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Jung KW, Yun JM, Lee JM, Choi IS. Sinonasal Manifestations of Severe Cherubism: A Case with 11-year Follow-up. EAR, NOSE & THROAT JOURNAL 2022:1455613221127588. [PMID: 36369646 DOI: 10.1177/01455613221127588] [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: 12/22/2023] Open
Abstract
Cherubism, a type of fibroosteodysplasia, is a rare hereditary disease that causes variable degrees of facial deformity in children. Hypertrophy of the mandible is the most common symptom, but in severe cases, the disease affects the eyes, teeth, and sinonasal cavity. There have been few reports regarding sinonasal complications and no standard treatment has been established. This paper reports long-term treatment of severe cherubism that invaded the sinonasal cavity treated with consecutive endoscopic sinonasal surgeries.
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Affiliation(s)
- Keun-Woo Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, Ilsan Paik hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Ji Min Yun
- Department of Otorhinolaryngology-Head and Neck Surgery, Ilsan Paik hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Jeon Mi Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Ilsan Paik hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Ick Soo Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Ilsan Paik hospital, Inje University College of Medicine, Goyang, Republic of Korea
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2
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Cherubism in two siblings; a case report. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2022. [DOI: 10.1016/j.adoms.2022.100318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Sharma T, Cotney J, Singh V, Sanjay A, Reichenberger EJ, Ueki Y, Maye P. Investigating global gene expression changes in a murine model of cherubism. Bone 2020; 135:115315. [PMID: 32165349 PMCID: PMC7305689 DOI: 10.1016/j.bone.2020.115315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 02/25/2020] [Accepted: 03/08/2020] [Indexed: 11/22/2022]
Abstract
Cherubism is a rare genetic disorder caused primarily by mutations in SH3BP2 resulting in excessive bone resorption and fibrous tissue overgrowth in the lower portions of the face. Bone marrow derived cell cultures derived from a murine model of cherubism display poor osteogenesis and spontaneous osteoclast formation. To develop a deeper understanding for the potential underlying mechanisms contributing to these phenotypes in mice, we compared global gene expression changes in hematopoietic and mesenchymal cell populations between cherubism and wild type mice. In the hematopoietic population, not surprisingly, upregulated genes were significantly enriched for functions related to osteoclastogenesis. However, these upregulated genes were also significantly enriched for functions associated with inflammation including arachidonic acid/prostaglandin signaling, regulators of coagulation and autoinflammation, extracellular matrix remodeling, and chemokine expression. In the mesenchymal population, we observed down regulation of osteoblast and adventitial reticular cell marker genes. Regulators of BMP and Wnt pathway associated genes showed numerous changes in gene expression, likely implicating the down regulation of BMP signaling and possibly the activation of certain Wnt pathways. Analyses of the cherubism derived mesenchymal population also revealed interesting changes in gene expression related to inflammation including the expression of distinct granzymes, chemokines, and sulfotransferases. These studies reveal complex changes in gene expression elicited from a cherubic mutation in Sh3bp2 that are informative to the mechanisms responding to inflammatory stimuli and repressing osteogenesis. The outcomes of this work are likely to have relevance not only to cherubism, but other inflammatory conditions impacting the skeleton.
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Affiliation(s)
- Tulika Sharma
- Department of Reconstructive Sciences, School of Dental Medicine, University of Connecticut Health, United States of America
| | - Justin Cotney
- Department of Genetics and Genome Sciences, University of Connecticut Health, United States of America
| | - Vijender Singh
- Computational Biology Core, Institute for Systems Genomics, University of Connecticut, United States of America
| | - Archana Sanjay
- Department of Orthopedic Surgery, University of Connecticut Health, United States of America
| | - Ernst J Reichenberger
- Department of Reconstructive Sciences, School of Dental Medicine, University of Connecticut Health, United States of America
| | - Yasuyoshi Ueki
- Department of Biomedical Sciences and Comprehensive Care, Indiana University, United States of America
| | - Peter Maye
- Department of Reconstructive Sciences, School of Dental Medicine, University of Connecticut Health, United States of America.
