Maxillofacial left a huge one case of osteosarcoma.docVIP

 PAGE \* MERGEFORMAT 4 Maxillofacial left a huge one case of osteosarcoma [Keywords:] Maxillofacial bone, osteosarcoma, CT, DSA Case Information Patients, female, 37 years old, because of “progressive left facial bone tumor in May, adding a half months,” admitted .10 years ago because of “NPC” line history of radical radiotherapy 2. Physical examination: vital signs were acceptable. Malnourished, passive position, the body of superficial lymph node enlargement. Skull deformities, one can see the size of the left maxillofacial about 10cm × 12cm mass, red, nose deformity, pressure left side, proptosis, eyelid closed, open problems, language impairment (Figure 1. Laboratory tests: alkaline phosphatase (ALP: 336U / L, three conventional normal. CT examination: the loss of the left facial bone morphology, bone destruction was bone, the left nasal cavity, external nose, the left parapharyngeal space, the left middle cranial fossa also involved the left eye was prominent, the left cheek was swollen and a large number of tumor bone formation, uneven density, state of the obscure (Figure 2). occlusion of the left nostril, nasal cavity narrower. Because the tumor density is high, the real situation observed enhancement is unclear (Figure 3). Diagnosis: Left maxillofacial osteosarcoma tumor. Bilateral maxillary and facial artery angiography (DSA: bilateral maxillary A, side A are thicker, the pressure shift was more than one branch, course rigor, branches were seen slightly dense peripheral tumor vessels, parenchymal phase, the left See irregular side maxillofacial tumor stain, darker staining, and see more of the tumor bone formation (Figure 4. Biopsy (left maxillary lesion: see a large number of grid-like bone matrix and bone-like formation, mesh extrusion of bone edge of the spindle cells was some deep staining of nuclear, nuclear / cytoplasm ratio was significantly increased (Figure 5. Diagnosis: osteosarcoma. Discussion Osteosarcoma is t