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上颌窦近端型上皮样肉瘤1例

2018-01-20 佚名 中国口腔颌面外科杂志

上颌窦上皮样肉瘤
关注

女，16岁

【一般资料】

女，16岁

【主诉】

因“左颊部进行性肿胀2周”来院就诊。

【现病史】

自述2周前左颊部触及一肿物，进行性肿胀、麻木伴疼痛，触摸该区域时疼痛加重。自述无明显口、鼻腔内渗出物，无外伤史，服用抗生素和止痛药后无明显效果，其他重要生命体征在正常范围内。

【体格检查】

左侧面中部硬性肿物，位于上颌骨体，大小约3.0cm×2.5cm。表面皮肤外观正常，伸展性良好，未受累及。眼球运动无受限，视敏度及开口度均正常，睑裂宽度同健侧（图1）。口内检查：左侧颊部口腔前庭沟可触及一肿物，无波动，境界从第一前磨牙到第二磨牙，与第二前磨牙至第二磨牙区相对应的腭侧牙龈轻度肿胀，第二磨牙松动度Ⅱ度。



【初步诊断】

根据患者年龄、病史和体格检查，初步诊断为上颌窦内的恶性肿瘤，可能为骨肉瘤或鳞癌。随后进行一系列检查，包括曲面体层扫描、上颌骨增强CT和活检辅助诊断等（图2）。通过显微镜下观察H-E染色组织标本，初步病理诊断为“软组织肉瘤或低分化鳞癌”。最终通过特殊的免疫组织化学染色，确诊为近端型上皮样肉瘤（图3）。







【治疗】

。IHC结果显示AE1/AE3和CD34强阳性，INI1及CD31阴性。双颈超声及颌面CT并未发现颈部淋巴结转移征象，在与患者及其家属交谈后，对患者进行左侧上颌骨次全切除术。术后患者恢复良好，应用腭护板进行局部封闭，以促进创口愈合及恢复语音、吞咽功能。术后未行辅助放疗，密切随诊。术后随访1a，未出现复发及转移迹象（图4），目前仍在随访中。

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    2018-01-22 木头人516

    #上皮样肉瘤#

    0

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    2018-01-22 AspirantSuo

    #上颌窦#

    0

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    2018-01-22 hittouch

    #近端#

    0

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    2018-01-22 qblt

    #上皮样#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1490825, encodeId=aef614908252a, content=<a href='/topic/show?id=9f352002552' target=_blank style='color:#2F92EE;'>#上皮样肉瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20025, encryptionId=9f352002552, topicName=上皮样肉瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74318828915, createdName=木头人516, createdTime=Mon Jan 22 08:11:00 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1575270, encodeId=f35015e527055, content=<a href='/topic/show?id=0d3a20096d0' target=_blank style='color:#2F92EE;'>#上颌窦#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20096, encryptionId=0d3a20096d0, topicName=上颌窦)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cb4316082286, createdName=AspirantSuo, createdTime=Mon Jan 22 08:11:00 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1579498, encodeId=776c15e949828, content=<a href='/topic/show?id=3afd942e905' target=_blank style='color:#2F92EE;'>#近端#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94279, encryptionId=3afd942e905, topicName=近端)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=da2116536440, createdName=hittouch, createdTime=Mon Jan 22 08:11:00 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603251, encodeId=a98d1603251fd, content=<a href='/topic/show?id=c9ee2002218' target=_blank style='color:#2F92EE;'>#上皮样#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20022, encryptionId=c9ee2002218, topicName=上皮样)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0c9e19008088, createdName=qblt, createdTime=Mon Jan 22 08:11:00 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1631132, encodeId=399d16311327e, content=<a href='/topic/show?id=271b20090b0' target=_blank style='color:#2F92EE;'>#上颌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20090, encryptionId=271b20090b0, topicName=上颌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c07f21689347, createdName=hanhaisha2015, createdTime=Mon Jan 22 08:11:00 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280680, encodeId=8cd8280680a5, content=CG股海护航回家结婚, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b0171930782, createdName=为你把脉, createdTime=Sun Jan 21 12:38:58 CST 2018, time=2018-01-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280426, encodeId=37f228042627, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Sat Jan 20 18:46:05 CST 2018, time=2018-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280413, encodeId=1090280413fc, content=v滚滚滚红红火火, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b0171930782, createdName=为你把脉, createdTime=Sat Jan 20 17:25:40 CST 2018, time=2018-01-20, status=1, ipAttribution=)]
    2018-01-22 hanhaisha2015

    #上颌#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1490825, encodeId=aef614908252a, content=<a href='/topic/show?id=9f352002552' target=_blank style='color:#2F92EE;'>#上皮样肉瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20025, encryptionId=9f352002552, topicName=上皮样肉瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74318828915, createdName=木头人516, createdTime=Mon Jan 22 08:11:00 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1575270, encodeId=f35015e527055, content=<a href='/topic/show?id=0d3a20096d0' target=_blank style='color:#2F92EE;'>#上颌窦#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20096, encryptionId=0d3a20096d0, topicName=上颌窦)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cb4316082286, createdName=AspirantSuo, createdTime=Mon Jan 22 08:11:00 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1579498, encodeId=776c15e949828, content=<a href='/topic/show?id=3afd942e905' target=_blank style='color:#2F92EE;'>#近端#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94279, encryptionId=3afd942e905, topicName=近端)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=da2116536440, createdName=hittouch, createdTime=Mon Jan 22 08:11:00 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603251, encodeId=a98d1603251fd, content=<a href='/topic/show?id=c9ee2002218' target=_blank style='color:#2F92EE;'>#上皮样#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20022, encryptionId=c9ee2002218, topicName=上皮样)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0c9e19008088, createdName=qblt, createdTime=Mon Jan 22 08:11:00 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1631132, encodeId=399d16311327e, content=<a href='/topic/show?id=271b20090b0' target=_blank style='color:#2F92EE;'>#上颌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20090, encryptionId=271b20090b0, topicName=上颌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c07f21689347, createdName=hanhaisha2015, createdTime=Mon Jan 22 08:11:00 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280680, encodeId=8cd8280680a5, content=CG股海护航回家结婚, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b0171930782, createdName=为你把脉, createdTime=Sun Jan 21 12:38:58 CST 2018, time=2018-01-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280426, encodeId=37f228042627, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Sat Jan 20 18:46:05 CST 2018, time=2018-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280413, encodeId=1090280413fc, content=v滚滚滚红红火火, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b0171930782, createdName=为你把脉, createdTime=Sat Jan 20 17:25:40 CST 2018, time=2018-01-20, status=1, ipAttribution=)]
    2018-01-21 为你把脉

    CG股海护航回家结婚

    0

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    2018-01-20 三生有幸9135

    学习一下谢谢分享

    0

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    2018-01-20 为你把脉

    v滚滚滚红红火火

    0