Gan Jianguo, Shi Congyu, Liu Shan, Tian Xudong, Wang Xiaoyi, Ma Xiangrui, Gao Pan
State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
Department of Oral and Maxillofacial Surgery, Binzhou Medical University Hospital, Binzhou, China.
Transl Pediatr. 2021 May;10(5):1386-1392. doi: 10.21037/tp-21-32.
Congenital granular cell tumour (CGCT) is a benign lesion that predominantly arises from the alveolar ridges of neonates, especially the maxilla. However, it's only 10 percent of multiple lesions in all reported cases, in which simultaneously mandibular and maxillary involvements are more extremely rare. For treatments of multiple CGCTs, few standard procedures were reported. In addition to surgical excision, which refers to a preferred method, conservative treatment is an available choice. Here, a case of multiple CGCTs using different therapeutic strategies was reported because of its rarity and innovation. A five-day-old female newborn presented two congenital masses attached to the right mandibular and maxillary alveolar ridge. The size of the mandibular lesion causing difficulty in feeding was 3 cm in diameter and 0.5 cm in the maxilla. Based on different manifestations, surgical excision and conservative treatment were adopted respectively. The mandibular mass was excised while that in the maxilla underwent spontaneous regression. Satisfactory results were achieved for this patient. There was no evidence of recurrence after a 6-month follow-up. Microscopic examination and immunohistochemistry analysis confirmed the diagnosis and differential diagnosis of CGCT and even proposed the possibility of histogenesis from neural crest. Moreover, we reviewed the literature and summarized the characteristics to provide new ideas for the treatment of multiple CGCTs.
先天性颗粒细胞瘤(CGCT)是一种良性病变,主要起源于新生儿的牙槽嵴,尤其是上颌骨。然而,在所有报道的病例中,它仅占多发病变的10%,其中下颌骨和上颌骨同时受累极为罕见。对于多发CGCT的治疗,报道的标准程序很少。除了手术切除(这是首选方法)外,保守治疗也是一种可行的选择。在此,报道了一例采用不同治疗策略的多发CGCT病例,因其罕见性和创新性。一名5日龄女婴,右侧下颌骨和上颌牙槽嵴附着有两个先天性肿块。导致喂养困难的下颌病变直径为3 cm,上颌病变为0.5 cm。根据不同表现,分别采用手术切除和保守治疗。下颌肿块被切除,而上颌肿块自行消退。该患者取得了满意的结果。6个月随访后无复发迹象。显微镜检查和免疫组化分析证实了CGCT的诊断和鉴别诊断,甚至提出了神经嵴组织发生的可能性。此外,我们回顾了文献并总结了其特点,为多发CGCT的治疗提供新思路。