fibrous dysplasia

纤维发育不良
  • 文章类型: Journal Article
    关于诊断FD/MAS的GNAS突变鉴定的准确性存在不一致的证据。本研究旨在评估GNAS突变检测的患病率和诊断准确性,并初步研究FD患者的基因型-表型相关性。
    从1995年到2024年,使用与GNAS和纤维发育不良相关的搜索词搜索了五个电子数据库。纳入对FD患者进行GNAS突变检测的观察性研究。
    共纳入878例FD患者。基于随机效应模型的FD中GNAS突变的合并患病率为74%(95%CI=64%-83%)。关于诊断准确性,灵敏度为0.83(95%CI,0.65-0.96),特异性为0.99(95%CI,0.98-1.00),受试者工作特征曲线下面积为98.38%。此外,荟萃分析和Fisher检验显示GNAS突变类型与FD类型显著相关(OR=3.51,95%CI=1.05~11.72,p<0.05)。
    在FD中发生了高检出率的GNAS突变,它的检测对于诊断FD是可靠的。此外,GNAS突变类型与FD类型显著相关。
    标识符CRD42024553469。
    UNASSIGNED: There is inconsistent evidence regarding the accuracy of GNAS mutations identification for the diagnosis of FD/MAS. This study was performed to estimate the prevalence and diagnostic accuracy of GNAS mutations detection and to preliminarily investigate the genotype-phenotype correlation in FD patients.
    UNASSIGNED: Five electronic databases were searched from 1995 to 2024 using search terms related to GNAS and fibrous dysplasia. Observational studies of FD patients undergoing GNAS mutation detection in FD were included.
    UNASSIGNED: A total of 878 FD patients were included. The pooled prevalence of GNAS mutations in FD based on the random effects model was 74% (95% CI = 64%-83%). Regarding diagnostic accuracy, a sensitivity of 0.83 (95% CI, 0.65-0.96), specificity of 0.99 (95% CI, 0.98-1.00) and the area under the receiver operating characteristic curve of 98.38% were found. Additionally, meta-analysis and Fisher\'s test showed the GNAS mutation types were significantly associated with FD types (OR = 3.51, 95% CI = 1.05 to 11.72; p < 0.05).
    UNASSIGNED: A high detection rate of GNAS mutations occurred in FD, and its detection is reliable for diagnosing FD. Additionally, GNAS mutation type was types were significantly associated with FD type.
    UNASSIGNED: Identifier CRD42024553469.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    常见的颅骨病变包括纤维发育不良(FD),骨内脑膜瘤,骨瘤,朗格汉斯细胞组织细胞增生症(LCH),骨内血管瘤,皮样和表皮样囊肿,和恶性肿瘤。手术切除并切除所涉及的颅骨是这些病变的治疗选择。以前,颅骨缺损是用同种异体移植修复的,和同种异体材料已被新的聚醚醚酮(PEEK)材料所取代,它更有抵抗力,生物相容性并且可以3D打印。高分辨率3D打印使用非常精细的挤出机将材料放入精细的层中,以真实地重建患者的解剖学结构,这提供了优越的美容效果。我们的目标是使用PEEK材料的3D打印颅骨成形术进行颅骨切除术和颅骨病变重建以及颅骨缺损重建的术前计划。
    在本系列中,我们描述了11例颅骨病变在同一坐位中使用3D打印PEEK植入物进行切除和重建的病例,该植入物术前使用高分辨率计算机断层扫描技术设计.所有病例均于2021年至2023年在BangabandhuSheikhMujib医科大学神经外科完成。术后随访6个月。
    关于11个案例,六例为FD,3例为骨内脑膜瘤,1例为骨内血管瘤,一个案例是LCH。平均病灶大小12.73~5.77cm。用PEEK材料进行颅骨成形术。轻微并发症保守治疗。血清腺瘤,术后发热,恶心也在其中。
    人类类似骨骼的生物相容性和对物理力的抵抗力导致PEEK的使用更加频繁,可以更好地修复复杂的颅面缺损。尽管有一些限制,PEEK颅骨修补术植入物继续蓬勃发展,并显示出其成为优秀材料的前景。Further,该技术的开发应投入研究和投资。
    UNASSIGNED: Common calvarial lesions include fibrous dysplasia (FD), intraosseous meningioma, osteoma, Langerhans cell histiocytosis (LCH), intraosseous hemangioma, dermoid and epidermoid cyst, and malignancy. Surgical removal with removal of the involved skull is the choice of treatment for these lesions. Previously, the skull defect was repaired using allograft, and alloplastic materials have been replaced with newer polyetheretherketone (PEEK) material, which is more resistant, biocompatible, and can be 3-dimension (3D)--printed. High-resolution 3D printing uses very fine extruders to put materials in fine layers to recreate patients\' anatomy authentically, which gives superior cosmetic outcomes. Our objectives were preoperative planning of craniectomy and reconstruction for calvarial lesions and reconstruction of skull defects using 3D-printed cranioplasty with PEEK materials.
