颞骨巨细胞修复性肉芽肿一例

正1病例资料患者女,30岁,因右耳听力进行性下降,伴搏动性耳鸣3个月于2014年4月2日收入我院。患者3个月前无明显诱因出现右耳听力进行性下降,伴右侧头部钝痛,呈间歇性,右耳闷胀感,伴右耳搏动性耳鸣,呈持续性,与脉搏跳动一致,无溢液、溢脓、溢血,无发热、眩晕、恶心、呕吐,曾于外院行右侧外耳道肿物活检术,术后病理示:毛细胞瘤样增生伴出血,少量慢性炎细胞浸润及表皮坏死。入我院查体:     

颞骨巨细胞修复性肉芽肿

Jaffe于1953年首次提出巨细胞修复性肉芽肿(giant cell reparative granuloma,GCRG)的诊断,认为GCRG是一种少见的非肿瘤性病变,是对骨内出血的修复反应,但其具有局部侵袭性.GCRG好发于下颌骨、上颌骨,很少涉及颞骨.该病的诊断困难,常误诊为骨巨细胞瘤(giant cell tumour,GCT).现详细介绍l例颞骨GCRG的诊治经过,并对其病因、诊断、鉴别诊断及治疗进行讨论.     

颞骨巨细胞修复性肉芽肿

1临床资料 患者,女,51岁,因右耳前肿块4个月余入院治疗,自述肿块逐渐长大,伴头痛,既往健康,无外伤史。全身检查正常,双耳正常,右耳前可见一约4cm×3cm×2cm大小之肿块,质硬,轻度压痛,界线不清,颈部无肿大淋巴结。辅助检查：B超示右耳前多发实性包块（2块,血供不丰富）。颞骨CT示右侧颞骨占位性病变,伴有骨质破坏,     

颅骨巨细胞修复性肉芽肿

目的 探讨颅骨巨细胞修复性肉芽肿（ｇｉａｎｔｃｅｌｌｒｅｐａｒａｔｉｖｅｇｒａｎｕｌｏｍａ,ＧＣＲＧ）的病因,诊断,鉴别诊断以及治疗。方法 回顾性分析１９８７年６月－１９９９年５月收治的３例颅骨ＧＣＲＧ（颞骨２例,眶骨１例）的临床,组织学和影像学资料,结果 ３例病变部位均无外伤史,１例因手术未彻底切除病变,术后复发,组织学分析：３例病变均有纤维化,成纤维细胞呈椭圆形或梭形,并且大量增生,基质细胞间     

头颈部巨细胞修复性肉芽肿

巨细胞修复性肉芽肿（giantcellreParativegranuloma,GCRG）是一种少见的非肿瘤性病变,具有局部侵袭性,容易误诊为骨巨细胞瘤（giantcelltumor,GCT）。本文对头颈部GCRG的病因、诊断、鉴别诊断和治疗问题综述如下。     

颅骨巨细胞修复性肉芽肿

目的　探讨颅骨巨细胞修复性肉芽肿 (giantcellreparativegranuloma,GCRG)的病因、诊断、鉴别诊断以及治疗。方法　回顾性分析 1 987年 6月～ 1 999年 5月收治的 3例颅骨GCRG(颞骨 2例、眶骨 1例 )的临床、组织学和影像学资料。结果　 3例病变部位均无外伤史 ,1例因手术未彻底切除病变 ,术后复发。组织学分析 :3例病变均有纤维化 ,成纤维细胞呈椭圆形或梭形 ,并且大量增生 ,基质细胞间混有多核巨细胞 ,大小不一 ,分布不均匀。含有大小不等的出血区以及含铁血黄素沉着 ,有类骨质或新骨形成。CT检查示有溶骨性病变。磁共振成像 (magneticresonanceimaging ,MRI)检查示T1加权、T2加权均为低信号影像。结论　颅骨GCRG罕见 ,且易误诊为骨巨细胞瘤 ,对GCRG应结合临床、组织学、对治疗的反应做出诊断。手术彻底切除是最有效的治疗方法 ,术后应加强随访。     

颞骨巨大胆固醇肉芽肿1例及文献复习

1病历资料患者,男,29岁,因“左耳反复胀痛伴听力下降5月余”于2019年8月22日入院,患者无耳流脓、耳鸣,无头痛及意识障碍,无眩晕及恶心、呕吐,无畏寒、发热、面瘫等病史,曾经到当地医院就诊,诊断为“左耳胆脂瘤”,予以药物治疗(具体不详)后,上述症状无明显好转。     

颞骨嗜酸性肉芽肿1例

患儿,女,3岁,2004年9月发现右耳乳突区阵发性疼痛,未作处理,同年10月出现右耳流脓,在我院按“中耳炎”治疗,15d后发现右外耳道后壁膨隆,右耳后乳突区出现包块,且逐渐增大,清洗耳道时可引起歪嘴,但无闭目不全等其他面瘫症状。     

颞骨嗜酸性肉芽肿1例

患儿,男,7岁,右耳后包块伴疼痛1个月.1个月前患儿突然右耳后肿胀、疼痛,拒触摸,口服抗生素后好转.停药后很快复发,耳后包块渐长大.查体:右耳后肿胀,无青紫,皮温高,无波动,拒按.耳道及鼓膜正常.     