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Deconte D, Correia EPE, Haubert G, de Souza V, Correia JD, Maahs MAP, Zen PRG, Fiegenbaum M, Rosa RFM. Unusual Characteristics and Variable Expressivity in a Brazilian Family with Cherubism. J Pediatr Genet 2020; 10:63-69. [PMID: 33552642 DOI: 10.1055/s-0040-1705095] [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: 12/31/2019] [Accepted: 01/23/2020] [Indexed: 10/24/2022]
Abstract
Cherubism is a rare genetic condition characterized by a bone nonneoplastic disease. We aimed to report a 6-year-old girl with cherubism presenting similar cases in the maternal family. However, her mother and grandmother seemed to be asymptomatic. The patient had an enlarged and asymmetric jaw with multiple enlarged cervical lymph nodes that increased in size with time. Sanger sequencing revealed a heterozygous mutation in exon 9 of SH3BP2 not only in the patient but also in her mother. Thus, we observed a variable expression and a probably reduced penetrance within the family, as well as unusual characteristics of the patient (in this case, the asymmetrical involvement of the jaw).
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Affiliation(s)
- Desirée Deconte
- Graduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | | | - Géssica Haubert
- Graduation in Medicine, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Vinicius de Souza
- Graduation in Medicine, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Jamile Dutra Correia
- Graduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Marcia Angelica Peter Maahs
- Department of Speech Language Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Paulo Ricardo Gazzola Zen
- Graduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil.,Department of Clinical Medicine, Clinical Genetics, Universidade Federal de Ciências da Saúde de Porto Alegre and Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil
| | - Marilu Fiegenbaum
- Graduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil.,Department of Basic Health Sciences, Human Genetics, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Rafael Fabiano Machado Rosa
- Graduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil.,Department of Clinical Medicine, Clinical Genetics, Universidade Federal de Ciências da Saúde de Porto Alegre and Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil
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5
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Tekin AF, Ünal ÖF, Göksel S, Özcan İ. Clinical and radiological evaluation of cherubism: A rare case report. Radiol Case Rep 2020; 15:416-419. [PMID: 32071662 PMCID: PMC7016153 DOI: 10.1016/j.radcr.2020.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 01/07/2020] [Accepted: 01/07/2020] [Indexed: 11/25/2022] Open
Abstract
Cherubism is a rare, non-neoplastic, genetic disorder, characterized by painless bilateral swelling of the jaws. A 5-year-old girl presented with a painless, bilateral symmetrical swelling of both mandible and maxilla. Intraoral examination revealed malocclusion with displacement of teeth and expansion of the alveolar ridges. There was a bilateral expansion of the jaws. In conclusion, cherubism is a genetic disorder that has non-neoplastic bone lesions that affect the jaws. If there is a functional or esthetic problem, it should be treated surgically. The surgical treatment is usually delayed until after puberty.
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Affiliation(s)
- Ali Fuat Tekin
- Department of Radiology, Konya Training and Research Hospital, Konya, Turkey
| | - Ömer Faruk Ünal
- Department of Radiology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Sevde Göksel
- Department of Oral and Maxillofacial Radiology, Istanbul University Faculty of Dentistry, Istanbul, Turkey
| | - İlknur Özcan
- Department of Oral and Maxillofacial Radiology, Istanbul University Faculty of Dentistry, Istanbul, Turkey
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6
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Clinicoradiologic follow up of cherubism with aggressive characteristics: a series of 3 cases. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128:e191-e201. [DOI: 10.1016/j.oooo.2019.01.082] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 01/17/2019] [Accepted: 01/27/2019] [Indexed: 11/18/2022]
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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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Son JH, Marshall DC, Valiathan M, Otteson T, Ferretti G, Grigorian PA, Rosen C, Becker D, Rowe D, Soltanian H, Lakin G. Innovative Surgical Treatment of Severe Cherubism. Cleft Palate Craniofac J 2018; 56:90-93. [DOI: 10.1177/1055665618774008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Cherubism is an autosomal dominant syndrome characterized by excessive bilateral maxillomandibular bony degeneration and fibrous tissue hyperplasia. Conservative management is the preferred treatment as cherubism has a self-limiting course. Functional or emotional disturbances may, however, demand surgical intervention. We report a patient who underwent surgical intervention. Method/Description: He had significant enlargement of lower cheeks and bilateral lower lid scleral show. On computed tomography of the face, the patient had significant fibrous tissue involving bilateral maxilla and mandible. The mandibular tumor was excised. Given normal inferior border, bilateral sagittal split osteotomy was performed to infracture and inset the outer cortex. During the procedure, patient required blood transfusion intraoperatively, so the maxillary portion of the procedure was delayed until 6 months later. For the maxilla, bilateral transconjunctival approach was used to resect parts of the orbital floors that were concave, resulting in 1 × 2 cm defects bilaterally which were reconstructed using resorbable plates. Then the anterior maxillary tumor was excised. Results: The patient and his parents were satisfied with his appearance after surgery. The patient was noted to have improvement in contour and decreased scleral show. He has most recently followed up 15 months after the initial surgery. There were no long-term complications. Conclusions: Severity of cherubism influences the type of surgical intervention. The present case is innovative because this is the first reported case of recontouring orbital floors with resorbable plates and infracturing of the mandible using sagittal split osteotomies for surgical treatment of cherubism.