    UNASSIGNED: In this series, we describe 11 cases in which skull lesions were removed and reconstructed in the same sitting using a 3D-printed PEEK implant designed preoperatively using high-resolution computer tomography. All the cases were done in the neurosurgery department of Bangabandhu Sheikh Mujib Medical University from 2021 to 2023. Patients were followed up for 6 months after surgery.
    UNASSIGNED: Regarding 11 cases, six cases were FD, three cases were intraosseous meningioma, one case was intraosseous hemangioma, and one case was LCH. Average lesion size were 12.73-5.77 cm. Cranioplasty was done with PEEK material. Minor complications were treated conservatively. Seroma, postoperative fever, and nausea were among these.
    UNASSIGNED: The human bone-like biocompatibility and resistance to physical forces leads to more frequent use of PEEK, which enables to repair of complex craniofacial defects with better cosmesis. Despite some limitations, the PEEK cranioplasty implant continued to thrive and showed its promise to be an excellent material. Further, research and investment should be put into developing the technique.
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  • 文章类型: Case Reports
    纤维发育不良是一种良性纤维骨病变,正常骨被未成熟的发育不良编织骨和纤维组织所取代。纤维发育不良有可能在罕见的情况下累及颅面区域的多个骨骼。应仔细评估这种参与类型的管理。
    这里,我们报告了一名52岁男性患者,患有进行性和双侧额叶头痛.放射/病理诊断显示鼻旁窦纤维发育不良,前颅底延伸和脑气。病人做了开颅手术,手术后两周,症状缓解,无任何并发症。
    在纤维发育不良的情况下,新发病和/或症状轻微的患者可能在多个颅面骨骼中有广泛的病变。
    UNASSIGNED: Fibrous dysplasia is a benign fibro-osseous lesion where normal bone is replaced with immature dysplastic woven bone and fibrous tissue. Fibrous dysplasia has the potential to involve multiple bones of the craniofacial area in a rare condition. Management of this involvement type should be assessed carefully.
    UNASSIGNED: Here, we report a 52-year-old man with progressive and bilateral frontal headache. The radio/pathologic diagnosis revealed fibrous dysplasia of paranasal sinuses with anterior skull-base extension and pneumocephalus. The patient underwent a craniotomy, and 2 weeks after the procedure, the symptoms were alleviated without any complications.
    UNASSIGNED: in case of fibrous dysplasia, patients with new onset and/or mild symptoms may have extensive lesions in multiple craniofacial bones.
