颌骨转移性腺癌临床及CT影像学特征分析

doi:10.13701/j.cnki.kqyxyj.2022.02.016

口腔医学研究 ›› 2022, Vol. 38 ›› Issue (2): 176-180.DOI: 10.13701/j.cnki.kqyxyj.2022.02.016

颌骨转移性腺癌临床及CT影像学特征分析

单姗¹, 杨振宇¹, 王铁梅^1*, 林梓桐¹, 冯英连¹, 帕克扎提·色依提¹, 黄晓峰², 张磊², 孙国文³

1.南京大学医学院附属口腔医院,南京市口腔医院口腔颌面医学影像科江苏南京 210008;
2.南京大学医学院附属口腔医院,南京市口腔医院口腔病理科江苏南京 210008;
3.南京大学医学院附属口腔医院,南京市口腔医院口腔颌面外科江苏南京 210008

收稿日期:2021-08-18 出版日期:2022-02-28 发布日期:2022-02-23
通讯作者: *王铁梅,E-mail:tiemei106@263.net
作者简介:单姗(1995~ ),女,江苏人,硕士在读,主要从事口腔颌面影像的研究工作。
基金资助:
江苏省自然科学基金面上项目(编号:BK20150089);南京市科技发展计划人口卫生健康基金(编号:201503038);南京市科技发展计划医疗卫生与国际合作基金(编号:201405049)

Analysis of Clinical and CT Imaging Features of Metastatic Adenocarcinoma of the Jaw

SHAN Shan¹, YANG Zhenyu¹, WANG Tiemei^1*, LIN Zitong¹, FENG Yinglian¹, Pakezhatia·SEYITI¹, HUANG Xiaofeng², ZHANG Lei², SUN Guowen³

1. Department of Oral and Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China;
2. Department of Oral Pathology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China;
3. Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China

Received:2021-08-18 Online:2022-02-28 Published:2022-02-23

摘要/Abstract

摘要： 目的: 探讨以口腔颌面部症状为首发的颌骨转移性腺癌(metastatic adenocarcinoma of the jaw,MAJ)临床及CT影像学特征。方法: 收集2006~2020年符合纳入标准的MAJ患者,回顾性分析其临床及CT影像学特点。结果: 14例分别源于肺(6例)、肝(4例)、肾(2例)、前列腺和贲门(各1例)。骨质改变分为5型:溶骨型占5/14,边缘呈浸润型改变;混合型占4/14,边缘大多呈虫蚀状改变;成骨型占1/14,边缘呈硬化型改变;类囊型及牙槽骨吸收型分别占3/14、1/14,边缘均呈地图型改变。结论: MAJ多见于中老年男性的下颌骨后部。首次将其在传统分类基础上,新增类囊型及牙槽骨吸收型。MAJ以进展迅速的溶骨型骨质破坏伴骨膜反应及局限性软组织肿块,且颌骨无明显膨隆及颏部麻木综合征为特征,为临床诊断提供重要依据。

关键词: 转移癌, 腺癌, 颌骨, CT影像学, 临床特征

Abstract: Objective: To explore the features of metastatic adenocarcinoma of the jaw (MAJ) with oral and maxillofacial lesions as the first symptom. Methods: Fourteen cases of MAJ from 2006 to 2020 were collected. The clinical and CT features were analyzed retrospectively. Results: The primary sites were lung (n=6), liver (n=4), kidney (n=2), prostate (n=1), and cardia (n=1). CT manifestations were classified as 5/14 osteolytic type with permeative destruction margin, 4/14 mixed type mostly with moth-eaten destruction margin, 3/14 cystic type and 1/14 alveolar bone resorption type with geographic destruction margin, and 1/14 osteoblastic type with sclerotic destruction margin. Conclusion: MAJ usually occurs in the middle-aged and elderly men, especially in the posterior part of mandible. It is the first time to add the cystic type and alveolar bone resorption type on the basis of classical classification. MAJ is characterized by rapidly progressive osteolytic bone destruction with periosteal reaction and localized soft tissue mass without jaw expansion, which plays an important role in differential diagnosis.

Key words: metastasis, adenocarcinoma, jaws, CT characteristics, clinical features

单姗, 杨振宇, 王铁梅, 林梓桐, 冯英连, 帕克扎提·色依提, 黄晓峰, 张磊, 孙国文. 颌骨转移性腺癌临床及CT影像学特征分析[J]. 口腔医学研究, 2022, 38(2): 176-180.

SHAN Shan, YANG Zhenyu, WANG Tiemei, LIN Zitong, FENG Yinglian, Pakezhatia·SEYITI, HUANG Xiaofeng, ZHANG Lei, SUN Guowen. Analysis of Clinical and CT Imaging Features of Metastatic Adenocarcinoma of the Jaw[J]. Journal of Oral Science Research, 2022, 38(2): 176-180.

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颌骨转移性腺癌临床及CT影像学特征分析

Analysis of Clinical and CT Imaging Features of Metastatic Adenocarcinoma of the Jaw

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