目的通过对颌面部孤立性纤维瘤这一罕见疾病的临床病例回顾性分析,探讨颌面部孤立性纤维瘤的诊断要点与治疗原则。方法 2009至2014年间,对收入上海交通大学医学院附属第九人民医院口腔病理数据库的颌面部孤立性纤维瘤进行统计,收集临床资料,影像学资料及诊疗方法进行分析。结果共有13例患者入选研究,临床特征无特异性,CT表现为强化明显的肿物,术后病理均为颌面部孤立性纤维瘤,免疫组化CD34、Vim均为(+),Des均(-)。术后创口均一期愈合,未见明显并发症。随访3~60月,发现2例恶性孤立性纤维瘤患者出现复发情况,再次行手术治疗后,随访未见复发情况。结论颌面部SFT是一种罕见的疾病,最终确诊需依靠病理学及免疫组化检查。首选手术治疗,术后密切随访,预后较好。
Objective To explore the diagnostic methods and therapeutic principles of maxillofacial solitary fibrous tumors(SFT)through a retrospective analysis of clinical cases. Methods From 2009 to 2014,patients with maxillofacial SFT were counted in Shanghai No. 9 Hospital oral- pathology database. The clinical data,imaging data and diagnostic methods were analyzed. Results 13 patients were selected in this study,whose post- operative pathology diagnoses were SFT with no typical clinical specificities,and their tumors were significantly enhancing masses according to the CT data. The immunohistochemistry of neoplasm cells were all positive for CD34 and Vim,and negative for Des. The wound healings were fine without any complications in 13 patients. During the post- operative follow- up period of 3 to 60 months,recurrences were found in 2 patients whose first pathological results were malignant SFT. After a reoperation,recurrences didn't happen again in these 2 patients. Conclusions SFT was a rare disease in the maxillofacial region,and only the immunohistochemistry of the whole specimen would confirm the diagnosis. Complete radical resection was the first choice,long- term close follow- up was mandatory to control the recurrences,and the patient's prognosis was usually satisfactory.