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  • 文章类型: Journal Article
    良性纤维骨性病变(BFOL)包括骨骼疾病的异质集合,其特征在于用类骨质或编织骨的纤维胶原组织代替正常骨骼,和水泥。尽管它们具有临床意义,沙特阿拉伯的BFOL频率仍需评估。
    这项回顾性研究调查了利雅得BFOL的频率和人口统计学,沙特阿拉伯,通过从单个口腔病理学实验室档案中检索1984年1月至2013年1月期间记录的所有病例。
    共有64例被归类为BFOL,女性占主导地位(67.2%),中位年龄为21.5岁。确定的最普遍的疾病是纤维发育不良(45.31%),其次是骨水泥骨化性纤维瘤(26.56%)。BFOLs之间存在显著的性别差异,p值为0.03。FD主要位于上颌骨(65.5%),而COF主要存在于下颌骨(82.3%)。在17.2%的FD患者中观察到复发,与COF患者未报告复发相反。
    这项研究代表了利雅得首次探索BFOL频率和人口统计学,沙特阿拉伯,强调需要进一步调查,以全面了解我们人群中这些病变的性质。
    UNASSIGNED: Benign fibroosseous lesions (BFOLs) encompass a heterogenous collection of bone conditions characterized by replacing normal bone with fibro-collagenous tissue with osteoid or woven bone, and cementicles. Despite their clinical significance, the frequency of BFOLs in Saudi Arabia still needs to be assessed.
    UNASSIGNED: This retrospective study investigated the frequency and demographics of BFOLs in Riyadh, Saudi Arabia, by retrieving all cases recorded between January 1984 and January 2013 from a single Oral Pathology Laboratory archive.
    UNASSIGNED: A total of 64 cases were classified as BFOLs, with a predominance in females (67.2 %) and a median age of 21.5 years. The most prevalent condition identified was fibrous dysplasia (45.31 %), followed by cemento-ossifying fibroma (26.56 %). There were significant sex differences between BFOLs, with a p-value of 0.03. FD was predominantly located in the maxilla (65.5 %), whereas COF was predominantly found in the mandible (82.3 %). Recurrence was observed in 17.2 % of patients with FD, in contrast to no reported recurrence in patients with COF.
    UNASSIGNED: This study represents the first exploration of BFOL frequency and demographics in Riyadh, Saudi Arabia, highlighting the need for further investigations to comprehensively understand the nature of these lesions in our population.
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  • 文章类型: Journal Article
    纤维发育不良(FD)是骨骼的马赛克非遗传性遗传疾病,其中正常骨骼被结构不健全的纤维骨组织所取代。FD没有治愈性治疗,部分原因是其病理生理学尚未完全了解。我们提出了一个简单的数学模型,包括其基本的已知生物学,为了深入了解所涉及的骨细胞群的动态,并阐明其病理生理学。我们对模型进行了分析研究,并研究了其基本性质。研究了稳态的存在性和稳定性,对模型参数的敏感性进行了分析,不同的数值模拟提供了与分析结果一致的发现。我们讨论了模型动力学与已知疾病事实的匹配,以及如何使用该模型解决一些悬而未决的问题。
    Fibrous dysplasia (FD) is a mosaic non-inheritable genetic disorder of the skeleton in which normal bone is replaced by structurally unsound fibro-osseous tissue. There is no curative treatment for FD, partly because its pathophysiology is not yet fully known. We present a simple mathematical model of the disease incorporating its basic known biology, to gain insight on the dynamics of the involved bone-cell populations, and shed light on its pathophysiology. We develop an analytical study of the model and study its basic properties. The existence and stability of steady states are studied, an analysis of sensitivity on the model parameters is done, and different numerical simulations provide findings in agreement with the analytical results. We discuss the model dynamics match with known facts on the disease, and how some open questions could be addressed using the model.