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Affiliation(s)
- Ji H. Son
- Division of Plastic and Reconstructive Surgery, University Hospitals Case Medical Center, Cleveland, OH, USA
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | - Manish Valiathan
- Case Western Reserve University School of Dental Medicine, Cleveland, OH, USA
| | - Todd Otteson
- Division of Plastic and Reconstructive Surgery, University Hospitals Case Medical Center, Cleveland, OH, USA
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
- University Hospitals Rainbow Babies and Children’s Hospital, Cleveland, OH, USA
| | - Gerald Ferretti
- Case Western Reserve University School of Dental Medicine, Cleveland, OH, USA
| | - Paula A. Grigorian
- Division of Plastic and Reconstructive Surgery, University Hospitals Case Medical Center, Cleveland, OH, USA
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Carol Rosen
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
- University Hospitals Rainbow Babies and Children’s Hospital, Cleveland, OH, USA
| | - Devra Becker
- Division of Plastic and Reconstructive Surgery, University Hospitals Case Medical Center, Cleveland, OH, USA
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - David Rowe
- Division of Plastic and Reconstructive Surgery, University Hospitals Case Medical Center, Cleveland, OH, USA
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Hooman Soltanian
- Division of Plastic and Reconstructive Surgery, University Hospitals Case Medical Center, Cleveland, OH, USA
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Gregory Lakin
- Division of Plastic and Reconstructive Surgery, University Hospitals Case Medical Center, Cleveland, OH, USA
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
- University Hospitals Rainbow Babies and Children’s Hospital, Cleveland, OH, USA
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9
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Jeevanandham B, Ramachandran R, Dhanapal V, Subramanian I, Sai V. Orphan disease: Cherubism, optic atrophy, and short stature. Indian J Radiol Imaging 2018; 28:111-114. [PMID: 29692538 PMCID: PMC5894306 DOI: 10.4103/ijri.ijri_203_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 12-year-old female presented with complaints of progressive visual impairment in both her eyes. On clinical examination, she was short for her age and her ophthalmoscopic examination revealed bilateral optic atrophy. Computed tomography of the patient revealed multiple expansile lytic lesions of mandible suggesting cherubism. The optic atrophy was confirmed on magnetic resonance imaging, which additionally revealed bilateral retrocerebellar arachnoid cysts. This association of cherubism with optic atrophy and short stature was grouped as orphan disease by National Institutes of Health and only one case was reported in the literature so far.
