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.