RESUMEN
Giant cell granuloma is a benign lesion that generally involves the mandible and maxilla. It may be locally aggressive and result in extensive tissue destruction in advanced cases. A retrospective analysis of giant cell granuloma during the interval 1970 to 1990 revealed 18 cases of advanced disease, as defined by bone destruction and a greatest dimension of 2.0 cm or more. Epidemiologic factors, physical findings, imaging studies, pathologic specimens, treatment modalities, and outcome were reviewed for each case. Eight lesions were treated by local excision and curettage, and 10 were treated by partial mandibulectomy. Five mandibular defects were reconstructed with iliac bone grafts and one with a free flap. Only one patient with maxillary giant cell granuloma who underwent curettage had regrowth of what is suspected to have been residual disease. Individualized treatment, tailoring the extent of resection to the extent of disease, provided excellent results.
Asunto(s)
Granuloma de Células Gigantes , Enfermedades Mandibulares , Enfermedades Maxilares , Adolescente , Adulto , Anciano , Trasplante Óseo , Niño , Preescolar , Legrado , Femenino , Estudios de Seguimiento , Granuloma de Células Gigantes/clasificación , Granuloma de Células Gigantes/diagnóstico , Granuloma de Células Gigantes/epidemiología , Granuloma de Células Gigantes/terapia , Humanos , Masculino , Enfermedades Mandibulares/clasificación , Enfermedades Mandibulares/diagnóstico , Enfermedades Mandibulares/epidemiología , Enfermedades Mandibulares/terapia , Enfermedades Maxilares/clasificación , Enfermedades Maxilares/diagnóstico , Enfermedades Maxilares/epidemiología , Enfermedades Maxilares/terapia , Persona de Mediana Edad , Pronóstico , Recurrencia , Índice de Severidad de la Enfermedad , Colgajos Quirúrgicos , Resultado del TratamientoRESUMEN
Acoustic neuromas account for 75 to 80 percent of cerebellopontine angle tumors and 8 to 10 percent of all intracranial neoplasms. These tumors arise from the Schwann cell sheath that surrounds the peripheral portion of the facial, cochlear, superior, and inferior vestibular nerves. Theoretically, a schwannoma may arise from Schwann cells anywhere along these nerves from the glial-Schwann cell junction to the end organ. Clinically, however, they most frequently originate from the vestibular nerves, occasionally from the facial, and only rarely from the cochlear nerve. This investigation utilized light microscopy, immunochemistry, and digital optical morphologic analysis to determine the distribution of Schwann cells along the facial and vestibulocochlear nerves in an attempt to explain the observed distribution of tumors, and to evaluate currently accepted theories. No direct correlation between the distribution of Schwann cells and the observed distribution of schwannomas was found. Thus, this study did not confirm the currently held theories regarding schwannoma distribution in these nerves.