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Affiliation(s)
- Balaji Jeevanandham
- Department of Radiology, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India
| | - Rajoo Ramachandran
- Department of Radiology, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India
| | - Vignesh Dhanapal
- Department of Radiology, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India
| | | | - Venkata Sai
- Department of Radiology, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India
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10
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Abstract
Cherubism is an autosomal-dominant benign bone disorder, characterized by fibro-osseous lesions in the mandible and maxilla commonly caused by mutations in the SH3-binding protein 2-gene. The purpose of the authors' study was to analyze craniofacial and dental features of children diagnosed with cherubism, describe their treatment, and assess their dental age compared with norms for Finnish children. Six children were diagnosed, followed up and treated due to dental and skeletal disorders caused by cherubsim. The patients were followed up for an average of 91.5 months with emphasis on the skeletal changes and development of dentition. The treatment consisted of minor orthodontic treatment, dental extractions, and exposures. One patient underwent cosmetic mandibular surgery. All patients had lesions in the lower jaw and 5 of 6 patients had lesions in the maxilla as well. The patients were characterized by varying swelling of the jaws, premature loss of deciduous teeth in the affected area and widely spaced, displaced, un-erupted, or absent permanent teeth. The dental age was delayed at younger age but near to normal or even a little ahead at older age. Even though cherubism affects the jaws, jaw positions, and malocclusion, no common dentofacial proportions associated with the disease could be confirmed by cephalometric analysis. The surgical interventions did not provoke adverse reactions or local growth of the lesions.
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Machado RA, Pontes H, Pires FR, Silveira HM, Bufalino A, Carlos R, Tuji FM, Alves D, Santos-Silva AR, Lopes MA, Capistrano HM, Coletta RD, Fonseca FP. Clinical and genetic analysis of patients with cherubism. Oral Dis 2017. [PMID: 28644570 DOI: 10.1111/odi.12705] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To describe the clinical and genetic features of patients with cherubism. MATERIAL AND METHODS A descriptive analysis of 14 cases from nine different families was carried out. Clinicopathological, imaging, and follow-up data were retrieved from patients' medical files and correlated with the genetic profile of each patient. Genomic DNA isolated from buccal mucosa cells was subjected to direct sequencing analysis of the SH3BP2 gene. RESULTS Females were more affected than males (8:6), and the mean age at diagnosis was 8.6 years (range 3-30 years). Eleven patients exhibited simultaneous bilateral involvement of the maxilla and mandible. Two patients did not have a familial history of cherubism. Progressive growth pattern was found in six patients and stable lesions were observed in other seven patients, whereas in one patient, complete spontaneous remission was documented during the follow-up (31 years). Mutations were found in 13 cases and included the typical heterozygous missense mutations R415Q, P418T, and P418H at exon 9 of SH3BP2. No correlation between the mutations and the clinical manifestations was observed. CONCLUSION Three different point mutations in the SH3BP2 gene were detected with variable clinical involvement. Genotype-phenotype association studies in larger population with cherubism are necessary to provide important knowledge about molecular mechanisms related to the disease.
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Affiliation(s)
- R A Machado
- Department of Oral Diagnosis (Pathology and Semiology), Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Har Pontes
- Service of Oral Pathology, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
| | - F R Pires
- Oral Pathology, School of Dentistry, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - H M Silveira
- Oral and Maxillofacial Surgery, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - A Bufalino
- Department of Diagnosis and Surgery, Araraquara Dental School, Universidade Estadual Paulista, Araraquara, Brazil
| | - R Carlos
- Centro Clinico de Cabeza y Cuello, Guatemala City, Guatemala
| | - F M Tuji
- School of Dentistry, Federal University of Pará, Belém, Brazil
