婴儿黑色素神经外胚层肿瘤是一种罕见的良性肿瘤，主要影响颅面部区域，通常通过切除来治疗，几乎不需要重建。然而，在特殊情况下，更大或更复杂的肿瘤可能需要开放颅面入路，详细说明这些情况的手术策略的文献有限。作者报告了一名儿科患者的婴儿期黑色素神经外胚层肿瘤侵袭性扩张的独特病例，描述了他们切除肿瘤的方法。一名 10 周大的男性因左上上部肿胀 2 周而到医院就诊。他的母亲和儿科医生注意到了牙龈线。术前活检发现柔软、充满液体的病变，促使手术计划完全切除。耳鼻喉科使用鼻窥器进行术中评估，整形外科使用压电锯有助于精确切除肿瘤。手术技术需要细致的解剖，确保边缘清晰，同时保留周围结构。肿瘤，包括牙槽和上颌前部，被完全切除，边缘阴性。压电锯的使用促进了安全的骨切割，保留重要结构，同时确保全面切除肿瘤。患者对手术的耐受性良好，术后没有立即出现并发症。完全切除对于最大限度地降低 MNTI 复发风险至关重要。压电手术的使用提高了肿瘤切除的精确度和安全性，保持了解剖结构的完整性并优化了患者的治疗效果。该病例强调了精细手术技术在颅面部肿瘤治疗中的重要性，提倡采用先进的手术工具来改善临床结果。版权所有 © 2024，作者：Mutaz B. Habal，医学博士。

Melanotic neuroectodermal tumors of infancy are rare, benign neoplasms predominantly affecting the craniofacial region, and they are typically managed through resection with minimal need for reconstruction. However, in exceptional cases, larger or more complex tumors may necessitate open craniofacial approaches, with limited literature detailing the surgical strategies for these scenarios. The authors report a distinctive case of an aggressively expanding melanotic neuroectodermal tumor of infancy in a pediatric patient, describing their approach for the tumor's resection.A 10-week-old male presented to the hospital with a reported 2 weeks of swelling of the left upper gum line noted by his mother and pediatrician. Preoperative biopsy revealed a soft, fluid-filled lesion, prompting surgical planning for complete excision. Intraoperative assessment with a nasal speculum by ENT, and utilization of a piezoelectric saw by plastic surgery facilitated precise tumor resection. The surgical technique required meticulous dissection, ensuring clear margins while preserving surrounding structures.The tumor, encompassing the alveolus and anterior maxilla, was completely excised with negative margins. Utilization of the piezoelectric saw facilitated safe bone cutting, preserving vital structures while ensuring comprehensive tumor removal. The patient tolerated the procedure well, with no immediate postoperative complications.Complete resection is essential in minimizing the risk of recurrence in MNTI. The utilization of piezoelectric surgery enhances precision and safety in tumor resection, preserving anatomic integrity and optimizing patient outcomes. This case underscores the importance of meticulous surgical techniques in managing craniofacial tumors, advocating for the adoption of advanced surgical tools to improve clinical outcomes.Copyright © 2024 by Mutaz B. Habal, MD.