筛窦巨细胞修复性肉芽肿1例

1病例报告 患者,男,44岁,2009年5月5日因鼻塞、流涕、头部胀痛、嗅觉减退5年,以慢性鼻一鼻窦炎、鼻息肉（双）,鼻中隔偏曲而收住院。于2009年5月8日局麻下行鼻内镜下鼻息肉摘除及鼻实开放术,术后病检报告为鼻息肉,     

Giant cell reparative granuloma of the temporal bone

Giant cell reparative granuloma (GCRG) is an uncommon non-neoplastic lesion that typically occurs in the mandible and maxilla: however, its involvement with the temporal bone is rare. It is usually misdiagnosed as a giant cell tumor. Although regarded as a benign process, GCRG may be locally aggressive. In this paper, we describe two cases of GCRG of the temporal bone and review the pertinent literature published in English. The clinical course, histological evaluation, diagnosis, differential diagnosis, treatment and prognosis of GCRG of the temporal bone were investigated.     

Giant cell reparative granuloma of posterior ethmoid: A case report

Giant cell reparative granuloma (GCRG) is an unusual, nonneoplastic fibrous lesion affecting maxillary and mandibular bones and only rarely, the cranial bones. Giant cell reparative granuloma of the posterior ethmoid is exceedingly rare. To the best of our knowledge none of such case has been previously reported. Being a soft fleshy lesion of bone, if tends to have a benign course, not aggressive, it often recurs following incomplete excision. We report the case of a woman with a GCRG of right posterior ethmoid. We discuss the clinical picture, differential diagnosis, histologic evaluation and appearance on computed tomography.     

Giant cell reparative granuloma of maxilla

Giant Cell Reparative Granuloma is a reparative process in mandible. A case of Giant Cell Reparative Granuloma of Maxilla in a 15 years old female is reported. Tumour is very rare in maxilla and more often is diagnosed as a giant cell tumour. The case is reported on account of its rarity in maxilla and dilemma in differentiating it from other giant cell lesions. Differentiation is only based on the clinical test histopathological examination.     

7例颞骨骨巨细胞瘤的临床分析

目的：探讨颞骨骨巨细胞瘤(giant cell tumor of temporal bone，GCTTB)的病因、诊断、鉴别诊断及合理的治疗方法。方法：治疗方法以手术为主，7例中肿瘤根治性切除5例，临界切除2例(术后1年复发，病理Ⅱ级)。结合经病理学证实的GCTTB的临床资料，复习有关文献并对7例GCTB的临床、组织学和影像学等资料进行分析。结果：7例GcTTB中，右侧颞骨5例，左侧2例。病理Ⅰ级1例。Ⅰ～Ⅱ级2例，Ⅱ级4例。临床表现依肿瘤所在具体部位而有所不同：耳呜6例，耳鸣伴听力损失5例，其中有2例患侧耳全聋。眩晕2例．面瘫伴听力受损1例。3例术后行放射治疗，其中2例疗效良好．1例复发(为临界切除患者)。结论：明确诊断GCTTB必须综合临床、影像和病理三方面资料，手术彻底切除是最有效的治疗方法，术后辅以放疗可能有一定的作用。     

Giant cell tumor of the temporal bone (osteoclastoma)

A 49-year-old white female patient was referred to the ENT Department, Zentralkrankenhaus, Bremen, because of conductive hearing loss. Widespread tumor formation was found in the left temporal bone and was identified by biopsy to be an osteoclastoma. The tumor was extirpated surgically and reconstruction was performed. Periodic clinical follow-ups during a 36-month period after surgery have included control computed tomographic scans and have shown no evidence for recurrent disease. The specific pathology of the osteoclastoma is presented and different ways for treatment are discussed.     

Idiopathic bilateral central giant cell reparative granuloma of jaws: A case report and literature review

Objectives

The central giant-cell reparative granuloma has been defined as a localized benign but sometimes aggressive osteolytic proliferation consisting of fibrous tissue with hemorrhage and hemosiderin deposits, presence of osteoclast-like giant cells and reactive bone formation. It is a benign lesion usually appears as solitary, multilocular, radiolucencies, located in the mandible and maxilla. Multiple CGCRGs of the jaw bones is very rare and, if it occurs, it is usually associated with hyperparathyroidism in majority of the cases .This report presents an unusual case of a 12-year-old girl who has idiopatic, bilateral giant cell granulomas of the angulus mandible.

Methods

A 12 year-old girl was admitted to our department with complain of swelling on both right and left side of her lower jaw. There was no history of trauma, dental problem or neck infection. Blood chemistry, including calcium, alkaline phosphatase and inorganic phosphorus was normal. Patient had not family history, clinical apperiance like cherubism or noonan sydrome and systemic anomalies. MRI showed, in right ramus mandible, 37 × mm × 35 mm × 28 mm size mass and in lenf ramus mandible, an expansile, 30 mm 38 mm × 12 mm size mass. The patient underwent surgical curettage of the lesion through an intraoral approach under general anesthesia.

Result

The histopathologic examination of the lesion was reported as ‘giant cell reparative granuloma.

Conclusion

Our patient had multiple CGCRG in her jaw. In literature there is several reports about multiple CGCRG but unlike of that report our patient had no syndromes like Cherubism, Noonan syndrome, neurofibromatosis type-1 and systemic disease like hyperparathyroidism ,fibrous dysplasia. So we define this case as Idiopatic bilaterally central giant cell reparative granuloma of jaw.