No abstract

Eosinophilic granuloma (EG) is the localized and mildest form of the triad commonly known as Langerhans cell histiocytosis. This report describes a case manifesting itself as a periodontal problem with the localized osseous lesions in jawbones which was first diagnosed as early-onset periodontitis. Later on, the diagnosis of EG was established, relying on histopathological and immunohistochemical evaluations. Immunohistochemical findings confirm that a minor component of cell aggregates is phenotypically related to Langerhans cells among the sheet-like accumulations of histiocytes and eosinophils. The aetiology of the disease remains largely unknown. Although surgical curettage of lesions is usually effective in treatment of EG of bone, corticosteroids might be used as an adjunctive. This multifocal case of EG stresses the importance of clinical follow-up examinations, since the sequential lesions appear with irregular intervals, and this may cause diagnostic problems as well as a delay in starting the treatment regimen.

ÖzetAmaç: Nadir görülen bu vakada amaç, agresif santral dev hücreli granulomun (SDHG) cerrahi eksizyon ve kortikosteroid enjeksiyonu tekniğiyle tedavisinin uzun dönem bulgularını bildirmektir. SDHG, maksilla ve mandibulada ender rastlanan kemiğin iyi huylu lezyonudur. Yöntem: 14 yaşında bayan hasta sol ön bölgede maksillada vestibül korteksteki şişlik nedeniyle kliniğimize başvurdu. Lezyon cerrahi olarak lokal anestezi altında çıkarıldı. Histolojik tanısı SDHG olarak kondu. Takip eden sürede iyileşme olmadı. Sekiz ay sonra aynı saha tekrar açılarak derin küretaj yapıldı. Aynı seansta lezyonlu bölgeye kortikosteroid enjeksiyonu yapıldı. Enjeksiyon takip eden 6 hafta boyunca haftada bir kez olmak üzere tekrarlandı. Bulgular: Takip eden yedi yıllık takipte lezyon ve sol maksiller kanin stabil ve asemptomatik idi. Lezyon ile ilgili bri tekrarlama görülmedi. Sonuç: Cerrahi küretajın lezyon içine kortikosteroid enjeksiyonu ile kombinasyonu SDHG tedavisi için umut verici bir yöntem olarak tekrarlayan lezyonlarda önerilebilir. Anahtar Kelimeler: Santral dev hücreli granulom, kortikosteroid, cerrahi eksizyon Abstract Objectives: The aim of this unique report was to evaluate the long term outcome of an aggressive central giant cell granuloma (CGCG) lesion by using surgical removal and corticosteroid injection technique.CGCG is an uncommon benign bony lesion that occurs in the mandible and maxilla. Methods:A 14 year-old female was admitted to our clinic with a complaint of hard swelling in the left maxillary anterior vestibule cortex. The lesion was surgically removed by enucleation which was carried out under local anesthesia. Histological investigation revealed a diagnosis of central giant cell granuloma. Patient's recovery was uneventful. During follow-up for eight months, the mass was opened and deep curettage was performed. After that, at same séance, corticosteroids was injected. The injection was repeated at the same rate once a week for 6 following weeks. Results: At the follow-up examination after seven years, lesion and left maxillary canine were stable and asymptomatic. There was no recurrence of lesion. Conclusion: Surgical removal combined with intralesional corticosteroid injection is a promising treatment approach for CGCG, and it can be suggested to reduce the recurrence of the lesion.

No abstract

No abstract