Ossifying Fibromyxoid Tumor in the Mandibular Gingiva: Case Report and Review of the Literature
Ossifying Fibromyxoid Tumor in the Mandibular Gingiva: Case Report and Review of the Literature
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DOI：
10.1902/jop.2009.080535
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发表时间：
2009-04-01
影响因子：
4.3
通讯作者：
da Costa Miguel, Marcia Cristina
中科院分区：
文献类型：
--
作者：
Nonaka, Cassiano F. W.;Pacheco, Domingos F. S.;da Costa Miguel, Marcia Cristina
背景：骨化性纤维黏液样瘤是一种罕见的软组织肿瘤。只有一例发生在牙龈的病例被描述过。方法：一名21岁的女性，在6个月前发现了位于右下颌后龈的无痛外生性肿块。x线片显示病变内部不规则钙化，牙槽骨离散不规则，颊和舌皮质骨完整。根据临床诊断假设为外周骨化性纤维瘤或外周巨细胞肉芽肿，行切口活检。显微特征符合骨化性纤维瘤的诊断。整个肿块被切除并提交组织病理学和免疫组织化学分析。结果：组织病理学分析显示圆形到纺锤形细胞增生，排列成索状和巢状，并包埋在纤维黏液样基质中。假纤维包膜下可见骨小梁外壳不完整。免疫组化分析显示波形蛋白和S-100蛋白阳性，平滑肌肌动蛋白、肌肉特异性肌动蛋白和胶质纤维酸性蛋白阴性。最终诊断为OFT。患者在手术切除后7个月无临床复发迹象。结论：位于龈部的OFTs极为罕见。在这个部位，这些肿瘤在临床上与其他反应性或肿瘤性病变难以区分。虽然许多病例表现为惰性的生物学行为，但也有局部复发的报道；因此，长期随访是必须的。中华牙周病杂志（英文版）；2009;32(1):387 - 398。
Background: Ossifying fibromyxoid tumors (OFTs) are uncommon soft tissue neoplasms. Only one case arising in the gingiva has been described.Methods: A 21-year-old woman presented with a painless exophytic mass located in the right posterior mandibular gingiva, which was identified 6 months earlier. Radiographs showed irregular calcifications inside the lesion, discrete irregularity of alveolar bone, and integrity of buccal and lingual cortical bone. An incisional biopsy was performed based on the clinical diagnostic hypothesis of peripheral ossifying fibroma or peripheral giant cell granuloma. Microscopic features were compatible with the diagnosis of ossifying fibroma. The entire mass was excised and submitted to histopathologic and immunohistochemical analysis.Results: Histopathologic analysis revealed proliferation of round to spindle-shaped cells arranged in cords and nests and embedded in a fibromyxoid matrix. An incomplete shell of bone trabeculae located beneath the fibrous pseudocapsule was observed at the periphery. Immunohistochemical analysis showed positivity for vimentin and S-100 protein and negativity for smooth muscle actin, muscle-specific actin, and glial fibrillary acidic protein. The definitive diagnosis was OFT. The patient showed no clinical signs of recurrence 7 months after surgical excision.Conclusions: OFTs located in the gingiva are extremely rare. At this site, these tumors are clinically indistinguishable from other reactive or neoplastic lesions. Although many cases present an indolent biologic behavior, the local recurrence of OFTs has been reported; therefore, long-term follow-up is mandatory. J Periodontol 2009;80:687-692.