Mayo Clinic Alix School of Medicine, Rochester, MN.
Department of Otolaryngology, Head and Neck Surgery, Mayo Clinic, Phoenix, AZ.
J Craniofac Surg. 2021 May 1;32(3):e267-e269. doi: 10.1097/SCS.0000000000007112.
Central giant cell granuloma (CGCG) is a relatively uncommon benign bony lesion accounting for approximately 7% of all non-neoplastic lesions of the jaw. The clinical behavior of CGCG can vary from a slow-growing, painless lesion to fast-growing and locally destructive. When such a lesion involves the mandible, this can be quite debilitating for the patient, inhibiting oral intake and requiring an extensive resection and bone graft reconstruction. The authors present a case of effectively decreasing the surgical morbidity associated with a large and rapidly growing CGCG of the mandible in a pediatric patient. Neoadjuvant immunotherapy with denosumab (human monoclonal antibody) facilitated treatment of the tumor without the need for a large resection which would have otherwise necessitated a vascularized bony mandibular reconstruction. Consideration of neoadjuvant medical management of CGCG as the primary treatment is advocated.
中央性 giant 细胞肉芽肿（CGCG）是一种相对罕见的良性骨病变，约占颌骨所有非肿瘤性病变的 7%。CGCG 的临床行为可从缓慢生长、无痛性病变到快速生长和局部破坏性病变不等。当此类病变累及下颌骨时，可能会使患者非常虚弱，妨碍口腔摄入，并需要广泛的切除和骨移植重建。作者介绍了一例儿科患者下颌骨内大而快速生长的 CGCG，通过使用地舒单抗（人单克隆抗体）进行新辅助免疫治疗，有效地降低了与手术相关的发病率，而无需进行大的切除，否则需要进行带血管化的下颌骨重建。提倡将 CGCG 的新辅助药物治疗作为主要治疗方法。
