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題名 | Fibrous Dysplasia of Mandible with Chronic Osteomyelitis in a Child: Report of One Case=兒童下顎骨纖維化發育異常合併慢性骨髓炎:一病例報告 |
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作者 | 張家堯; 吳克恭; 刁翠美; 黃碧桃; | 書刊名 | 臺灣兒科醫學會雜誌 |
卷期 | 43:6 民91.11-12 |
頁次 | 頁354-357+376 |
分類號 | 417.626 |
關鍵詞 | 兒童; 纖維化發育異常; 下顎骨; 骨髓炎; Child; Fibrous dysplasia; Mandible bone; Osteomyelitis; |
語文 | 英文(English) |
中文摘要 | 骨頭纖維給發育異常是一種少見的良性疾病,是受侵犯之骨頭的骨髓被許多纖維組織所取代,造成骨頭之擴張變形或結構脆弱。本文報告一個纖維化發育異常合併慢性骨髓炎的6歲女孩,以右下顎腫塊合併間歇性反腫痛的症狀爲表現,起初症狀爲外傷後的局部腫痛,被當作骨髓炎,抗生素治療僅得暫時性改善,在影像學檢查上似有腫瘤,做了切片仍無法確定診斷,直到一年後病人轉來本院,做了第二次切片後骨頭纖維化發育異常合併慢性骨髓炎的診斷才確定。本安全骨頭纖維化發育異常診斷延遲的原因有三:一是骨髓炎與骨頭纖維化發育異常在臨床表現和影像學上的特征十分相似,常造成診斷上的困難和混淆;二是本安全在第一次切片時可能未取得病灶部位標本;對於兒童下顎骨不明原因的腫塊,除了須拔除掉惡性腫瘤的可能性外,骨頭纖維化發育異常也是要放在鑑別診斷的考慮之中。本文也回顧骨髓炎與骨頭纖維化發育異常兩者在放射影像和核磁共振影像檢查中的表現,這些特征有助於鑑別診斷。骨頭纖維化發育異常之病患有急性症狀時,必須留意是否合併骨髓炎以及可能的惡性變化。 |
英文摘要 | We report here a 6-year-old girl with fibrous dysplasia (FD) of the mandibular bone. She had a growing mass with local pain over right chin after a severe trauma, which was thought to be chronic osteomyelitis (OM). After failure of antibiotic treatment, malignant bone tumor was suspected from imaging studies including magnetic resonance imaging (MRI). FD of the mandible with chronic OM was confirmed one year after its onset by repeated biopsy performed at our hospital. Causes of delayed diagnosis may include (1) FD of the mandibular bone and chronic OM have similar characteristics clinically and radiographically, (2) the previous biopsy was not performed at appropriate site, and (3) failure to include fibrous dysplasia in the differential diagnosis. In this report, we also review the features in radiology and MRI of OM and FD, which may help differentiate the diagnosis. When a patient with mandibular FD has acute symptoms, the possibility of superimposed OM or malignant change should be considered. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。