1
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Khan O, Bertagna A, Damm D, Weyh A, Callahan N. Multiple radiolucencies in a 12-year-old boy. J Am Dent Assoc 2024:S0002-8177(24)00109-0. [PMID: 38573271 DOI: 10.1016/j.adaj.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 01/29/2024] [Accepted: 02/26/2024] [Indexed: 04/05/2024]
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2
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Alsufyani N, Alzahrani A. Imaging of Fibro-osseous Lesions and Other Bone Conditions of the Jaws. Dent Clin North Am 2024; 68:297-317. [PMID: 38417992 DOI: 10.1016/j.cden.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
This review directs the focus on the imaging features of various fibro-osseous lesions and other bone lesions that can be of similar presentation. Broad diagnosis of "fibrous osseous lesion" may culminate in improper treatment and management. Radiographic discriminating factors between these entities are highlighted and summarized to improve the diagnostic process when encountering these lesions.
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Affiliation(s)
- Noura Alsufyani
- Department of Oral Medicine and Diagnostic Sciences, Oral & Maxillofacial Radiology, College of Dentistry, King Saud University, P.O. Box 60169, Riyadh 11545, Kingdom of Saudi Arabia; Department of Medicine and Dentistry, School of Dentistry, University of Alberta, 5-522, Edmonton Clinic Health Academy, 11405 - 87 Avenue NW, T6G 1C9, Edmonton, AB, Canada.
| | - Adel Alzahrani
- Department of Oral Medicine and Diagnostic Sciences, Oral & Maxillofacial Radiology, College of Dentistry, King Saud University, P.O. Box 60169, Riyadh 11545, Kingdom of Saudi Arabia
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3
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Choi Y, Ji JM, Kim CH, Sung KP. Surgical management of severe cherubism persisting into early adulthood: a case report and literature review. Arch Craniofac Surg 2024; 25:38-43. [PMID: 38461827 PMCID: PMC10924791 DOI: 10.7181/acfs.2023.00577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/07/2023] [Accepted: 12/20/2023] [Indexed: 03/12/2024] Open
Abstract
Cherubism is a rare fibro-osseous condition characterized by bilateral expansion of the mandible and maxilla. Due to its rarity, treatment guidelines for cherubism have not been clearly established. Observation without surgical intervention is typically recommended, as cherubism often regresses spontaneously after puberty. However, a surgical intervention may be necessary if aggressive lesions lead to severe complications. In this report, we present a case involving surgical management of cherubism that did not spontaneously regress until early adulthood. An 18-year-old man was diagnosed with cherubism, presenting characteristic upward-looking eyes and a swollen face. He strongly desired surgical management. Gross contouring of the mandible was performed using an osteotome. Subsequently, delicate contouring was performed by bone burring and curettage. The remaining multiple locular bony defects were filled with demineralized bone matrix. No major complications, including infection and hematoma, occurred during the 8-month follow-up period. The facial contour remained stable without the aggravation of cherubism. The patient was satisfied with the cosmetic results. Considering that cherubism is a rare disease globally, with few reported cases in Korea, and that treatment guidelines are not clearly established, we anticipate that the results of this case will contribute to the development of future protocols for treating cherubism.
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Affiliation(s)
- Youngwoong Choi
- Department of Plastic and Reconstructive Surgery, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Jeong Min Ji
- Department of Plastic and Reconstructive Surgery, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Choong Hyeon Kim
- Department of Plastic and Reconstructive Surgery, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Ki Pyo Sung
- Department of Plastic and Reconstructive Surgery, Inje University Ilsan Paik Hospital, Goyang, Korea
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4
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Schreuder WH, Meijer EB, Cleven AHG, Edelenbos E, Klop C, Schreurs R, de Jong RT, van Maarle MC, Horsthuis RBG, de Lange J, van den Berg H. Efficacy and Toxicity of Calcitonin Treatment in Children with Cherubism: A Single-Center Cohort Study. J Bone Miner Res 2023; 38:1822-1833. [PMID: 37823782 DOI: 10.1002/jbmr.4922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 09/19/2023] [Accepted: 10/06/2023] [Indexed: 10/13/2023]
Abstract
Cherubism is a rare autosomal dominant disease characterized by expansile osteolytic jawbone lesions. The effect and safety of off-label calcitonin treatment during the progressive phase of the disease are not well described. In this retrospective study, we present data on the radiological response and adverse effects of subcutaneously administered calcitonin in a cohort of nine cherubism children (three female, six male). Two of the nine patients underwent two separate treatment courses with a significant off-treatment interval in between; therefore, a total of 11 treatment courses with a mean duration of 17.9 months (range <1 to 35, SD 10.8) were studied. To measure the response, the cumulative volume of cherubism lesions was calculated from available three-dimensional imaging. The primary outcome was the change in the volume of lesions during calcitonin treatment and only assessed for the eight treatment courses with a minimal duration of 6 months. A statistically significant reduction in the mean cumulative volume of lesions was seen regardless of treatment duration. Average volume reduction was highest in the first half year of treatment, with a gradual, ongoing reduction thereafter. For the secondary outcome, the change in the cumulative volume of lesions after treatment cessation was assessed for the seven treatment courses with follow-up imaging available. After six of these seven treatment courses, the cumulative volume increased again but remained undoubtedly smaller than the initial volume at the start of therapy. Adverse effects were assessed for all 11 treatment courses and occurred in 73% of them. Most adverse effects were mild and low grade, with the most severe being one grade 3 symptomatic hypocalcemia requiring hospitalization and early treatment termination. Calcitonin treatment seems effective and tolerable in treating actively progressing cherubism in children. However, further research is required to better understand the pharmacological treatment of cherubism, including also other drugs, dosing, and protocols. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Willem H Schreuder
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers Location AMC and Academic Center for Dentistry Amsterdam, University of Amsterdam, Amsterdam, the Netherlands
- Department of Head and Neck Surgery and Oncology, Antoni van Leeuwenhoek, Netherlands Cancer Center, Amsterdam, the Netherlands
| | - Ethan B Meijer
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers Location AMC and Academic Center for Dentistry Amsterdam, University of Amsterdam, Amsterdam, the Netherlands
| | - Arjen H G Cleven
- Department of Pathology, University Medical Center Groningen, Groningen, the Netherlands
| | - Esther Edelenbos
