下顎骨関節突起に発生した好酸球肉芽腫の一例

概要

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Many patients with temporomandibular joint dysfunctions can be seen, however, lesions with organic changes in the condyle which involve chiefly benign tumor and hyperplasia, are relatively unusual. Particularly eosinophilic granuloma of the mandibular condyle is very rare. Clinical diagnosis of the lesions in the mandibular condyle is difficult, as radiography of symptomatic areas is the only effective technique.<BR>In the present case, radiographically poorly demarcated bone defect appeared to involve the entire condyle. Computed tomographic radiography and scintigraphic examination revealed that the lesion was localized in the condyle. At that stage, a defined diagnosis was not made, but the following tentative opinions were ventured: osteomyelitis, eosinophilic granuloma, giant cell granuloma, Ewing's tumor and osteosarcoma. Biopsy under local anesthesia was performed. As eosinophilic granuloma was mostly suspected on histological examination of an immediate frozen-section, the lesion was curetted as much as possible.<BR>Excision or irradiation are the mainstream of therapy. In the present case, conservative surgical removal was effective. Postoperatively, the temporomandibular joint dysfunction disappeared and the course was favorable.
社団法人日本口腔外科学会の論文