Altuğ Hasan Ayberk, Günal Armağan, Günhan Omer, Sençimen Metin
Department of Dental Services Diyarbakir, Diyarbakir Military Hospital, Turkey.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009 Nov;108(5):e59-63. doi: 10.1016/j.tripleo.2009.06.034. Epub 2009 Sep 26.
Juvenile hyaline fibromatosis (JHF) is a rare autosomal-recessive hereditary disease, characterized by gingival hypertrophy, flexion contractures of joints, bone lesions, hyaline deposition in the extracellular spaces of the dermis and soft tissues, stunted growth, and skin lesions such as multiple nodules, tumors and pink, pearly papules. No case of JHF with a mandibular bone involvement, exists in the literature. Bone involvement in JHF is an uncommon finding and distinct solitary lesions in the calvarial bones has been reported by some authors. A 21-year-old male patient was referred to Diyarbakir Military Hospital, Department of Dental Service. Clinical findings were consistent with a solid alveolar mass in the right mandibular premolar-molar region and displaced right mandibular molar teeth. Orthopantomographic examination showed impaction of all lower right molars in a mixed radioopaque/radiolucent area. Microscopically, increased nodular connective tissue was seen under the lobulated mucosal surfaces of the resected area. The case presented here had a localized fibrous proliferation that infiltrated bone trabeculae and caused displacement of teeth. Juvenile hyaline fibromatosis should be considered in the differential diagnosis with the other intraosseous radiolucent-patchy opaque lesions of jaw bones. Based on the clinical and histopathological findings, a diagnosis of JHF was made.
青少年透明纤维瘤病(JHF)是一种罕见的常染色体隐性遗传性疾病,其特征为牙龈肥大、关节屈曲挛缩、骨病变、真皮和软组织细胞外间隙透明质沉积、生长发育迟缓以及皮肤病变,如多个结节、肿瘤和粉红色珍珠样丘疹。文献中尚无下颌骨受累的JHF病例。JHF累及骨骼较为罕见,一些作者曾报告过颅骨中有明显的孤立性病变。一名21岁男性患者被转诊至迪亚巴克尔军事医院牙科。临床检查结果显示右下颌前磨牙 - 磨牙区有一实性牙槽肿物,右下颌磨牙移位。全景片检查显示右下所有磨牙均阻生于一个混合性不透光/透光区域。显微镜下,在切除区域的分叶状黏膜表面下可见结节状结缔组织增多。此处报告的病例有局部纤维组织增生,浸润骨小梁并导致牙齿移位。在鉴别诊断颌骨其他骨内透光 - 斑片状不透光病变时应考虑青少年透明纤维瘤病。根据临床和组织病理学检查结果,诊断为JHF。