- Department of Pediatric Oncology, Amsterdam University Medical Centers Location AMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Cornelis Klop
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers Location AMC and Academic Center for Dentistry Amsterdam, University of Amsterdam, Amsterdam, the Netherlands
| | - Ruud Schreurs
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers Location AMC and Academic Center for Dentistry Amsterdam, University of Amsterdam, Amsterdam, the Netherlands
| | - Renate T de Jong
- Department of Internal Medicine, Endocrine section, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Merel C van Maarle
- Department of Clinical Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Roy B G Horsthuis
- Department of Oral and Maxillofacial Surgery, Ziekenhuisgroep Twente, Almelo and Medisch Spectrum Twente, Enschede, the Netherlands
| | - Jan de Lange
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers Location AMC and Academic Center for Dentistry Amsterdam, University of Amsterdam, Amsterdam, the Netherlands
| | - Henk van den Berg
- Department of Pediatric Oncology, Amsterdam University Medical Centers Location AMC, University of Amsterdam, Amsterdam, the Netherlands
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5
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Schreuder WH, van der Wal JE, de Lange J, van den Berg H. Multiple versus solitary giant cell lesions of the jaw: Similar or distinct entities? Bone 2021; 149:115935. [PMID: 33771761 DOI: 10.1016/j.bone.2021.115935] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 02/27/2021] [Accepted: 03/17/2021] [Indexed: 02/06/2023]
Abstract
The majority of giant cell lesions of the jaw present as a solitary focus of disease in bones of the maxillofacial skeleton. Less frequently they occur as multifocal lesions. This raises the clinical dilemma if these should be considered distinct entities and therefore each need a specific therapeutic approach. Solitary giant cell lesions of the jaw present with a great diversity of symptoms. Recent molecular analysis revealed that these are associated with somatic gain-of-function mutations in KRAS, FGFR1 or TRPV4 in a large component of the mononuclear stromal cells which all act on the RAS/MAPK pathway. For multifocal lesions, a small group of neoplastic multifocal giant cell lesions of the jaw remain after ruling out hyperparathyroidism. Strikingly, most of these patients are diagnosed with jaw lesions before the age of 20 years, thus before the completion of dental and jaw development. These multifocal lesions are often accompanied by a diagnosis or strong clinical suspicion of a syndrome. Many of the frequently reported syndromes belong to the so-called RASopathies, with germline or mosaic mutations leading to downstream upregulation of the RAS/MAPK pathway. The other frequently reported syndrome is cherubism, with gain-of-function mutations in the SH3BP2 gene leading through assumed and unknown signaling to an autoinflammatory bone disorder with hyperactive osteoclasts and defective osteoblastogenesis. Based on this extensive literature review, a RAS/MAPK pathway activation is hypothesized in all giant cell lesions of the jaw. The different interaction between and contribution of deregulated signaling in individual cell lineages and crosstalk with other pathways among the different germline- and non-germline-based alterations causing giant cell lesions of the jaw can be explanatory for the characteristic clinical features. As such, this might also aid in the understanding of the age-dependent symptomatology of syndrome associated giant cell lesions of the jaw; hopefully guiding ideal timing when installing treatment strategies in the future.
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Affiliation(s)
- Willem H Schreuder
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC and Academic Center for Dentistry Amsterdam, University of Amsterdam, Amsterdam, the Netherlands; Department of Head and Neck Surgery and Oncology, Antoni van Leeuwenhoek / Netherlands Cancer Institute, Amsterdam, the Netherlands.
| | - Jacqueline E van der Wal
- Department of Pathology, Antoni van Leeuwenhoek / Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Jan de Lange
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC and Academic Center for Dentistry Amsterdam, University of Amsterdam, Amsterdam, the Netherlands
| | - Henk van den Berg
- Department of Pediatrics / Oncology, Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Amsterdam, the Netherlands
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6
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Holmes KR, Holmes RD, Martin M, Murray N. Practical Approach to Radiopaque Jaw Lesions. Radiographics 2021; 41:1164-1185. [PMID: 34086497 DOI: 10.1148/rg.2021200187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Radiopaque lesions of the jaw are myriad in type and occasionally protean in appearance. In turn, the radiologic analysis of these lesions requires a systematic approach and a broad consideration of clinical and imaging characteristics to enable reliable radiologic diagnosis. Initially categorizing lesions by attenuation pattern provides a practical framework for organizing radiopaque jaw lesions that also reflects important tissue characteristics. Specifically, the appearance of radiopaque lesions can be described as (a) densely sclerotic, (b) ground glass, or (c) mixed lytic-sclerotic, with each category representing a distinct although occasionally overlapping differential diagnosis. After characterizing attenuation pattern, the appreciation of other radiologic features, such as margin characteristics or relationship to teeth, as well as clinical features including demographics and symptoms, can aid in further narrowing the differential diagnosis and lend confidence to clinical decision making. The authors review the potential causes of a radiopaque jaw lesion, including pertinent clinical and radiologic features, and outline a simplified approach to its radiologic diagnosis, with a focus on cross-sectional CT. An invited commentary by Buch is available online. ©RSNA, 2021.
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Affiliation(s)
- Kenneth R Holmes
- From the Departments of Medicine (K.R.H.) and Radiology (R.D.H.), University of British Columbia, 2775 Laurel St, 11th Floor, Vancouver, BC, Canada V5Z 1M9; BC Cancer Agency, Vancouver, British Columbia, Canada (M.M.); and Vancouver General Hospital, Vancouver, British Columbia, Canada (N.M.)
| | - R Davis Holmes
- From the Departments of Medicine (K.R.H.) and Radiology (R.D.H.), University of British Columbia, 2775 Laurel St, 11th Floor, Vancouver, BC, Canada V5Z 1M9; BC Cancer Agency, Vancouver, British Columbia, Canada (M.M.); and Vancouver General Hospital, Vancouver, British Columbia, Canada (N.M.)
| | - Montgomery Martin
- From the Departments of Medicine (K.R.H.) and Radiology (R.D.H.), University of British Columbia, 2775 Laurel St, 11th Floor, Vancouver, BC, Canada V5Z 1M9; BC Cancer Agency, Vancouver, British Columbia, Canada (M.M.); and Vancouver General Hospital, Vancouver, British Columbia, Canada (N.M.)
| | - Nicolas Murray
- From the Departments of Medicine (K.R.H.) and Radiology (R.D.H.), University of British Columbia, 2775 Laurel St, 11th Floor, Vancouver, BC, Canada V5Z 1M9; BC Cancer Agency, Vancouver, British Columbia, Canada (M.M.); and Vancouver General Hospital, Vancouver, British Columbia, Canada (N.M.)
