牙龈低度恶性肌纤维母细胞肉瘤伴颌骨破坏1例报告并文献复习

Low-grade myofibroblastic sarcoma with jaw destruction of gingiva:A case report and literature review

目的:探讨低度恶性肌纤维母细胞肉瘤(low-grade myofibroblastic sarcoma,LGMS)的临床和病理特征、鉴别诊断、治疗与预后,并通过报道发生在儿童下颌牙龈的1例LGMS,以提高临床医师对此疾病的认识。方法:对1例发生在右下颌牙龈伴颌骨破坏的LGMS儿童患者进行临床资料、治疗、病理分析,并对国内外相关LGMS进行分析和总结。结果:患者因右下颌牙龈一无痛性包块入院手术治疗,病理提示为牙龈瘤,术后2周复发,行二次扩大手术,术后病理提示为LGMS。结论:LGMS是一种罕见的来源于间叶组织的肿瘤,好发于口腔,无明显的临床特异性表现,需要通过组织病理检查进行确诊,同时应与炎性肌纤维母细胞瘤、平滑肌肉瘤等疾病相鉴别,临床上通常采用手术扩大切除,并应该长期随访观察。

Objective:To discuss the clinical and pathological features,differential diagnosis,treatment and prognosis of low-grade myofibroblastic sarcoma(LGMS),and report a case of LGMS that occurs in children's mandibular gingiva to raise awareness of this disease among clinicians.Methods:Analyze the clinical data,treatment,and pathological result of a child with LGMS in the right mandibular gingiva with jaw destruction,and the relevant LGMS at home and abroad were analyzed and summarized.Results:Due to a painless mass in the right mandibular gingiva,the patient came to hospital for surgical treatment,and the pathological result was gingival tumor.Recurrence occurred two weeks after surgery,so we did the second enlargement surgery,and the pathological result was LGMS.Conclusion:LGMS is a rare tumor derived from mesenchymal tissue,which tends to occur in the oral cavity and has no obvious clinically specific symptoms.It requires histopathological examination to confirm the diagnosis,and it should be distinguished from diseases such as inflammatory myofibroblastic tumor and leiomyosarcoma.Surgical enlargement is usually used clinically and the patient should be followed up for a long time.