Smith P G, Marrogi A J, Delfino J J
Department of Oral and Maxillofacial Surgery, St. John's Mercy Medical Center, St. Louis, MO 63141.
J Oral Maxillofac Surg. 1990 Mar;48(3):300-5. doi: 10.1016/0278-2391(90)90398-l.
The classification of giant cell lesions of the maxillofacial skeleton is one that remains controversial. Classifying giant cell lesions of the jaw as granulomatous based solely on location seems inappropriate. The categories of benign or malignant are more realistic. Benign lesions may then be subdivided into aggressive and nonaggressive. Multifocal giant cell lesions strongly suggest the brown tumor of hyperparathyroidism. Serum chemistry tests including calcium, phosphorus, ionized calcium, and PTH levels should routinely be obtained when a giant cell lesion is suspected. A case of benign, aggressive, multifocal central giant cell lesions of the maxillofacial skeleton, in the absence of either primary or secondary hyperparathyroidism is presented. Whether this represents metastasis from the initial lesion, metabolic osteoclastic dysfunction, or a new entity, craniofacial giant cell dysplasia, is unknown.
颌面部骨骼巨细胞病变的分类一直存在争议。仅根据位置将颌骨巨细胞病变归类为肉芽肿性病变似乎并不合适。良性或恶性的分类更为实际。良性病变可再细分为侵袭性和非侵袭性。多灶性巨细胞病变强烈提示甲状旁腺功能亢进的棕色瘤。当怀疑有巨细胞病变时，应常规进行血清化学检查，包括钙、磷、离子钙和甲状旁腺激素水平测定。本文报告一例颌面部骨骼良性、侵袭性、多灶性中央巨细胞病变，且不存在原发性或继发性甲状旁腺功能亢进的病例。这种情况是代表初始病变的转移、代谢性破骨细胞功能障碍，还是一种新的疾病——颅面巨细胞发育异常，目前尚不清楚。