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7
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Sahu B, Anand R, Kumar S, Solanki RS, Mehra P, Jain M. A Pattern-based Imaging Approach to Pediatric Jaw Lesions. Indian J Radiol Imaging 2021; 31:210-223. [PMID: 34316129 PMCID: PMC8299508 DOI: 10.1055/s-0041-1729767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Jaw lesions in the pediatric population, although infrequently encountered in clinical practice, can cause functional impairment and cosmetic disfiguring. It is further complicated by the difficulty in diagnosis due to complex anatomy and facial developmental process during infancy and childhood. Intraosseous pediatric jaw lesions may vary from odontogenic to nonodontogenic types with nonspecific clinical features in most cases. They deserve careful attention by a systematic approach to provide a relevant diagnosis or differential diagnosis for timely management. Imaging plays a major role in diagnosis with orthopantomograph being the foremost investigation, followed by cross-sectional imaging, essentially computed tomography as a problem-solving tool. This article highlights the imaging spectrum of various jaw lesions in the pediatric population with a pattern-based approach for radiological diagnosis.
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Affiliation(s)
- Biswanath Sahu
- Department of Radio-Diagnosis, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Rama Anand
- Department of Radio-Diagnosis, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Sandeep Kumar
- Department of Radio-Diagnosis, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Ravi Shankar Solanki
- Department of Radio-Diagnosis, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Pravesh Mehra
- Department of Dental and Oral Surgery, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Manjula Jain
- Department of Pathology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
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8
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Abdel Razek AAK. Bone-related disorders of the jaw: A clinico-radiological diagnostic algorithm. Neuroradiol J 2021; 34:289-299. [PMID: 33678062 DOI: 10.1177/1971400921998967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Bone-related disorders of the jaw (BRDJ) include a spectrum of non-neoplastic and neoplastic lesions of the maxillofacial region that have been recently classified into fibro-osseous lesions, giant cell lesions and osseous tumours. The histopathological features of BRDJ can be similar and overlie each other. Imaging is important in order to reach a specific diagnosis. However, the appearance of BRDJ on imaging is non-specific in some cases. Computed tomography (CT) and magnetic resonance imaging (MRI) are used for accurate localisation, characterisation of the tumour matrix, delineation of the lesion extension and establishment of the relation of BRDJ to the surrounding structures. Imaging is usually done to detect the relationship with the adjacent surrounding vital structures and to diagnose aggressive forms, malignant transformation and associated syndromes. The correlation of the demographic findings, the location and the clinical presentations with the imaging features are important for the diagnosis of BRDJ. The proposed clinico-radiological diagnostic algorithm with CT and MRI helps a specific diagnosis to be reached in some cases.
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9
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Chen Wongworawat Y, Jack D, Inman JC, Abdelhalim F, Cobb C, Zuppan CW, Raza A. Regional Lymph Node Enlargement in Clinically Severe Cherubism. CLINICAL PATHOLOGY 2019; 12:2632010X19861107. [PMID: 31321387 PMCID: PMC6611013 DOI: 10.1177/2632010x19861107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 06/06/2019] [Indexed: 11/17/2022]
Abstract
Cherubism is a rare benign autosomal dominant disorder characterized by progressive, painless, bilateral enlargement of the mandible and/or maxilla because of bone replacement by fibrotic stromal cells and osteoclast-like cells forming multilocular cysts. The lesions typically stabilize and regress after puberty. We present a 14-year-old male with severe familial cherubism. Bilateral mandibular enlargement began around age 4 and progressed until puberty, affecting his speech and mastication without subsequent involution. Composite mandibulectomy and mandible reconstruction with fibula free flap technique improved functionality and cosmesis. Histology was consistent with the diagnosis of cherubism, showing large areas of bland spindle-cell fibrous tissue and moderately abundant collagen and multiple nodules of giant cell-rich tissue resembling central giant cell granuloma. Regional lymph nodes were sampled due to enlargement, demonstrating hemosiderin-laden macrophages and basophilic laminated concretions localized to the cortical interfollicular space and along the peripheral follicular marginal zone, findings which have not been previously reported.
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Affiliation(s)
- Yan Chen Wongworawat
- Department of Pathology and Laboratory Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Daniel Jack
- Department of Pathology and Laboratory Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Jared C Inman
- Department of Otolaryngology, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Fouad Abdelhalim
- Department of Pathology, Jerry L Pettis Memorial VA Medical Center, Loma Linda, CA, USA
| | - Camilla Cobb
- Department of Pathology and Laboratory Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Craig William Zuppan
- Department of Pathology and Laboratory Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Anwar Raza
- Department of Pathology and Laboratory Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA
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10
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Abstract
Cherubism is a rare benign, autosomal-dominant inherited fibro-osseous lesion of jaw characterized by excessive bone degradation of the upper and lower jaws followed by the development of fibrous tissue masses. It is usually self-limiting; it starts in early childhood and involutes by puberty. The purpose of this clinical report is to describe a nonfamilial case of cherubism on a teenager female patient first treated by calcitonin nasal spray followed by surgical resection and recontouring after puberty.