| | - Dbm Alves
- Instituto Esperança de Ensino Superior, Santarém, Brazil
| | - A R Santos-Silva
- Department of Oral Diagnosis (Pathology and Semiology), Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - M A Lopes
- Department of Oral Diagnosis (Pathology and Semiology), Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - H M Capistrano
- Department of Oral Pathology, School of Dentistry, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, Brazil
| | - R D Coletta
- Department of Oral Diagnosis (Pathology and Semiology), Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - F P Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Kadlub N, Sessiecq Q, Dainese L, Joly A, Lehalle D, Marlin S, Badoual C, Galmiche L, Majoufre-Lefebvre C, Berdal A, Deckert M, Vazquez MP, Descroix V, Coudert AE, Picard A. Defining a new aggressiveness classification and using NFATc1 localization as a prognostic factor in cherubism. Hum Pathol 2016; 58:62-71. [PMID: 27498064 DOI: 10.1016/j.humpath.2016.07.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 07/16/2016] [Accepted: 07/17/2016] [Indexed: 10/21/2022]
Abstract
Cherubism is a rare genetic disease characterized by bilateral giant cell reparative granuloma of the jaws consisting of a fibrotic stroma with giant multinucleated cells (GMCs) and osteoclastic features. Cherubism severity is highly variable, and recurrence after surgery is the most important risk. Currently, there are no prognostic indicators. The aims of this study were to evaluate the osteoclastogenesis phenotype by histologic examination of nuclear factor of activated T cells 1 (NFATc1) localization and tartrate-resistant acid phosphatase (TRAP) activity and to correlate the results to disease aggressiveness to define prognostic indicators. Based on cherubism evolution 1 year after surgery, 3 classes of cherubism aggressiveness were identified: mild (group A), moderate (group B), and severe (group C). Histologically, in grade A and B cherubism lesions, GMCs were negative for both TRAP activity and NFATc1 nuclear localization. In contrast, in grade C cherubism lesions, GMCs were all positive for TRAP activity and NFATc1 nuclear localization and displayed osteoclast-like features. Other histopathologic findings were not different among the 3 groups. Our results establish that TRAP activity and NFTAc1 nuclear localization are associated with aggressive cherubism and therefore could be added to routine pathologic examination to aid in prognosis and management of the disease. The finding of NFATc1 nuclear localization in aggressive tumors supports the addition of anticalcineurin treatment to the therapeutic arsenal for cherubism.
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Affiliation(s)
- Natacha Kadlub
- INSERM, UMRS 1138, Centre de Recherche de Cordeliers, Molecular Oral Pathology, 75006 Paris, France; Université Paris Descartes, 75006 Paris, France; APHP, Necker Enfants Malades, Service de Chirurgie Maxillo-Faciale et Plastique, 75015 Paris, France; APHP, CRMR des Malformations Rares de la Face et de la Cavité Buccale, 75015 Paris, France.
| | - Quentin Sessiecq
- CHU de Bordeaux, Service de Chirurgie Maxillo-Faciale, 33000 Bordeaux, France
| | - Linda Dainese
- APHP, Hôpital Armand Trousseau, Service d'Anatomopathologie et Cytologie, 75012 Paris, France; Université Pierre et Marie Curie, 75005 Paris, France
| | - Aline Joly
- INSERM, UMRS 1138, Centre de Recherche de Cordeliers, Molecular Oral Pathology, 75006 Paris, France; Université Paris Descartes, 75006 Paris, France; APHP, Necker Enfants Malades, Service de Chirurgie Maxillo-Faciale et Plastique, 75015 Paris, France; APHP, CRMR des Malformations Rares de la Face et de la Cavité Buccale, 75015 Paris, France
| | | | - Sandrine Marlin
- APHP, Necker Enfants Malades, Service de Génétique, 75015 Paris, France
| | - Cecile Badoual
- Université Paris Descartes, 75006 Paris, France; APHP, Hôpital Européen Georges Pompidou, Service d'Anatomopathologie et Cytologie, 75015 Paris, France
| | - Louise Galmiche
- Université Paris Descartes, 75006 Paris, France; APHP, Necker Enfants Malades, Service d'Anatomopathologie et Cytologie, 75015 Paris, France
| | | | - Ariane Berdal
- INSERM, UMRS 1138, Centre de Recherche de Cordeliers, Molecular Oral Pathology, 75006 Paris, France; UFR Odontologie, Garancière, Université Paris Diderot, 75006 Paris, France
| | - Marcel Deckert
- INSERM, U1035, Université Nice Sophia-Antipolis, Microenvironment, Signaling and Cancer, 06000 Nice, France
| | - Marie-Paule Vazquez
