of clinical appearance,clinical treatment and prognosis. Methods From July 2003 to December 2015, 8 patients with aneurysmal bone cyst in jaw bone was treated and recorded with the general condition, clinical symptoms, imaging examinations, surgical treatment and prognosis. Results Among the 8 patients, there were 5 females and 3 males with the age from 5 to 48 years old. 5 cases happened in mandibular bone and 3 cases originated from the maxillary bone. All the patients were primary lesions and diagnosed by pathology. CT scan showed multilocular cystic expansive space occupying lesions, septa, residual bone crest and liquid-liquid form; enhanced imaging showed the tortuous and dilated small blood vessels.Cystic wall composed of spindle shaped fiber cells, tissues and cells, broken bone like multinucleated giant cells and chronic inflammatory cells form and a ribbon like structure, cysts separated by fibrous tissue containing bone and bone fragments, hemorrhage and hemosiderin deposition was observed which was confirmed under the light microscope. The main treatment of aneurysmal bone cyst was radical operation. After 1~6 years of follow-up, no patient was found recurrence. Conclusion The imaging findings of aneurysmal bone cyst in jaw bone was distintive, with diagnosis of the disease depended on pathology; the main treatment was radical operation with good prognosis.