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Affiliation(s)
- Heena Mazhar
- Department of Oral and Maxillofacial Surgery, Chhattisgarh Dental College and Research Institute, Rajnandgaon, Chhattisgarh, India
| | - Ratna Samudrawar
- Department of Oral Medicine and Radiology, Raipur, Chhattisgarh, India
| | - Rubi Gupta
- Department of Oral and Maxillofacial Surgery, Rungta College of Dental Sciences and Research, Bhilai, Chhattisgarh, India
| | - Mukesh Kumar Kashyap
- Department of Oral and Maxillofacial Surgery, Rungta College of Dental Sciences and Research, Bhilai, Chhattisgarh, India
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11
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Abstract
Cherubism is an inherited, autosomal dominant disorder that affects the jaws of children. The disease is usually obvious as a painless bilateral swelling in which bone is replaced with fibrous tissue. Affected children appear normal at birth. Swelling of the jaws usually occurs between 2 and 7 years of age and relapses as age progresses leaving a few facial deformities and malocclusion. The disease is microscopically indistinguishable from other giant cell lesions. The association of cherubism with gingival fibromatosis, epilepsy, mental retardation, stunted growth, and hypertrichosis is referred to as a rare case of possible Ramon syndrome with extraordinary tissue enlargement over the teeth. Here, we present a case of Ramon syndrome in a 6-year-old girl describing the clinical and radiographic features successfully treated with a brief review of literature.
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Affiliation(s)
- L K Surej Kumar
- Department of Oral and Maxillofacial Surgery, KIMS Hospital, Thiruvananthapuram, Kerala, India
| | - D S Deepa
- Department of Oral and Maxillofacial Surgery, KIMS Hospital, Thiruvananthapuram, Kerala, India
| | - S Dilna
- Department of Oral and Maxillofacial Surgery, KIMS Hospital, Thiruvananthapuram, Kerala, India
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12
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Thompson KS, Owosho AA. Worth syndrome "mandibular osteosclerosis" as an incidental finding: a report of 2 cases. Dentomaxillofac Radiol 2018; 47:20180171. [PMID: 30028190 DOI: 10.1259/dmfr.20180171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
This report presents two cases of Worth syndrome involving the mandible which were identified as an incidental finding on radiologic evaluation. Both patients were females who presented with enlarged mandibles. Radiologic evaluation revealed multiple bilateral mandibular enostoses, widened and thickened inferior cortical border of the mandible, with no other major clinical finding on examination. One of the patients received orthognathic surgery and healed uneventfully with no post-surgical complications. In this report, we reviewed possible differential diagnoses to this syndrome to facilitate identification among general dentists and oral and maxillofacial radiologists.
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Affiliation(s)
- Kent S Thompson
- 1 College of Dental Medicine, University of New England , Portland, ME , USA
| | - Adepitan A Owosho
- 1 College of Dental Medicine, University of New England , Portland, ME , USA
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13
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Argyris PP, Gopalakrishnan R, Hu Y, Reichenberger EJ, Koutlas IG. Clinicopathologic and Molecular Characteristics of Familial Cherubism with Associated Odontogenic Tumorous Proliferations. Head Neck Pathol 2017; 12:136-144. [PMID: 28721660 PMCID: PMC5873491 DOI: 10.1007/s12105-017-0837-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 07/07/2017] [Indexed: 12/14/2022]
Abstract
Cherubism is a rare autosomal dominant condition affecting the jaws and caused by mutations in the gene encoding for the adapter protein SH3BP2 that maps to chromosome 4p16.3. Cherubism is characterized by symmetrically developing bone lesions in the maxilla and mandible. The lesions have been radiographically and histopathologically well-described. Here, we present a family with cherubism with two of its members featuring odontogenic tumorous proliferations in association with persistent central giant cell lesions (CGCL). Specifically, the proband, a 25-year-old male, developed a radiolucent lesion characterized histologically by central odontogenic fibroma-like proliferation in association with a CGCL component, while his mother, at age 57, was diagnosed with primary intraosseous odontogenic carcinoma with areas of benign fibro-osseous lesions. In both patients the lesions occurred in the anterior mandible and presented with clinical enlargement. The son underwent incisional biopsy and did not have additional treatment. His mother underwent extensive mandibulectomy due to widespread tumor. The son has two affected children with classic cherubism while a third child at age 5, had not shown any features of the disease. Mutation analysis of three affected members resulted in the identification of a heterozygous mutation in SH3BP2 (c.1244G>C; p.Arg415Pro). To the best of our knowledge, association of cherubism with odontogenic neoplastic lesions has hitherto not been reported in the literature, thus suggesting a relationship between cherubism with disturbed odontogenesis.
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Affiliation(s)
- Prokopios P Argyris
- Division of Oral and Maxillofacial Pathology, School of Dentistry, University of Minnesota, 515 Delaware Street SE 16-206B, Minneapolis, MN, 55455, USA
| | - Rajaram Gopalakrishnan
- Division of Oral and Maxillofacial Pathology, School of Dentistry, University of Minnesota, 515 Delaware Street SE 16-206B, Minneapolis, MN, 55455, USA
| | - Ying Hu
- Department of Reconstructive Sciences, University of Connecticut, Farmington, CT, USA
| | - Ernst J Reichenberger
- Department of Reconstructive Sciences, University of Connecticut, Farmington, CT, USA
| | - Ioannis G Koutlas
- Division of Oral and Maxillofacial Pathology, School of Dentistry, University of Minnesota, 515 Delaware Street SE 16-206B, Minneapolis, MN, 55455, USA.
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14
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Abstract
Cherubism is a rare hereditary developmental condition of the jaws and generally inherited as an autosomal dominant trait. It is also known as familial fibrous dysplasia of the jaws, familial multilocular cystic disease and hereditary fibrous dysplasia of the jaws. The gene for cherubism is mapped to chromosome 4p16.3 may lead to pathologic activation of osteoclasts and disruption of jaw morphogenesis. The lesion usually appears between 2 and 5 years shows a predilection for the mandible and causes a bilateral swelling giving rise to a cherubic chubby appearance. The eosinophilic cuffing of blood vessels appears to be specific for cherubism. The diagnosis is based on clinical, radiographic and histopathologic findings. The purpose of this article is to present a rare case of nonfamilial cherubism as there are very few cases reported and to review the literature with its cone beam computed tomography findings.
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Affiliation(s)
- Revati Deshmukh
- Department of Oral Pathology, Bharati Vidyapeeth Deemed University, Dental College and Hospital, Pune, Maharashtra, India
| | - Samir Joshi
- Department of Oral and Maxillofacial Surgery, Bharati Vidyapeeth Deemed University, Dental College and Hospital, Pune, Maharashtra, India
| | - Priya Nimish Deo
- Department of Oral Pathology, Bharati Vidyapeeth Deemed University, Dental College and Hospital, Pune, Maharashtra, India
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15
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Abstract
Cherubism is rarely described in the African paediatric population. Orphanet currently lists cherubism as a rare disease; its prevalence is unknown and difficult to determine because of the wide clinical spectrum. Approximately 300 cases have been reported in various ethnic groups worldwide. This report analyses a child referred to our hospital for bilateral jaw swelling, diagnosed with cherubism based on clinical and radiological findings, and confirmed on histology.
