頭頚部領域における所謂Fibro-osseous lesionの臨床的、病理組織的研究

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Fibro-osseus lesions of the facial skeleton are a controversial disease and have been reported under many different names. In this paper, 24 cases of such disease which were furgically treated in Kobe University Hospital and Kobe Central Municipal Hospital are studied clinico-pathologically. We classified the histopathological pictures obtained from each patient into 3 types : matured type, immatured type and intermediate type. These classifications were based on the findings of fibrous components and on maturity of newly formed osseous elements. According to typical histological appearance, we can designate "fibrous osteoma" as a matured type, "ossifying fibroma" as an immatured type, and "fibrous dysplasia" as an intermediate type. There is no correlation between the histological maturity of the lesions and surgical and clinical findings such as X-ray. The operative procedure has no relation to the prognosis. Through preoperative examinations, we can not estimate the maturity of the lesions and make a precise pathological diagnosis. There is a tendency for the immatured type to occur in young patients. But, the lesions of all the adult in our study except one were of the intermediate or matured type. The matured type seldom recurred even if the operation was not radical. Recurrence was found in 5 out of 13 patients who were followed up for more than 3 years. Four out of the five patients with recurrence were under 10 years old. All of the patients with lesions of immatured and intermediate type in histology had recurrence. The one exceptional adult case whose biopsy specimen showed an immatured type, which was compatible with ossifying fibroma, later developed a clinically malignant tumor that was diagnosed histologically as an aggressive osteoblastoma. In conclusion, we consider that a good biopsy is the most important indication for the decision of treatment. When the biopsy shows an immatured type, total removal of the lesion should be undertaken as much as possible. And, when the biopsy shows a matured type, curetment of the involved bones should be sufficient therapy.
神戸大学の論文

頭頚部領域における所謂Fibro-osseous lesionの臨床的、病理組織的研究

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