Mirmohammadsadeghi Arash, Eshraghi Bahram, Shahsanaei Azadeh, Assari Raheleh
Ocular Plastic and Reconstructive Surgery Department, Tehran University of Medical Sciences, Farabi Eye Research Center , Tehran , Iran.
Orbit. 2015 Feb;34(1):33-7. doi: 10.3109/01676830.2014.950287. Epub 2014 Sep 29.
To report 3 cases of cherubism, one of whom underwent surgery for orbital manifestations, and to provide a literature review.
Our patients were normal at birth and developed painless enlarging of the cheeks and jaws when they were 4-5 years old. Ophthalmologic examinations showed mild proptosis, superior globe displacement and inferior scleral show in all cases. Cases 2 and 3 had lower lid skin discoloration. Computed tomography (CT) scans demonstrated bilateral multicystic lesions in the maxilla and mandible with cortical thinning in all cases. In Case 3, left eye hyperglobus and anisometropic amblyopia was seen. In this case, the CT scan showed a round, well-defined and homogeneous mass, involving the anterior and superior walls of the maxillary sinus on the left side, extending into inferior orbit. Debulking of the mass was performed at the surgery. The pathologic findings were compatible with the diagnosis of giant cell reparative granuloma. He returned 1 year after surgery with recurrence of the mass.
A few cases were reported in the literature with histopathologically proven orbital cherubism. To our knowledge, lower lid skin discoloration in Cases 2 and 3 and anisometropic amblyopia in case 3 were not described elsewhere in cherubism cases. We recommend that all cases with cherubism must be examined by an ophthalmologist to diagnose and treat possible orbital manifestations.
报告3例颌骨多囊性纤维性骨炎病例,其中1例因眼眶表现接受手术治疗,并进行文献复习。
我们的患者出生时正常,4 - 5岁时出现面颊和颌骨无痛性肿大。眼科检查显示所有病例均有轻度眼球突出、眼球上移及巩膜下显露。病例2和病例3有下睑皮肤色素沉着。计算机断层扫描(CT)显示所有病例上颌骨和下颌骨均有双侧多囊性病变,伴有皮质变薄。病例3可见左眼眼球高度突出及屈光参差性弱视。该病例CT扫描显示一个圆形、边界清晰且均匀的肿块,累及左侧上颌窦前壁和上壁,延伸至眼眶下部。手术中对肿块进行了减容。病理结果与巨细胞修复性肉芽肿的诊断相符。术后1年他因肿块复发前来复诊。
文献报道了少数经组织病理学证实的眼眶颌骨多囊性纤维性骨炎病例。据我们所知,病例2和病例3的下睑皮肤色素沉着以及病例3的屈光参差性弱视在颌骨多囊性纤维性骨炎病例中未见其他地方有描述。我们建议所有颌骨多囊性纤维性骨炎病例必须由眼科医生进行检查,以诊断和治疗可能的眼眶表现。