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16
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Ali IK, Karjodkar FR, Sansare K, Salve P, Dora AC. Non-Familial Cherubism with Bilateral Maxilla and Mandible Involvement - Clinicoradiographic Findings. Cureus 2016; 8:e709. [PMID: 27588230 PMCID: PMC4999156 DOI: 10.7759/cureus.709] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Cherubism is a self-limiting non-neoplastic autosomal dominant fibro-osseous syndrome of the jaws. It is occasionally manifested before the age of two years. It occurs in children and more often in boys. It is characterized by notable clinical bilateral swelling of the cheeks due to a bony enlargement of the jaws that impart a characteristic ‘cherubic’ look. Regression occurs in the course of puberty leaving a few facial deformities and malocclusion. Cherubism might occur in solitary cases or in several members of the family, often in many generations. The reported case is an example of solitary sporadic occurrence within a family, which is a rarely documented condition in the literature.
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Affiliation(s)
- Ibrahim K Ali
- Oral Medicine and Radiology, Nair Hospital Dental College
| | | | | | - Prashant Salve
- Oral Medicine and Radiology, Nair Hospital Dental College
| | - Amaresh C Dora
- Oral Medicine and Radiology, Nair Hospital Dental College
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17
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Abstract
Cherubism is an uncommon hereditary benign fibro-osseous disorder characterized by bilateral enlargement of the mandible and the maxilla that presents with varying degrees of involvement and a tendency toward spontaneous remission.The first visit was in 2002. A 16-year-old female was referred to an orthodontist for correction of her dental crowding. In the radiographic examination that was taken for her treatment the first time in 2002, a jaw bone lesion was discovered accidentally. X-ray panoramic imaging revealed well-defined multilocular radiolucencies involving the posterior body of the mandible and ascending rami with displaced teeth. This lesion had no effect on inferior alveolar canal and maxilla.There was no significant past medical history, and there was no family history suggestive of a similar complaint. On extraoral examination, there was no swelling in both rami of the mandible and face. Histopathological examination of the biopsy specimen showed proliferating fibrous connective tissue interspersed by multinucleated giant cells. It was diagnosed as a case nonfamilial cherubism. An extensive long-term follow-up till 12 years was maintained. In 2014, after 12-years follow-up for this lesion, panoramic imaging examination showed progress of this lesion in mandible and maxilla.
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Al-Omar AF, Moussa BG, El-Dakrory UAERM. Cherubism. EGYPTIAN JOURNAL OF ORAL & MAXILLOFACIAL SURGERY 2015; 6:62-65. [DOI: 10.1097/01.omx.0000462787.66530.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Degala S, Mahesh KP, Monalisha. Cherubism: a case report. J Maxillofac Oral Surg 2015; 14:258-62. [PMID: 25861190 DOI: 10.1007/s12663-013-0474-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Accepted: 01/14/2013] [Indexed: 11/28/2022] Open
Abstract
Cherubism is a benign, self-limiting fibro-osseous lesion characterized by bilateral symmetric painless expansion of jaw which is more prominent in mandible than in maxilla. Males are commonly affected (2:1) and with greater severity. It becomes noticeable in early childhood and gradually regresses after puberty. Although cherubism is considered as a familial/inherited disease but many sporadic cases have been reported in literature with no familial history. Osteoblastic and osteoclastic remodeling replaces normal bone by excessive amount of fibrovascular tissue containing multinucleated giant cells. Here, we present a case report of cherubism in a 10 year old boy describing the clinical, histological, biochemical and radiographic features.
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Affiliation(s)
- Saikrishna Degala
- Department of OMFS, JSS Dental College and Hospital, JSS University, Mysore, Karnataka India
| | - K P Mahesh
- Oral Medicine & Radiology, JSS University, Mysore, Karnataka India
| | - Monalisha
- Department of OMFS, JSS Dental College and Hospital, JSS University, Mysore, Karnataka India
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20
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Harmon M, Arrigan M, Toner M, O'Keeffe S. A radiological approach to benign and malignant lesions of the mandible. Clin Radiol 2015; 70:335-50. [DOI: 10.1016/j.crad.2014.10.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 10/08/2014] [Accepted: 10/22/2014] [Indexed: 12/22/2022]
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21
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Cherubizm u 9-letniej dziewczynki – opis przypadku i systematyczny przegląd piśmiennictwa. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.pepo.2014.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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22
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Hershkovitz I, Spigelman M, Sarig R, Lim DS, Lee IS, Oh CS, May H, Boaretto E, Kim YS, Lee SD, Peled N, Kim MJ, Toledano T, Bar-Gal GK, Shin DH. A possible case of cherubism in a 17th-century Korean mummy. PLoS One 2014; 9:e102441. [PMID: 25093864 PMCID: PMC4122385 DOI: 10.1371/journal.pone.0102441] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 05/26/2014] [Indexed: 11/18/2022] Open
Abstract
Cherubism is a benign fibro-osseous disease of childhood limited specifically to the maxilla and mandible. The progressive replacement of the jaw bones with expansile multilocular cystic lesions causes eventual prominence of the lower face, and hence the classic “cherubic” phenotype reflecting variable extents of jaw hypertrophy. Histologically, this condition has been characterized as replacement of the normal bone matrix with multicystic pockets of fibrous stroma and osteoclastic giant cells. Because of radiographic features common to both, primarily the presence of multiloculated lucencies with heterogeneous “ground-glass” sclerosis on CT imaging, cherubism was long mistaken for a craniofacial subtype of fibrous dysplasia. In 1999, however, the distinct genetic basis for cherubism was mapped to chromosome 4p16.3 and the SH-3 binding protein SH3BP2. But while there are already three suspected cases of fibrous dysplasia amongst archaeological populations, no definitive cases of cherubism have yet been reported in historical populations. In the current study we describe micro- and macro-structural changes in the face of a 17th century Joseon Dynasty Korean mummy which may coincide with the clinic-pathologic and radiologic features of cherubism.
