Central giant cell granuloma

  • 文章类型: Journal Article
    目的:本文的目的是描述最近一例中央性巨细胞肉芽肿(CGCG),该病例在皮质类固醇治疗后迅速发展,同时还回顾了有关头颈部CGCG(HNCGCG)的现有文献,特别强调下颌外和上颌病例。
    方法:研究人员设计并实施了一项为期32年的文献综述,使用联机数据库:PubMed,谷歌学者,Medline,和Proquest。分析的病例总数为55例(42例病例报告;3例病例系列;8个比较研究;1个回顾性队列)。
    方法:我们介绍一例10岁男性的CGCG病例。病变起源于右下颌前体,经皮质类固醇治疗后进展。结合影像学和组织学进行诊断。及时对半下颌骨进行了减积手术,随访时无复发。
    结果:诊断CGCG时的平均年龄为27.5岁。HNCGCG在颌骨中最常见(43.1%),但也发现在颞骨(33.3%)。最常用的治疗方式是完全手术切除(76.9%)。93.2%的患者在随访时没有疾病的证据,而6.8%的患者在随访时出现复发。中位随访时间为13个月。
    结论:对于临床医生来说,认识到CGCG能够表现在颌外是很重要的。CGCG在非牙源性放射性病变的鉴别诊断中应考虑,尤其是年轻患者。CGCG还需要与甲状旁腺功能亢进(BTH)和巨细胞瘤的棕色肿瘤区分开来,组织学相似。
    OBJECTIVE: The purpose of this paper is to describe a recent case of central giant cell granuloma (CGCG) that rapidly progressed post corticosteroid treatment while also providing a review of the existing literature on CGCG of the head and neck (HNCGCG), with particular emphasis on extra-mandibular and maxillary cases.
    METHODS: The investigators designed and implemented a 32-year review of literature, using the online databases: PubMed, Google Scholar, Medline, and Proquest. The total number of cases analyzed was 55 (42 case reports; 3 case series; 8 comparative studies; 1 retrospective cohort).
    METHODS: We present a case of a CGCG in a 10-year old male. The lesion originated in the right anterior mandibular body and progressed after corticosteroid treatment. Diagnosis was made using a combination of imaging and histology. A timely debulking procedure of the hemi-mandible was performed and there was no recurrence of the lesion at follow up.
    RESULTS: The average age at the time of diagnosis of CGCG was 27.5 years. HNCGCG was most commonly detected in the jaw (43.1%), but was also found in the temporal bone (33.3%). The most frequently employed treatment modality was complete surgical excision (76.9%). 93.2% of patients were alive with no evidence of disease at follow-up, while 6.8% of patients exhibited recurrence at follow-up. The median follow up was 13 months.
    CONCLUSIONS: It is important for clinicians to recognize that CGCGs are capable of manifesting outside of the jaw. CGCG should be considered in the differential diagnosis of non-odontogenic radiolucent lesions, especially in young patients. CGCGs also need to be distinguished from brown tumor of hyperparathyroidism (BTH) and giant cell tumors, which are histologically similar.
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  • 文章类型: Journal Article
    回顾分析中心性巨细胞肉芽肿患者的临床和影像学特征,并复习相关文献,为中心性巨细胞肉芽肿的诊断和临床表现提供参考。
    回顾性选择7例中央性巨细胞肉芽肿患者作为研究对象,所有病例均经病理证实,并进行了相关影像学检查.所有七例病例都接受了CT扫描,3例接受了MRI扫描。将详细的临床特征与影像学发现进行比较,并根据其表现和影像学特征进行分析。
    临床特征,影像学特征因病变部位而异.CT特征包括不均匀致密的膨胀性肿块,导致骨破坏和皮质变薄。而MRI在T1和T2加权图像中具有低到等强度的特征。可能存在囊性变性,出血或含铁血黄素沉积或类骨质形成,这可能导致T1和T2信号变化。在对比研究中,病变不增强,但周围可能轻度增强。
    在T1加权和T2加权图像中,具有骨骼破坏和皮质变薄的不均匀致密的膨胀质量,并且在外周轻度增强,应考虑中枢巨细胞肉芽肿。
    UNASSIGNED: To review and analyze the clinical and imaging features of central giant cell granuloma patients and to review the relevant literatures for the diagnosis and clinical manifestation of central giant cell granuloma.
    UNASSIGNED: Seven cases of central giant cell granuloma were retrospectively selected for the study, all of which were confirmed by pathology and had relevant imaging investigations. All seven cases had undergone CT scan, three cases had undergone MRI scan. Detailed clinical features were compared along with the imaging findings and analysis was done on the basis of their presentation and imaging features.
    UNASSIGNED: The clinical features, radiologic features were varied according to the site of the lesion. CT features include unevenly dense expansile mass causing bone destruction and cortical thinning. While MRI features with low to iso-intensity in T1- and T2 weighted images. There may be presence of cystic degeneration, hemorrhage or hemosiderin deposits or osteoid formation, which can cause T1 and T2 signal changes. On contrast study, the lesion doesn\'t enhance but periphery may enhance mildly.
