Pelo Sandro, Gasparini Giulio, Boniello Roberto, Moro Alessandro, Amoroso Pier Francesco
Department of Oral and Maxillofacial Surgery, Catholic University of S, Cuore, A. Gemelli Rome, Via G. Moscati 31/33, 00168 Rome, Italy.
Head Face Med. 2009 Feb 16;5:8. doi: 10.1186/1746-160X-5-8.
A rare case of aneurysmal bone cyst (ABC) located in the mandibular condyle in a 10-year-old boy is presented. The patient came to our attention for a sudden swelling in the right temporomandibular region, the mouth opening was not reduced. A rapid growing mass, depicting soft tissue invasion, in the right condyle of the mandible was found. Clinically and radiographically it resembled to a malignant lesion. The surgical excision of the mandibular condyle allowed a complete removal of the lesion. The histological examination revealed a pseudocystic expanding osteolytic lesion containing blood-filled space separated by connective tissue and many osteoclastic giant cells, which was a conventional vascular ABC. The ABC is an infrequent bone lesion which can only be found very rarely at the craniofacial skeleton. There have been described about 160 cases of ABC originated in the molar region or in upper maxilla and even more rare is the location of this cyst in the mandibular condyle. Only 6 cases were reported in the literature to date. A complete surgical resection of this osteolytic lesion is the treatment of choice considering its high recurrence rate. The condyle was not replaced with any graft. Therefore a functional device was used after surgery to overcome the lack of the condyle and to stimulate the growth of the ramus.
本文报告了一例罕见的动脉瘤样骨囊肿(ABC),发生于一名10岁男孩的下颌骨髁突。该患者因右颞下颌区域突然肿胀前来就诊,开口度未受限。在右侧下颌骨髁突发现一个快速生长的肿物,显示有软组织侵犯。临床和影像学表现类似恶性病变。下颌骨髁突的手术切除使病变得以完全切除。组织学检查显示为一个假囊性膨胀性溶骨性病变,包含由结缔组织分隔的充满血液的腔隙以及许多破骨巨细胞,这是一个典型的血管性ABC。ABC是一种罕见的骨病变,在颅面骨骼中极为少见。已有约160例ABC起源于磨牙区或上颌骨的报道,而该囊肿位于下颌骨髁突更为罕见。迄今为止,文献中仅报道了6例。鉴于其高复发率,对这种溶骨性病变进行完整的手术切除是首选治疗方法。髁突未用任何移植物替代。因此,术后使用了功能性装置来弥补髁突缺失并刺激下颌支生长。