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Affiliation(s)
- Israel Hershkovitz
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- * E-mail: (IH); (DHS)
| | - Mark Spigelman
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Rachel Sarig
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Do-Sun Lim
- Department of Dental Hygiene, Eulji University, Seongnam, Gyeonggi-do, Korea
| | - In Sun Lee
- Department of Diagnostic Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Chang Seok Oh
- Department of Anatomy, Seoul National University College of Medicine, Seoul, Korea
- Institute of Forensic Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hila May
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Elisabetta Boaretto
- D-REAMS Radiocarbon Dating Laboratory, Weizmann Institute of Science, Rehovot, Israel
| | - Yi-Suk Kim
- Department of Anatomy, Ewha Womans University School of Medicine, Seoul, Korea
| | - Soong Deok Lee
- Institute of Forensic Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Forensic Science, Seoul National University College of Medicine, Seoul, Korea
| | - Nathan Peled
- Department of Radiology, Carmel Medical Center, Haifa, Israel
| | - Myeung Ju Kim
- Department of Anatomy, Dankook University College of Medicine, Yongin-si, Gyeonggi-do, Korea
| | - Talya Toledano
- Department of Radiology, Maimonides Medical Center, Brooklyn, New York, United States of America
| | - Gila Kahila Bar-Gal
- Department of Virology, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - Dong Hoon Shin
- Department of Anatomy, Seoul National University College of Medicine, Seoul, Korea
- Institute of Forensic Medicine, Seoul National University College of Medicine, Seoul, Korea
- * E-mail: (IH); (DHS)
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Agrawal A, Gupta SK, Saxena P, Kumar P. Non-familial cherubism: clinical and radiological findings. BMJ Case Rep 2014; 2014:bcr-2013-202031. [PMID: 24695657 DOI: 10.1136/bcr-2013-202031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Cherubism is a rare, self-limiting, usually hereditary, benign fibro-osseous disease mostly affecting the jaws of the paediatric population. The disease is characterised by bilateral, diffuse and multilocular bony enlargement of the mandible and maxilla, and a tendency towards spontaneous remission. It has a typical radiographic and histopathological appearance. We present a case of a 9-year-old child lacking family history of this genetic disorder.
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Affiliation(s)
- Anuradha Agrawal
- Department of Pediatric Dentistry, Government Dental College, Indore, Madhya Pradesh, India
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Sangu N, Shimosato T, Inoda H, Shimada S, Shimojima K, Ando T, Yamamoto T. Novel nucleotide mutation leading to a recurrent amino acid alteration in SH3BP2 in a patient with cherubism. Congenit Anom (Kyoto) 2013; 53:166-9. [PMID: 24712477 DOI: 10.1111/cga.12013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Accepted: 01/25/2013] [Indexed: 11/30/2022]
Abstract
Cherubism is a rare genetic disorder characterized by progressive facial deformity caused by non-neoplastic bone lesions in the mandible and/or the maxilla. Src homology-3 binding protein 2 gene (SH3BP2) has been found to be the responsible gene, with alterations in six amino acids noted in patients with this condition. Recently, mutations in this domain have been found to cause stabilization of SH3BP2 by uncoupling with tankyrase. In this study, we identified a new 2-bp mutation that led to a recurrent amino acid change in a sporadic case of cherubism. Our findings indicate that it is important to understand the pattern of progress in typical cherubism.
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Affiliation(s)
- Noriko Sangu
- Department of Oral and Maxillofacial Surgery, School of Medicine, Tokyo Women's Medical University, Tokyo; Institute for Integrated Medical Sciences, Tokyo Women's Medical University, Tokyo
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Tsodoulos S, Ilia A, Antoniades K, Angelopoulos C. Cherubism: a case report of a three-generation inheritance and literature review. J Oral Maxillofac Surg 2013; 72:405.e1-9. [PMID: 24280174 DOI: 10.1016/j.joms.2013.10.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2013] [Revised: 10/02/2013] [Accepted: 10/04/2013] [Indexed: 11/15/2022]
Abstract
Cherubism is a rare, non-neoplastic pathologic entity first described by Jones in 1933. It affects mostly younger individuals and is usually inherited. Cherubism presents as a painless jaw enlargement that affects both the maxilla and the mandible and is characterized by replacement of the osseous tissue by fibrous connective tissue. Radiologically, the lesions appear as multiple, multilocular radiolucent spaces with distinct borders divided by bony septations, which often dramatically alter the shape and size of the jaw structures. These often result in marked facial abnormalities. Cervical lymphadenopathy is not uncommon in those affected. The disease is self-limited and can reverse itself with time. Approximately 250 cases have been reported in published studies, mostly affecting males. The purpose of our report was to present a case of cherubism diagnosed in a young girl and the long-term (3 generations) follow-up evaluation of her mother and grandmother, both of whom had been diagnosed with the same pathologic entity.
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Affiliation(s)
- Spyridon Tsodoulos
- Associate Professor, Department of Oral and Maxillofacial Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anastasia Ilia
- Dentist, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Konstantinos Antoniades
- Professor, Department of Oral and Maxillofacial Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christos Angelopoulos
- Consultant, Department of Maxillofacial Radiology, Bronx Veterans Affairs Hospital, Bronx, NY
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26
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Redfors M, Jensen JL, Storhaug K, Prescott T, Larheim TA. Cherubism: panoramic and CT features in adults. Dentomaxillofac Radiol 2013; 42:20130034. [PMID: 24048692 DOI: 10.1259/dmfr.20130034] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To describe the panoramic radiographic and CT features of cherubism in an unselected series of 15 adults. METHODS In this cross-sectional study, 15 individuals aged 29-84 years with familial non-syndromal molecularly confirmed cherubism were examined with panoramic radiography and CT. Bone abnormalities were analysed and described. RESULTS 11 (73%) of the 15 adults had mandibular abnormalities. These abnormalities ranged from subtly detectable to severe, and were less prevalent and expansive but could be rather similar to the characteristic image features in children. Unilocular radiolucencies were more common than multilocular radiolucencies, and a specific feature of these abnormalities was that they were exclusively found in the anterior mandible. CONCLUSIONS The radiographic and CT abnormalities of cherubism in adults were frequent and extremely heterogeneous, with some distinct features.
