摘要
目的探讨单囊型成釉细胞瘤(unicystic ameloblastoma, UAM)的临床特点、诊治措施及误诊原因,并总结防范误诊措施。方法对术前误诊的8例UAM临床资料进行回顾性分析。结果 8例临床均表现为颌骨区膨大肿胀不适,4例术前诊断为牙源性角化囊性瘤,2例术前诊断为未特指的颌骨囊肿,术前诊断为颌骨囊性病变及钢丝异物炎各1例,均经手术病理检查诊断为UAM,其中2例复发,2例失访,余4例随访6个月~7年未复发。结论 UAM常不具有经典型成釉细胞瘤的影像学改变,普通X线及CT平扫影像易与其他颌骨囊肿尤其是牙源性角化囊性瘤混淆;临床医师对此类疾病认识不够,未完善术前相关检查及对术前增强CT、MRI检查不够重视,是导致误诊的主要原因。
Objective To explore the clinical characteristics, diagnosis and treatment methods, and causes of misdiagnosis of unicystic ameloblastoma(UAM) and to summarize the prevention of misdiagnosis. Methods Clinical data of 8 cases of UAM misdiagnosed before surgery was analyzed retrospectively. Results All lesions in 8 cases were clinically manifested as discomfort and swelling of the jaw region. Preoperative diagnosis of 4 cases was keratocystic odontogenic tumor, 2 cases were unspecified jaw bone cyst, 1 case was cystic lesion of jaw and 1 case was foreign body inflammation. All patients were diagnosed with UAM after postoperative pathology. There were 2 cases of recurrence and 2 cases were lost to follow-up. The remaining 4 cases were followed up for 6 months to 7 years without recurrence. Conclusion UAM generally does not have the imaging changes of classical ameloblastoma. Ordinary x-ray and CT plain scan images are easily confused with other jaw cysts, especially keratocystic odontogenic tumor. Insufficient knowledge of clinicians on UAM, incomplete preoperative examination and insufficient attention to enhancement CT and MRI are the main causes of misdiagnosis of UAM.
作者
黄大伟
曹锐
HUANG Da-wei;CAO Rui(Department of Stomatology,Changshu the Second People's Hospital,the Fifth Affiliated Clinical Medical College of Yangzhou University,Changshu,Jiangsu 215500,China)
出处
《临床误诊误治》
2020年第7期15-18,共4页
Clinical Misdiagnosis & Mistherapy
关键词
成釉细胞瘤
误诊
牙源性角化囊性瘤
颌骨囊肿
异物炎
病理检查
Ameloblastoma
Misdiagnosis
Keratocystic odontogenic tumor
Jaw cyst
Foreign body inflammation
Pathological examination