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  • 文章类型: Case Reports
    背景:良性脊索细胞肿瘤(BNCT)是骨肿瘤范围内的一种罕见实体,通常出现在轴向骨架中。虽然这些肿瘤通常是良性的,由于它们与更具侵袭性的病变的组织学相似性,它们的诊断和管理带来了重大挑战,如脊索瘤。了解临床行为,诊断细微差别,BNCT的最佳管理策略不断发展。
    方法:椎骨的良性脊索细胞肿瘤通常无症状,可在影像学上识别,应与脊索瘤区分开来。具有更积极的临床过程。这份报告描述了一名15岁的女孩,患有腰骶部疼痛,诊断为良性脊索细胞瘤,这会影响腰椎的大部分S1椎骨,强调遇到的诊断挑战,放射学和组织学研究的作用,以及肿瘤良性性质的最终决定。
    结论:本报告强调了诊断良性脊椎脊索细胞瘤的方法以及排除鉴别诊断的重要性。通过探索这个案子的复杂性,我们为围绕BNCT的越来越多的文献做出了贡献,目的是提高对这种罕见骨肿瘤的临床认识和管理策略。
    BACKGROUND: Benign notochordal cell tumours (BNCTs) represent a rare entity within the spectrum of bone neoplasms, which typically arise in the axial skeleton. Although these tumours are often benign, their diagnosis and management pose significant challenges due to their histological similarity to more aggressive lesions, such as chordomas. Understanding of the clinical behaviour, diagnostic nuances, and optimal management strategies for BNCTs continues to evolve.
    METHODS: Benign notochordal cell tumours of the vertebra are usually asymptomatic and identified on imaging and should be distinguished from chordomas, which has a more aggressive clinical course. This report describes a 15-year-old girl with lumbosacral pain and a diagnosis of a benign notochordal cell tumour, which affects a large part of the S1 vertebra in the lumbar spine, highlighting the diagnostic challenges encountered, the role of radiological and histological investigations, and the ultimate determination of the benign nature of the tumour.
    CONCLUSIONS: This report highlights the approach taken for the diagnosis of a benign notochordal cell tumour of the vertebra and the importance of excluding differential diagnoses. By exploring the intricacies of this case, we contribute to the growing body of literature surrounding BNCTs, with the aim of improving clinical awareness and management strategies for this uncommon bone tumour.
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  • 文章类型: Case Reports
    背景:Mazabraud综合征(MS)是一种罕见且缓慢进展的良性疾病,其特征是同时存在骨纤维异常增生和肌内粘液瘤,并且被认为与GNAS基因的突变有关。迄今为止,文献中仅报道了约100例MS,但其标准治疗策略尚不清楚.
    方法:我们报告了2例根据症状和疾病表现接受不同治疗的年轻女性MS。第一个病人,37岁,接受内固定和静脉注射双膦酸盐治疗右股骨颈病理性骨折,随后切除右股内侧粘液瘤以控制疼痛,无症状腰大肌粘液瘤未经手术监测。基因检测证实了该患者的GNAS基因突变。第二个病人,24岁,接受右股中间肌粘液瘤切除术,髂纤维发育不良的保守治疗。这些患者随访17个月和3年,分别,现在情况稳定.
    结论:已经为患有不同症状的MS患者选择了各种治疗方法。粘液瘤的主要治疗方法是手术切除,而如果患者经历病理性骨折或严重疼痛,则选择性治疗纤维发育不良。然而,鉴于已记录的MS患者中纤维发育不良的恶性转化实例,密切跟进是必要的。
    BACKGROUND: Mazabraud\'s syndrome (MS) is a rare and slowly progressive benign disease characterized by the concurrent presence of fibrous dysplasia of bone and intramuscular myxoma, and is thought to be associated with mutations of the GNAS gene. To date, only about 100 cases of MS have been reported in the literature, but its standard treatment strategy remains unclear.
    METHODS: We report two cases of MS in young women who underwent different treatments based on their symptoms and disease manifestations. The first patient, aged 37, received internal fixation and intravenous bisphosphonate for a pathological fracture of the right femoral neck, excision of a right vastus medialis myxoma was subsequently performed for pain control, and asymptomatic psoas myxomas were monitored without surgery. Genetic testing confirmed a GNAS gene mutation in this patient. The second patient, aged 24, underwent right vastus intermedius muscle myxoma resection, and conservative treatment for fibrous dysplasia of the ilium. These patients were followed-up for 17 months and 3 years, respectively, and are now in a stable condition.