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Affiliation(s)
- M Redfors
- Department of Maxillofacial Radiology, Faculty of Dentistry, University of Oslo, Blindern, Oslo, Norway
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27
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Wagel J, Luczak K, Hendrich B, Guziński M, Sąsiadek M. Clinical and radiological features of nonfamilial cherubism: A case report. Pol J Radiol 2012; 77:53-7. [PMID: 23049582 PMCID: PMC3447434 DOI: 10.12659/pjr.883375] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Accepted: 05/24/2012] [Indexed: 12/13/2022] Open
Abstract
Background: Cherubism is an uncommon hereditary benign fibro-osseous disorder characterized by bilateral enlargement of the mandible and the maxilla that presents with varying degrees of involvement and a tendency toward spontaneous remission. On radiography cherubic lesions appear as cystic multilocular radiolucencies limited to the jaw bones. Case Report: A 5-year-old boy was referred to the Department of Maxillo-Facial Surgery due to deformation of the lower and middle section of the face and displacement or absence of teeth. A panoramic radiograph and a computed tomography revealed extensive multilocular, bilateral radiolucent areas and marked bony expansion in the mandible and maxilla, with sparing of the mandibular condyles. Histopathological evaluation of an incisional biopsy of the left maxilla and genotypic characterization confirmed the diagnosis of cherubism. Conclusions: The radiologic characteristics of cherubism are not pathognomonic but the diagnosis is strongly suggested by bilateral relatively symmetric jaw involvement that is limited to the jaw bones and, together with clinical and histopathologic findings, enables the diagnosis of cherubism. Genotypic characterization confirms the diagnosis.
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Affiliation(s)
- Justyna Wagel
- Department of General and Interventional Radiology and Neuroradiology, Wrocław Medical University, Wrocław, Poland
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28
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Kau CH, Souccar NM, English JD, Kamel SG, Wong ME. The surgical and orthodontic management of cherubism in a growing child. J Craniomaxillofac Surg 2012; 40:229-33. [DOI: 10.1016/j.jcms.2011.04.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Revised: 03/07/2011] [Accepted: 04/27/2011] [Indexed: 11/28/2022] Open
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29
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Bhatnagar D, Gnanasundaram N, Kaur A. Cherubism—a case report with review. Indian J Dent 2011. [DOI: 10.1016/s0975-962x(11)60012-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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30
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Razek AAKA. Imaging appearance of bone tumors of the maxillofacial region. World J Radiol 2011; 3:125-34. [PMID: 21666818 PMCID: PMC3110914 DOI: 10.4329/wjr.v3.i5.125] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2010] [Revised: 04/25/2011] [Accepted: 05/02/2011] [Indexed: 02/06/2023] Open
Abstract
This paper reviews the imaging appearance of benign and malignant bone tumors of the maxillofacial region. A benign bone tumor commonly appears as a well circumscribed lesion. The matrix of the tumor may be calcified or sclerotic. Malignancies often display aggressive characteristics such as cortical breakthrough, bone destruction, a permeative pattern and associated soft-tissue masses. Computed tomography scan is an excellent imaging modality for accurate localization of the lesion, characterization of the tumor matrix and detection of associated osseous changes such as bone remodeling, destruction or periosteal reaction. Magnetic resonance imaging is of limited value in the evaluation of maxillofacial bone tumors.
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31
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Gadodia A, Seith A, Sharma R, Choudhury AR, Bhutia O, Gupta A. Multidetector computed tomography of jaw lesions in children and adolescents. J Med Imaging Radiat Oncol 2010; 54:111-9. [PMID: 20518873 DOI: 10.1111/j.1754-9485.2010.02148.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Jaw lesions in paediatric and adolescent population are uncommon and can arise in odontogenic or non-odontogenic tissues. With the advent of multidetector computed tomography (MDCT), algorithm for imaging jaw lesions has changed dramatically. This pictorial essay describes the imaging appearance of commonly encountered jaw lesions in children and adolescents with emphasis on MDCT findings.
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Affiliation(s)
- A Gadodia
- Department of Radio-diagnosis, All India Institute of Medical Sciences, New Delhi, India
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Suhanya J, Aggarwal C, Mohideen K, Jayachandran S, Ponniah I. Cherubism combined with epilepsy, mental retardation and gingival fibromatosis (Ramon syndrome): a case report. Head Neck Pathol 2010; 4:126-31. [PMID: 20512637 PMCID: PMC2878617 DOI: 10.1007/s12105-009-0155-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2009] [Accepted: 11/19/2009] [Indexed: 12/13/2022]
Abstract
Cherubism is an inherited, autosomal dominant disorder that characteristically affects the jaws of children. The disease typically manifest as a bilateral swelling with associated submandibular lymph node enlargements and usually regresses as age advances. The disease is microscopically indistinguishable from other giant cell lesions and is essentially a clinical diagnosis. The association of cherubism with gingival fibromatosis, epilepsy, mental retardation, stunted growth, and hypertrichosis is referred as Ramon syndrome. We report a case of Ramon syndrome in an 8 year old girl.
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Affiliation(s)
- J. Suhanya
- Department of Oral Medicine and Radiology, Tamil Nadu Government Dental College and Hospital, Chennai, 600 003 India
| | - Chakshu Aggarwal
- Department of Oral and Maxillofacial Pathology, Tamil Nadu Government Dental College and Hospital, Chennai, 600 003 India
| | - Khadijah Mohideen
- Department of Oral and Maxillofacial Pathology, Tamil Nadu Government Dental College and Hospital, Chennai, 600 003 India
| | - S. Jayachandran
- Department of Oral Medicine and Radiology, Tamil Nadu Government Dental College and Hospital, Chennai, 600 003 India
| | - I. Ponniah
- Department of Oral and Maxillofacial Pathology, Tamil Nadu Government Dental College and Hospital, Chennai, 600 003 India
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Lima GDMG, Almeida JD, Cabral LAG. Cherubism: clinicoradiographic features and treatment. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2010; 1:e2. [PMID: 24421967 PMCID: PMC3886048 DOI: 10.5037/jomr.2010.1202] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2010] [Accepted: 03/15/2010] [Indexed: 11/19/2022]
Abstract
Objectives Cherubism is a congenital childhood disease of autosomal dominant
inheritance. This disease is characterized by painless bilateral
enlargement of the jaws, in which bone is replaced with fibrous tissue.
