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特发性双侧颌骨中央巨细胞修复性肉芽肿:一例报告及文献复习

Idiopathic bilateral central giant cell reparative granuloma of jaws: a case report and literature review.

作者信息

Orhan Erkan, Erol Songül, Deren Orgun, Sevin Asuman, Ekici Ozlem, Erdoğan Bülent

机构信息

Department of Plastic and Reconstructive Surgery, Ankara Numune Training and Research Hospital, Ankara, Turkey.

出版信息

Int J Pediatr Otorhinolaryngol. 2010 May;74(5):547-52. doi: 10.1016/j.ijporl.2010.02.006. Epub 2010 Mar 12.

Abstract

OBJECTIVES

The central giant-cell reparative granuloma has been defined as a localized benign but sometimes aggressive osteolytic proliferation consisting of fibrous tissue with hemorrhage and hemosiderin deposits, presence of osteoclast-like giant cells and reactive bone formation. It is a benign lesion usually appears as solitary, multilocular, radiolucencies, located in the mandible and maxilla. Multiple CGCRGs of the jaw bones is very rare and, if it occurs, it is usually associated with hyperparathyroidism in majority of the cases .This report presents an unusual case of a 12-year-old girl who has idiopathic, bilateral giant cell granulomas of the angulus mandible.

METHODS

A 12 year-old girl was admitted to our department with complain of swelling on both right and left side of her lower jaw. There was no history of trauma, dental problem or neck infection. Blood chemistry, including calcium, alkaline phosphatase and inorganic phosphorus was normal. Patient had not family history, clinical appearance like cherubism or noonan syndrome and systemic anomalies. MRI showed, in right ramus mandible, 37 x mm x 35 mm x 28 mm size mass and in lenf ramus mandible, an expansile, 30 mm 38 mm x 12 mm size mass. The patient underwent surgical curettage of the lesion through an intraoral approach under general anesthesia.

RESULT

The histopathologic examination of the lesion was reported as 'giant cell reparative granuloma.

CONCLUSION

Our patient had multiple CGCRG in her jaw. In literature there is several reports about multiple CGCRG but unlike of that report our patient had no syndromes like Cherubism, Noonan syndrome, neurofibromatosis type-1 and systemic disease like hyperparathyroidism ,fibrous dysplasia. So we define this case as Idiopathic bilaterally central giant cell reparative granuloma of jaw.

摘要

目的

中央性巨细胞修复性肉芽肿被定义为一种局限性良性但有时具有侵袭性的溶骨性增殖,由伴有出血和含铁血黄素沉积的纤维组织、破骨细胞样巨细胞及反应性骨形成构成。它是一种良性病变,通常表现为位于下颌骨和上颌骨的孤立性、多房性透射区。颌骨多发性中央性巨细胞修复性肉芽肿非常罕见,若发生,多数病例通常与甲状旁腺功能亢进有关。本报告介绍了一例不寻常的病例,一名12岁女孩患有特发性双侧下颌角巨细胞肉芽肿。

方法

一名12岁女孩因双侧下颌肿胀入院。无外伤、牙齿问题或颈部感染史。血液化学检查,包括钙、碱性磷酸酶和无机磷均正常。患者无家族史,无 cherubism 或努南综合征样的临床表现及全身异常。MRI显示,右侧下颌升支有一个37mm×35mm×28mm大小的肿块,左侧下颌升支有一个膨胀性、大小为30mm×38mm×12mm的肿块。患者在全身麻醉下经口内入路对病变进行了手术刮除。

结果

病变的组织病理学检查报告为“巨细胞修复性肉芽肿”。

结论

我们的患者颌骨有多个中央性巨细胞修复性肉芽肿。文献中有几篇关于多发性中央性巨细胞修复性肉芽肿的报道,但与那些报道不同的是,我们的患者没有 cherubism、努南综合征、1型神经纤维瘤病等综合征以及甲状旁腺功能亢进、骨纤维异常增殖症等全身性疾病。因此,我们将此病例定义为特发性双侧颌骨中央性巨细胞修复性肉芽肿。

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