口腔疾病防治 ›› 2021, Vol. 29 ›› Issue (2): 106-109.DOI: 10.12016/j.issn.2096-1456.2021.02.006

• 防治实践 • 上一篇    下一篇

颌面结缔组织增生性毛发上皮瘤2例报告及文献复习

吴俊伟1(),郑俊发2(),严鑫1,丁旭宣1   

  1. 1.佛山市中医院口腔医疗中心,广东 佛山(528000)
    2.南方医科大学口腔医院口腔颌面外科,广东 广州(510280)
  • 收稿日期:2020-07-19 修回日期:2020-10-20 出版日期:2021-02-20 发布日期:2020-12-21
  • 通讯作者: 郑俊发
  • 作者简介:吴俊伟,主任医师,本科,Email: fswjw@hotmail.com

Maxillofacial connective tissue hyperplastic trichoepithelioma: report of two cases and a literature review

WU Junwei1(),ZHENG Junfa2(),YAN Xin1,DING XuXuan1   

  1. 1. Foshan Traditional Chinese Medicine Hospital Oral Medicine Center, Foshan 528000, China
    2. Department of Oral and Maxillofacial Surgery, Stomatology Hospital, Southern Medical Univerisity, Guangzhou 510280, China
  • Received:2020-07-19 Revised:2020-10-20 Online:2021-02-20 Published:2020-12-21
  • Contact: Junfa ZHENG

摘要:

目的 探讨结缔组织增生性毛发上皮瘤的诊断和临床治疗方法。方法 对2例颌面部结缔组织增生性毛发上皮瘤临床资料进行总结并结合文献分析。结果 2例结缔组织增生性毛发上皮瘤患者均为男性,年龄分别为21岁和30岁,临床表现分别为颌面部无痛性浅褐色及浅白色斑块,病变区质韧、界清,中间凹陷无溃疡,病程10~16个月,就医前1~3个月肿物有明显增大病史。手术行沿瘤体外周3 mm切开皮肤、完整切除肿物,邻近皮瓣修复局部组织缺损手术;术后病理报告镜下见病变肿瘤细胞位于真皮层,呈条索状、小梁状或巢状,可见微小囊腔,上皮巢周围可见纤维结缔组织增生,瘤细胞无异型性,核分裂不明显。免疫组化报告bcl-2(-)、CK7(-)、CK19(-)、CD34(+)、P63(+)、CK56(+)、Ki67(±),病理诊断为结缔组织增生性毛发上皮瘤。患者术后随诊24个月,期内未见肿物复发、手术疤痕不明显、颌面无畸形或功能障碍。结论 病理和免疫组化检查是确诊结缔组织增生性毛发上皮瘤的依据,手术切除肿物是有效的治疗方法。

关键词: 毛发上皮瘤, 增生性, 结缔组织, 颌面, 临床病理, 免疫组化, 治疗分析

Abstract:

Objective To investigate the diagnosis and clinical treatment of maxillofacial connective tissue hyperplastic trichoepithelioma. Methods The clinical data of two cases of maxillofacial connective tissue hyperplastic trichoepithelioma were summarized and analyzed along with the literature. Results Two cases of maxillofacial connective tissue hyperplastic trichoepithelioma were male, aged 21 and 30 years. The clinical manifestations were painless pale brown and pale white plaques in the maxillofacial region. The lesion was tough and clear, with no ulcers in the middle depression. The course was 10-16 months, with 1-3 months before medical treatment, and the tumor had a significant history of enlargement. After surgery, the skin was cut 3 mm along the outer circumference of the tumor, and local tissue defects were repaired by the adjacent flap. The pathological report showed that the tumor cells were located in the dermis, and were striped, trabecular or nested. The tiny sac contained fibrous connective tissue proliferation. The tumor cells were amorphous without obvious nuclear division. Immunohistochemical analysis reported bcl-2(-), CK7(-), CK19(-), CD34(+), P63(+), CK56(+), and Ki67(±). The pathological diagnosis was connective tissue proliferative hair epithelial tumor. The patient was followed up for 24 months. There was no recurrence of the tumor, no obvious scarring, and no deformity or dysfunction of the maxillofacial region. Conclusion Pathological and immunohistochemical examination is the basis for the differential diagnosis of maxillofacial connective tissue hyperplastic trichoepithelioma, and surgical removal of tumors is an effective treatment.

Key words: hair epithelioma, proliferative, connective tissue, maxillofacial, clinicopathology, immunohistochemistry, therapeutic analysis

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