    CONCLUSIONS: Various treatments have been selected for MS patients who suffer different symptoms. The main treatment for myxomas is surgical resection, while fibrous dysplasia is selectively treated if the patient experiences pathological fracture or severe pain. However, given the documented instances of malignant transformation of fibrous dysplasia in individuals with MS, close follow-up is necessary.
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  • 文章类型: Case Reports
    世界卫生组织(WHO)关于牙源性和颌面骨肿瘤分类的2022更新通过整合新的分子见解,彻底改变了诊断和治疗范式。上颌面部骨骼的纤维骨性病变构成了一个异质组,包括纤维发育不良,砂瘤样骨化性纤维瘤(PSOF),青少年骨小梁纤维化(JTOF),和其他变体。尽管组织学相似,其独特的临床表现和预后意义要求精确鉴别.诊断纤维骨病变的复杂性给病理学家带来了挑战,颌面外科医生,牙医和口腔外科医生,强调系统方法的重要性,以确保最佳的病人管理。在这里,我们提出了两个案例,纤维发育不良和Cemento骨化性纤维瘤,详细介绍他们的临床遭遇和管理策略。两位患者都提供了知情同意书来发布他们的数据和图像,坚持道德准则。
    The World Health Organization\'s (WHO) 2022 update on the classification of odontogenic and maxillofacial bone tumors has revolutionized diagnostic and treatment paradigms by integrating novel molecular insights. Fibro-osseous lesions of the maxillo-facial bones constitute a heterogeneous group encompassing fibrous dysplasia, Psammomatoid Ossifying Fibroma (PSOF), Juvenile Trabecular Ossifying Fibroma (JTOF), and other variants. Despite histological similarities, their distinct clinical manifestations and prognostic implications mandate precise differentiation. The intricacies of diagnosing fibro-osseous lesions pose challenges for pathologists, maxillofacial surgeons, dentists and oral surgeons, underscoring the importance of a systematic approach to ensure optimal patient management. Herein, we present two cases, fibrous dysplasia and Cemento-Ossifying Fibroma, detailing their clinical encounters and management strategies. Both patients provided informed consent for publishing their data and images, adhering to ethical guidelines.
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  • 文章类型: Case Reports
    纤维发育不良(FD)是一种罕见的,非遗传,先天性骨疾病,可能是单骨或多骨。当与骨骼外表现相关时,多骨形式很少出现在综合征形式中。Mazabraud综合征是一种罕见的综合征,由表现为肌内粘液瘤的多发性FD组成。McCune-Albright综合征被多发性FD识别,性早熟和“咖啡馆”斑点。本报告描述了一名患有Mazabraud综合征的成年患者和一名患有McCune-Albright综合征的儿童。
    放射学发现是典型的弯曲畸形,硬化,透明或混合病变和骨扩张,经常伴有骨内扇贝。MRI通常是非贡献性的,实际上可能模仿更具侵略性的过程。早期发现和正确诊断允许早期预防性治疗和康复,以防止破坏性的神经系统后遗症和残疾。
    Fibrous dysplasia (FD) is a rare, non-inherited, congenital bone disorder which may be monostotic or polyostotic. The polyostotic form may rarely present in syndromic forms when associated with extra-skeletal manifestations. Mazabraud syndrome is a rare syndrome consisting of polyostotic FD presenting with intramuscular myxomas. McCune-Albright syndrome is recognised by polyostotic FD, precocious puberty and \'café au lait\' spots. This report describes an adult patient with Mazabraud syndrome and a child with McCune-Albright syndrome.
    UNASSIGNED: Radiographic findings are typical with bowing deformities, sclerotic, lucent or mixed lesions and bony expansion, often with endosteal scalloping. MRI is often non-contributory and may actually mimic a more aggressive process. Early detection and correct diagnosis allow for early preventative treatment and rehabilitation to prevent devastating neurological sequelae and disability.
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