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广泛累及颅骨的棕色瘤的影像学特征:对口腔放射学的意义

Imaging features of a brown tumor with extensive skull involvement: Relevance for dental radiology.

作者信息

Ferreira Artemisa Fernanda Moura, Limeira-Júnior Francisco de Assis, de Oliveira José Jhenikártery Maia, Bonan Paulo Rogerio Ferreti, de Sales Marcelo Augusto Oliveira

机构信息

Postgraduate Program in Dentistry, Federal University of Paraiba, João Pessoa, Paraiba, Brazil.

Department of Morphology, Federal University of Paraiba, João Pessoa, Paraiba, Brazil.

出版信息

J Clin Exp Dent. 2025 May 1;17(5):e604-e607. doi: 10.4317/jced.62709. eCollection 2025 May.

Abstract

This case report describes a rare, asymptomatic brown tumor in a patient with end-stage renal disease. The lesion was incidentally detected during a computed tomography (CT) scan of the paranasal sinuses, performed upon a dentist's recommendation to investigate maxillary sinusitis. CT imaging revealed an expansive osteolytic lesion with irregular margins and a ground-glass appearance involving the left side of the sphenoid and frontal sinuses. Subsequent magnetic resonance imaging (MRI) with multiplanar T1 and T2-weighted sequences without contrast demonstrated a solid tissue-like expansive lesion affecting the left frontal and sphenoid bones, mildly compressing adjacent cerebral parenchyma. Despite these findings, the patient remained asymptomatic. Conservative management, including pharmacological therapy with calcimimetics to control parathyroid hormone levels, was initiated. A follow-up MRI after five years showed lesion stability without significant changes. The patient later underwent a renal transplant, which effectively stabilized the bone disease and improved his quality of life. This case underscores the pivotal role of computed tomography (CT) in detecting incidental systemic skeletal changes and the indispensable importance of interdisciplinary collaboration in managing complex conditions in systemically compromised patients, where each professional's expertise is crucial for the patient's well-being. Sinusitis, Brown Tumor, Hyperparathyroidism, Multidetector Computed Tomography, Magnetic Resonance Imaging, Multidisciplinary Care Teams.

摘要

本病例报告描述了一名终末期肾病患者罕见的无症状棕色瘤。该病变是在应牙医建议对鼻窦进行计算机断层扫描(CT)以调查上颌窦炎时偶然发现的。CT成像显示一个边界不规则、呈磨玻璃样外观的膨胀性溶骨性病变,累及蝶窦和额窦左侧。随后的磁共振成像(MRI)采用多平面T1和T2加权序列且未使用造影剂,显示一个实性组织样膨胀性病变,累及左侧额骨和蝶骨,轻度压迫相邻脑实质。尽管有这些发现,患者仍无症状。开始采取保守治疗,包括使用拟钙剂进行药物治疗以控制甲状旁腺激素水平。五年后的随访MRI显示病变稳定,无明显变化。患者后来接受了肾移植,这有效地稳定了骨病并改善了他的生活质量。本病例强调了计算机断层扫描(CT)在检测偶然的全身骨骼变化中的关键作用,以及跨学科协作在管理全身状况受损患者的复杂病情中的不可或缺的重要性,在这种情况下,每个专业人员的专业知识对患者的健康至关重要。鼻窦炎、棕色瘤、甲状旁腺功能亢进、多排螺旋计算机断层扫描、磁共振成像、多学科护理团队。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1770/12142367/8e185373600f/jced-17-05-e604-g001.jpg

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