- INSERM, UMRS 1138, Centre de Recherche de Cordeliers, Molecular Oral Pathology, 75006 Paris, France; Université Paris Descartes, 75006 Paris, France; APHP, Necker Enfants Malades, Service de Chirurgie Maxillo-Faciale et Plastique, 75015 Paris, France; APHP, CRMR des Malformations Rares de la Face et de la Cavité Buccale, 75015 Paris, France
| | - Vianney Descroix
- INSERM, UMRS 1138, Centre de Recherche de Cordeliers, Molecular Oral Pathology, 75006 Paris, France; UFR Odontologie, Garancière, Université Paris Diderot, 75006 Paris, France; APHP, Hôpital Pitié Salpétrière, Service d'Odontologie, 75013 Paris, France
| | - Amélie E Coudert
- INSERM, UMRS 1138, Centre de Recherche de Cordeliers, Molecular Oral Pathology, 75006 Paris, France; UFR Odontologie, Garancière, Université Paris Diderot, 75006 Paris, France
| | - Arnaud Picard
- INSERM, UMRS 1138, Centre de Recherche de Cordeliers, Molecular Oral Pathology, 75006 Paris, France; Université Paris Descartes, 75006 Paris, France; APHP, Necker Enfants Malades, Service de Chirurgie Maxillo-Faciale et Plastique, 75015 Paris, France; APHP, CRMR des Malformations Rares de la Face et de la Cavité Buccale, 75015 Paris, France
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13
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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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14
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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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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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Aloni MN, Kambere RS, Molua A, Dilu JN, Tshibassu PM, Kazadi-Lukusa A, Ngiyulu RM, Kalengayi RM, Ehungu JLG. Cherubism in sub-saharan Africa: a first case-report in a child. Rare Tumors 2015; 7:5675. [PMID: 25918610 PMCID: PMC4387356 DOI: 10.4081/rt.2015.5675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 11/20/2014] [Accepted: 11/23/2014] [Indexed: 12/03/2022] Open
Abstract
Cherubism is rare disease and has been rarely reported in African pediatric population. We report here the case of a 10-year-old child who was referred to our hospital for bilateral jaws swelling. Physical examination revealed bilateral swelling symmetry of the face. Histopathological examination of the biopsy specimen showed loose fibrous stroma, proliferating fibrous connective with tissue interspersed with multinucleated giant cells, small thin walled blood vessels and scattered sparse mononuclear inflammatory infiltrate. Our patient presented cherubism. Cherubism is rarely described in children living in sub-Saharan Africa. Genetic and molecular investigations plays an important role in diagnosis but were not available in poor resources settings in developing countries such as the Democratic Republic of Congo.
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Affiliation(s)
- Michel Ntetani Aloni
- Division of Pediatric Hemato-Oncology and Nephrology, Department of Pediatrics, University Hospital of Kinshasa, School of Medicine, University Hospital of Kinshasa, University of Kinshasa , Democratic Republic of Congo
| | - Renault Sitwaminya Kambere
- Department of Pathology, University Hospital of Kinshasa, School of Medicine, University Hospital of Kinshasa, University of Kinshasa , Democratic Republic of Congo
| | - Antoine Molua
- Department of Radiolology, University Hospital of Kinshasa, School of Medicine, University Hospital of Kinshasa, University of Kinshasa , Democratic Republic of Congo
| | - Joseph Nzinga Dilu
- Department of Stomatology and Maxillofacial Surgery, University Hospital of Kinshasa, School of Medicine, University Hospital of Kinshasa, University of Kinshasa , Democratic Republic of Congo
| | - Pierre Manianga Tshibassu
- Division of Gastroenterology and Neurology, Department of Pediatrics, University Hospital of Kinshasa, School of Medicine, University Hospital of Kinshasa, University of Kinshasa , Democratic Republic of Congo
| | - Aimé Kazadi-Lukusa
- Division of Pediatric Hemato-Oncology and Nephrology, Department of Pediatrics, University Hospital of Kinshasa, School of Medicine, University Hospital of Kinshasa, University of Kinshasa , Democratic Republic of Congo
| | - René Makuala Ngiyulu
- Division of Pediatric Hemato-Oncology and Nephrology, Department of Pediatrics, University Hospital of Kinshasa, School of Medicine, University Hospital of Kinshasa, University of Kinshasa , Democratic Republic of Congo
| | - Raphael Mbona Kalengayi