    UNASSIGNED: Unevenly dense expansile mass with bone destruction and cortical thinning with low to iso-intensity in T1 weighted and T2 weighted images and mildly enhance peripherally, Central giant cell granuloma should be considered.
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  • 文章类型: Journal Article
    背景:中枢巨细胞肉芽肿是一种良性骨内病变;髁突区域的肿瘤很少报道。
    方法:我们介绍一个60岁女性耳前肿胀的病例,关节运动和疼痛的限制仅在右侧。
    结论:根据患者的术前临床表现进行评估,通过正像断层扫描和计算机断层扫描(CT)。CT提示右侧髁头有病变。手术是根据这个影像学发现安排的,切开活检标本的组织学发现,以及患者的适应症和症状。
    结论:在所有报告的中央巨细胞肉芽肿病例中,只有五个(包括这个病例)位于下颌髁突。
    BACKGROUND: Central giant cell granuloma is a benign intraosseous lesion; tumours in the condylar region are rarely reported.
    METHODS: We present the case of a 60-year-old woman with preauricular swelling, limitation of joint motion and pain on only the right side.
    CONCLUSIONS: The patient was evaluated based on her preoperative clinical manifestations, by orthopantomography and computed tomography (CT). CT revealed a lesion on the right condylar head. Surgery was scheduled based on this imaging finding, histological findings from an incisional biopsy specimen, and the patient\'s indications and symptoms.
    CONCLUSIONS: Of all reported cases of central giantcell granuloma, only five (including this case) were located in the mandibular condyle.
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  • 文章类型: Case Reports
    背景:中枢巨细胞肉芽肿是下颌骨的良性肿瘤,在儿童和年轻人中呈现。分为非和侵略性亚型,侵袭性亚型相对罕见,偶尔可以快速进展,导致严重的发病率。
    方法:我们介绍一例6岁女性的侵袭性中央性巨细胞肉芽肿(CGCG)。病变起源于右下颌支,并迅速发展到累及髁突。结合影像学和病理学进行诊断。及时对半下颌骨进行整块切除,并放置了重建钛板和con突假体。
    结论:我们的病例证明了CGCG在儿童人群中快速进展的下颌骨病变的鉴别诊断中的重要性。及时的诊断和管理可以大大改善长期结果。
    BACKGROUND: Central giant cell granulomas are benign tumours of the mandible, presenting in children and young adults. Divided into non- and aggressive subtypes, the aggressive subtype is relatively rare and can occasionally progress rapidly, resulting in significant morbidity.
    METHODS: We present a case of an aggressive central giant cell granuloma (CGCG) in a six year-old female. The lesion originated in the right mandibular ramus and progressed rapidly to involve the condyle. Diagnosis was made using a combination of imaging and pathology. A timely en bloc resection of the hemi-mandible was performed with placement of a reconstructive titanium plate and condylar prosthesis.
    CONCLUSIONS: Our case demonstrates the importance of considering CGCG in the differential diagnosis of rapidly progressive mandibular lesions in the pediatric population. Prompt diagnosis and management can greatly improve long-term outcomes.
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  • 文章类型: Case Reports
    Central odontogenic fibroma (COF) is an uncommon intraosseous neoplasm of the gnathic bones which is composed of fibrous connective tissue, with or without calcifications, and variable amounts of inactive odontogenic epithelium. It makes up less than 5% of odontogenic tumors and is more commonly seen in females. Central giant cell granuloma (CGCG) is a locally destructive but benign lesion of the jaws containing osteoclast-like multinucleated giant cells in a fibrovascular stroma. CGCG makes up approximately 10% of all benign jaw tumors and typically occurs in females younger than 30 years of age. A hybrid lesion with histologic features of both COF and CGCG is very rare and was first described in 1992. To date, fewer than 50 cases of this lesion have been reported. In this study, we present three additional cases of COF developing in conjunction with giant cell granuloma-like lesion, as well as provide a comprehensive literature review. Two of the lesions presented in our study were located in the posterior mandible and one occurred in the anterior mandible. Buccal and/or lingual expansion was noted in two patients and no recurrence was reported. Histologically, all three lesions demonstrated a blend of odontogenic epithelial islands with numerous multinucleated giant cells in a highly cellular connective tissue stroma. Immunohistochemical staining with CK19 and CD68 highlighted the odontogenic epithelium and multinucleated giant cells respectively. The precise nature of these hybrid lesions remains obscure and additional molecular studies may be of help in understanding their pathogenesis.
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  • 文章类型: Case Reports
    OBJECTIVE: To describe the efficacy of denosumab in the treatment of an aggressive giant cell granuloma of the mandible.
    METHODS: Denosumab was administered to a patient with a large aggressive giant cell granuloma of the mandible resistant to standard medical therapy. The effectiveness and response was measured on the basis of patient symptoms and radiological parameters.
    RESULTS: A significant reduction in patient symptoms was reported in association with tumour regression on follow up radiographs.
    CONCLUSIONS: This report demonstrates potential use of denosumab in aggressive giant cell granulomas of the jaws that have been resistant to medical therapy.
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