Imanimoghaddam Mahrokh, Mortazavi Samareh, Goudarzi Fereshteh, Mohtasham Nooshin
Department of Oral and Maxillofacial Radiology, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
Oral and Maxillofacial Diseases Research Center, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
Iran J Otorhinolaryngol. 2021 Sep;33(118):319-325. doi: 10.22038/ijorl.2021.53844.2838.
Central giant cell granuloma (CGCG) is a benign bone tumor that occurs more in young females and anterior of the mandible. It can be unilocular or multilocular with wispy-septation, undulating borders, cortical expansion, and perforation. Central giant cell granuloma in association with other benign lesions of the jaws is named hybrid lesion. An aneurysmal bone cyst (ABC) is a rare, rapidly growing benign tumor that is commonly developed in young females and the mandible molar and ramus regions. It is usually a well-defined cyst-like expansile lesion with an internal structure similar to CGC lesions in radiographic features.
A 17-year-old girl was referred to the radiology department for panoramic radiography at the end of orthodontic treatment. The complete opacification of the right maxillary sinus, root resorption, and periodontal ligament widening was evident in panoramic radiography. Cone-beam computed tomography revealed a soft-tissue mass and displacement of the lateral nasal wall. The lesion was multilocular with wispy septation and ground glass in some parts. On T2-weighted magnetic resonance imaging, a heterogeneous mass with low to intermediate signals and fluid-fluid levels were observed. The patient underwent surgical curettage, and the histopathological diagnosis was the coexistence of CGCG and ABC.
An unusual view of the coexistence of CGCG and ABC could be a lesion with ground glass pattern calcification. Hybrid lesions with the coexistence of CGCG and ABC are rare, and only six cases are reported in the literature in this regard.
中央巨细胞肉芽肿(CGCG)是一种良性骨肿瘤,多见于年轻女性及下颌骨前部。它可为单房或多房,有纤细分隔,边界呈波浪状,伴有皮质扩张和穿孔。与颌骨其他良性病变相关的中央巨细胞肉芽肿被称为混合性病变。动脉瘤样骨囊肿(ABC)是一种罕见的、生长迅速的良性肿瘤,常见于年轻女性及下颌磨牙和升支区域。它通常是边界清晰的囊肿样膨胀性病变,在影像学特征上其内部结构与CGC病变相似。
一名17岁女孩在正畸治疗结束时被转诊至放射科进行全景X线摄影。全景X线摄影显示右侧上颌窦完全不透光、牙根吸收和牙周膜增宽。锥形束计算机断层扫描显示有软组织肿块及鼻侧壁移位。病变为多房性,有纤细分隔,部分区域呈磨玻璃样。在T2加权磁共振成像上,观察到一个信号强度从低到中等的不均匀肿块及液-液平面。患者接受了手术刮除术,组织病理学诊断为CGCG和ABC并存。
CGCG和ABC并存的一种不寻常表现可能是具有磨玻璃样钙化的病变。CGCG和ABC并存的混合性病变很罕见,关于这方面文献仅报道了6例。