The condition has sui generis clinical, radiographic and
histological features, of which the clinician should be aware for a
better differential diagnosis in the presence of a fibro-osseous lesion
affecting the bones of the maxillomandibular complex. The purpose of
present paper was to review the literature and to report the most
important aspects of cherubism in order to facilitate the study of this
disease Material and Methods Literature was reviewed about cherubism, emphasizing the relevant
clinicoradiographic features and treatment. Literature was selected
through a search of PubMed and Scielo electronic databases. The keywords
used for search were adolescent, cherubism, cherubism/physiopathology,
cherubism/treatment, cherubism/radiography. A manual search of the
reference lists of the identified articles and the authors' article
files and recent reviews was conducted to identify additional
publications. Those studies that described new features about cherubism
were included in this review. Results In total 44 literature sources were obtained and reviewed. Studies that
described new features about cherubism physiopathology, diagnostics and
treatment were reviewed. Conclusions Despite the exceptions, cherubism is a clinically well-characterized
disease. In cases of a suspicion of cherubism, radiographic examination
is essential since the clinical presentation, the location and
distribution of the lesions may define the diagnosis. Histopathological
examination is complementary. Nowadays, genetic tests should be used for
final diagnosis of cherubism.
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Affiliation(s)
- Gabriela de Morais Gouvêa Lima
- Postgraduation Program in Oral Biopathology, São José dos Campos Dental School, São Paulo State University - UNESP, São José dos Campos, São Paulo Brazil
| | - Janete Dias Almeida
- Postgraduation Program in Oral Biopathology, São José dos Campos Dental School, São Paulo State University - UNESP, São José dos Campos, São Paulo Brazil
| | - Luiz Antonio Guimarães Cabral
- Department of Biosciences and Oral Diagnosis, São José dos Campos Dental School, São Paulo State University - UNESP, São José dos Campos, São Paulo Brazil
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Roginsky VV, Ivanov AL, Ovtchinnikov IA, Khonsari RH. Familial cherubism: the experience of the Moscow Central Institute for Stomatology and Maxillo-Facial Surgery. Int J Oral Maxillofac Surg 2008; 38:218-23. [PMID: 19038533 DOI: 10.1016/j.ijom.2008.10.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2007] [Revised: 07/06/2008] [Accepted: 10/28/2008] [Indexed: 11/18/2022]
Abstract
The Central Institute for Stomatology and Maxillo-facial Surgery in Moscow is one the main centers for the treatment of pediatric head and neck tumors in the territory of the former Soviet Union. A series of 33 patients presenting with cherubism (24 children and 9 of their parents) is presented. The authors discuss the atypical clinical presentations, the relevant associated anomalies and the different treatment strategies. They report the first case of cherubism associated with gingival hypertrophy without neurological signs.
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Affiliation(s)
- V V Roginsky
- Central Institute for Stomatology and Maxillo-Facial Surgery, Moscow, Russia
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35
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Chung EM, Murphey MD, Specht CS, Cube R, Smirniotopoulos J. From the Archives of the AFIP Pediatric Orbit Tumors and Tumorlike Lesions: Osseous Lesions of the Orbit. Radiographics 2008; 28:1193-214. [DOI: 10.1148/rg.284085013] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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36
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Jain V, Sharma R. Radiographic, CT and MRI features of cherubism. Pediatr Radiol 2006; 36:1099-104. [PMID: 16847596 DOI: 10.1007/s00247-006-0261-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2006] [Revised: 05/01/2006] [Accepted: 05/09/2006] [Indexed: 10/24/2022]
Abstract
Cherubism is a paediatric disease affecting the jaws. It is a close radiological mimic of giant cell lesions of the mandible. The radiographic features of this condition are well known; however, the MR imaging features have not been well described. We describe the radiographic, CT and MR imaging features of cherubism in a 5-year-old girl. We highlight the MR appearances of cherubic lesions and the ability of MRI to not only accurately depict the anatomical extent of the lesions, but also to reveal signal intensity changes in those areas that are apparently normal on radiographs and CT images.
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Affiliation(s)
- Vaibhav Jain
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, 110009, India
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37
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Martínez-Tello FJ, Manjón-Luengo P, Martin-Pérez M, Montes-Moreno S. Cherubism associated with neurofibromatosis type 1, and multiple osteolytic lesions of both femurs: a previously undescribed association of findings. Skeletal Radiol 2005; 34:793-8. [PMID: 16096755 DOI: 10.1007/s00256-005-0938-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2005] [Revised: 03/30/2005] [Accepted: 03/31/2005] [Indexed: 02/08/2023]
Abstract
We present a patient with neurofibromatosis type 1, with the clinical, radiological and histological features of cherubism mandibular lesions, and multiple osteolytic, geographic lesions in both femurs, consistent with multiple non-ossifying fibromas. We have been unable to find a similar case in the world literature. We discuss our findings in relationship with a number of syndromes that present clinical, radiological or pathological similarities.
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Affiliation(s)
- Francisco J Martínez-Tello
- Departamento de Anatomía Patológica, Hospital Universitario "12 de Octubre", Carretera de Andalucía Km. 5400, 28041, Madrid, Spain.
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38
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Wang CN, Song YL, Peng B, Lu DH, Fan MW, Li J, Ye XQ, Fan HL, Bian Z. The aggressive form of cherubism: report of two cases in unrelated families. Br J Oral Maxillofac Surg 2005; 44:322-4. [PMID: 16310907 DOI: 10.1016/j.bjoms.2005.10.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2005] [Accepted: 10/13/2005] [Indexed: 11/21/2022]
Abstract
Cherubism is a benign lesion that causes painless symmetrical enlargement of the jaws, usually with a familial tendency. We describe in two Chinese families two cases of the aggressive form of cherubism with extensive swelling on both sides of the mandible, typical microscopic findings, and apparent familial history.
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Affiliation(s)
- C N Wang
- Key Lab. for Oral Biomedical Engineering of Ministry of Education, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan 430079, PR China
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