171例颌面部骨软骨瘤及恶变病例临床病理分析

Clincopathological analysis of 171 patients with osteochondroma and malignant transformation in maxillofacial bone

目的:探讨颌面部骨软骨瘤(osteochondroma)的临床及病理特征,总结罕见的骨软骨瘤恶变患者的临床病理特点,为临床诊治提供指导。方法:回顾性收集2018年1月—2023年8月上海交通大学医学院附属第九人民医院手术治疗的171例骨软骨瘤患者,总结分析临床、影像及病理学特点。结果:171例骨软骨瘤患者中,66%(113/171)为女性,34%(58/171)为男性,发病年龄11~76岁,平均44岁。95.3%(163/171)发生于髁突,4%(7/171)发生于冠突,0.5%(1/171)发生于颧弓。98%(159/161)的髁突骨软骨帽厚度小于1 cm。171例骨软骨瘤中,2例(2/171,1.1%)发生恶变,1例恶变为软骨肉瘤(Ⅰ级),1例恶变为高分化骨肉瘤。结论:颌面部骨软骨瘤多发生于女性,以髁突最常见,恶变率为1.1%,与全身其他部位骨软骨恶变率相当。影像学表现对骨软骨瘤恶变的诊断具有重要意义。

PURPOSE:To investigate the clinical and pathological features of osteochondroma in maxillofacial region,and to summarize the clinicopathological features of rare osteochondroma malignant transformation in order to provide clinical guidance.METHODS:From January 2018 to September 2023,a total of 171 patients with osteochondroma were retrospectively collected in Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine.Their preoperative CT and clinicopathological features were analyzed.RESULTS:Of the 171 patients with osteochondroma in maxillofacial bone,66%(113/171)were females and 34%were male.Their age ranged from 11-76 with an average age was 44 years old.Of the 171 cases,95.3%(163/171)in mandible condyle,4%(7/171)in mandible processus coronoideus,and 0.5%(1/171)in zygomatic arch.The imaging findings showed that the thickness of cartilaginous cap was less than 1 cm in 98%(159/161)cases with condyle lesions.Only 2 cases(2/171,1.1%)had malignant transformation.One was diagnosed with secondary chondrosarcoma,another developed low-grade osteosarcoma.CONCLUSIONS:Osteochondroma in maxillofacial region mostly occurs in females,and most commonly located in condylar process,with a malignant change rate of 1.1%,which is similar to that of other parts of the body.Imaging findings have important guiding significance for the diagnosis of osteochondroma malignant change.