Aksis’in dev hücreli reperatif granüloması

Giant cell reparative granuloma (GCRG) is a rare, benign fibroosseous lession. It typically arises in the mandible and maxilla, and less frequently in the skull bones. We report a case of GCRG of the axis, which is the first to be reported in the literature. A 35-year-old man was admitted to our clinic with the complaint of pain at his neck. There was no neurological deficit. CT and MRI showed a lesion destructing the body of the axis. Biopsy specimens were taken through the transoral-transpharyngeal route. Histopathological diagnosis was GCRG. The lesion was removed subtotally by the same route. We filled the tumor cavity with a bone graft and the patient was discharged with a halo brace without any neurological deficits. The follow-up CT revealed one year after the surgery showed sclerosis at the tumor site. The etiopathogenesis of GCRG is still controversial and the differential diagnosis, especially from giant cell tumor of bone is quite difficult. The treatment of choice for these lesions is complete surgical removal. Some authors recommend radiotherapy if total removal fails.

Özet

Dev hücreli reparatif granüloma (DHRG) nadir görülen iyi huylu fibroosseoz bir lezyondur. Tipik olarak mandibula ve maksillada daha az sıklıkta ise kafa kemiklerinde görülür. Biz literatürde ilk defa aksisin DHRG sini bildiriyoruz. 35 yaşında erkek hasta kliniğimize boyun ağrısı şikayeti ile geldi. Nörolojik defisiti yoktu. CT ve MR da axis cimini destrükte eden lezyon saptandı. Transoraltransfaringeal yol ile alınan biopsi sonucu DHRG olarak saptandı. Lezyon aynı yaklaşım kullanılarak subtotal eksize edildi. Tümör kavitesi kemik greft ile dolduruldu ve hasta nörolojik defisiti olmadan halo ortez ile taburcu edildi. 1 yıl sonra çekilen kontrol CT de tümör bölgesinde skleroz gözlendi. DHRG nin etyopatogenezi hala tartışmalıdır ve özellikle kemiğin dev hücreli tümöründen ayırıcı tanısı oldukça zordur. Tedavi yaklaşımı lezyonun total cerrahi eksizyonudur. Bazı otörler total eksizyonun yapılamadığı durumlarda radyoterapi önermektedir

🔖

Cite This Article

BAYAR, M. A., ERDEM, Y., GÖKÇEK, C., KÖKTEKİR, E., KILIÇ, C., YAŞITLI, U., TEKİNER, A. (2009). Aksis’in dev hücreli reperatif granüloması. Turkish Neurosurgery, Cilt: 19 - Sayı: 4, 423–427. https://ajindex.com/articles/405170

📄 Full Text PDF Viewer

Open in New Tab ↗

↗New Tab

📄

PDF görüntüleyici hazırlanıyor...

References (1)

Alappat JP, Pillai AM, Prasanna D: Giant cell reparative granuloma of the cranio facial complex: Case report and review literature. Brt J Neurosurg 6: 71-74, 1992 2. Auclair P, Cuenin P, Kratochvil FJ, Slater LJ: Clinical and histomorphologic comparison of the central giant cell granuloma and the giant cell tumor. Oral Surg 66: 197-208, 1988 3. Bertoni F, Unni KK, Beabut JW, Ebersold MJ: Giant cell tumor of the skull. Cancer 70: 1124-1132, 1992 4. Ciappetta P, Salvati M, Bernardi C, Raco A, Di Lorenzo N: Giant cell reparative granuloma of the skull base mimicking an intracranial tumor. Case report and review of the literature. Surg Neurol 33:52-56, 1990 5. Felsberg GJ, Tien RD, Mc Lendon RE: Frontoethmoidal giant cell reparative granuloma. AJNR 16: 1551-1554, 1995 6. Garza-Mercado R, Cavasos E, Hernandez-Batres F: Giant cell reparative granuloma of the cranial vault: Exceptional bone lesion. Neurosurgery 15: 228-232, 1984 7. Hirschl S, Katz A: Giant cell reparative granuloma outside the jaw bone: diagnostic criteria and review of the literature with the first case described in the temporal bone. Hum Pathol 5: 171-181, 1974 8. Hutter RVP, Worcester JN, Francis KC, Foote FW Jr, Stewart FW: Benign and malignant giant cell tumors of bone. A clinicopathological analysis of the natural history of the disease. Cancer 15: 653-690, 1962 9. Inoue H, Tsuneyoshi M, Enjoji M, Shinohara N, Yokoyama K: Giant cell reparative granuloma of the thoracic vertebra. Acta Pathol Jpn May, 36(5):745-750, 1986 10. Jaffe HL, Lichenstein L, Pertis RB: Giant cell tumor of bone: Its pathologic appearance, grading, supposed variants and treatment. Arc Pathol 30: 993-1031, 1940 11. Jaffe HL: Giant cell reparative granuloma, traumatic bone cyst, and fibrous (fibro-osseous) dysplasia of the jawbones. Oral Surg 61: 159-175, 1953 12. Katz A, Hirschl S: Giant cell reparative granuloma in the temporal bone. Arch Otolaryngol 100: 380-382, 1974 13. Mauruno M, Yoshimine T, Kubo T, Hayakawa T: A case giant cell reparative granuloma of the petrous bone: Demonstration of the proliferative component. Surg Neurol 48: 64-68, 1997 14. Neivaser JS, Esenberger SH: Giant cell reparative granuloma of the cervical spine: Case Report. Bull Hosp Joint Dis. 1954 15(1):73-78, 1954 15. Sato K, Sugiura H, Yamamura S, Takahashi M, Nagasaka T, Fukatsu T: Solid variant of an aneurysmal bone cyst (Giant cell reparative granuloma) of the 3rd lumbar vertebra. Nagoya J Med Sci. 59(3-4):159-165, 1996 16. Som PM, Lawson