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The aggressive form of cherubism: Report of two cases in unrelated families

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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.

Introduction

Cherubism is a rare, non-neoplastic lesion that causes painless symmetrical enlargement of the jaws, usually with a family history.1 The clinical appearance varies from nearly indiscernible swelling of a single jaw to gross enlargement of both jaws.2 We describe two cases of cherubism in an unusually aggressive and extensive form and an apparent family history in two unrelated Chinese families.

Section snippets

Case 1

A 10-year-old girl was referred with bilateral overgrowth of the mandible in November 2000. The mandibular swelling appeared at the age of 7 years and expanded rapidly at the age of 9. An investigation of the family history showed that three members had been affected with the disorder in three generations. The child's grandfather had curettage twice when he was 28 and 32 years old, because of enlargement of the mandible. Two masses in the maxilla and mandible were excised in the girl's father

Case 2

A 33-year-old man was referred with an enlarged mandible in October 2003. The lesion was first noticed at age 18 and grew rapidly over the next 5 years. He was one of seven siblings; a 31-year-old sister had the same disorder when she was 16 years old, and the mandible was excised and replaced by autotransplanted rib at the age of 20. The patient's father had expansion of the mandible when he was 17 years old, which progressively extended to a huge size over several years and remained untreated

Discussion

Jones first reported cherubism in 1933, and described it as “familiar multilocular cystic disease of the jaws” based on its radiographic appearance.3 Whitaker et al. differentiated giant cell granulomas into aggressive and nonaggressive types, and the cases presented here can be regarded as aggressive.4, 5

Cherubism usually arises around ages 2–4, is most active between the ages of 3 and 7 years, often enlarges progressively until puberty, and then gradually regresses.6 Some cases have been

Acknowledgements

This study was supported by grant no. 30271415 from the National Science Foundation of China and grant no. 2004ABC004 from Innovative Research Team of Hubei province.

References (10)

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Both authors contributed equally to the work.

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