- Department of Pathology, University Hospital of Kinshasa, School of Medicine, University Hospital of Kinshasa, University of Kinshasa , Democratic Republic of Congo
| | - Jean Lambert Gini Ehungu
- Division of Pediatric Hemato-Oncology and Nephrology, Department of Pediatrics, University Hospital of Kinshasa, School of Medicine, University Hospital of Kinshasa, University of Kinshasa , Democratic Republic of Congo
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Misra SR, Mishra L, Mohanty N, Mohanty S. Cherubism with multiple dental abnormalities: a rare presentation. BMJ Case Rep 2014; 2014:bcr-2014-206721. [PMID: 25301429 DOI: 10.1136/bcr-2014-206721] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Cherubism is a progressive, hereditary fibro-osseous lesion exclusively affecting the jaw bones. It is caused by the abnormal functioning of osteoblasts and osteoclasts, leading to replacement of normal bone by cellular fibrous tissue and immature bone, which produces painless progressive growth of the jaw, with a round facial appearance. It was first described in 1933 by Jones as 'familial multilocular cystic disease of the jaws'. The term 'cherubism' was later coined to describe the rounded facial appearance resulting from jaw hypertrophy that was reminiscent of cherubs depicted throughout Renaissance art. The bony lesions generally occur at an early age, affect one or both jaws symmetrically, and grow progressively until puberty. Spontaneous regression is seen in most cases, although surgical re-contouring may be required for others for aesthetic reasons.
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Affiliation(s)
- Satya Ranjan Misra
- Department of Oral Medicine and Radiology, Institute of Dental Sciences, Bhubaneswar, Odisha, India
| | - Lora Mishra
- Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Bhubaneswar, Odisha, India
| | - Neeta Mohanty
- Department of Oral Pathology and Microbiology, Institute of Dental Sciences, Bhubaneswar, Odisha, India
| | - Susant Mohanty
- Department of Paediatric Dentistry, Institute of Dental Sciences, Bhubaneswar, Odisha, India
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Affiliation(s)
- Stephen A Sachs
- The New York Center for Orthognathic and Maxillofacial Surgery, State University of New York at Stony Brook, Hofstra North Shore-Long Island Jewish School of Medicine, 2001 Marcus Avenue, Lake Success, New York 11042, USA.
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Sekerci AE, Balta B, Dundar M, Hu Y, Reichenberger EJ, Etoz OA, Nazlim S, Bayrakdar IS. A c.1244G>A (p.Arg415Gln) mutation in SH3BP2 gene causes cherubism in a Turkish family: report of a family with review of the literature. Med Oral Patol Oral Cir Bucal 2014; 19:e340-4. [PMID: 24608212 PMCID: PMC4119308 DOI: 10.4317/medoral.19496] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Accepted: 11/20/2013] [Indexed: 11/05/2022] Open
Abstract
Objectives: The present study was aimed at advancing the understanding of the pathogenesis of cherubism by presenting a case study based on history, physical examination, typical radiological features, molecular and histopathological laboratory tests and a review of the literature.
Study Design: This study began with a 7-year-old boy who was referred due to mandibular overgrowth. A panoramic radiograph revealed multilocular radiolucent lesions of the upper/lower jaws suggestive of cherubism. Overall, a total of four family members were tested for SH3BP2 mutations, namely two siblings and their parents. Both siblings had been clinically diagnosed with cherubism; however, the parents were clinically normal. Peripheral blood was collected from all participants and genomic DNA sequencing was carried out.
Results: A missense mutation was found in the two affected siblings and their asymptomatic mother. The mutation was a 1244 G>A transversion which resulted in an amino acid substitution from arginine to glutamine (p.Arg415Gln) in exon 9.
Conclusions: The present study emphasized the importance of further clinical and molecular investigation even when only a single case of cherubism is identified within a family. Genotype-phenotype association studies in individuals with cherubism are necessary to provide important insights into the molecular mechanisms associated with this disease.
Key words:Cherubism, mandible, maxilla, SH3BP2, gene analysis, CBCT.
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Affiliation(s)
- Ahmet-Ercan Sekerci
- Erciyes University, Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Kayseri-Turkey,
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Abstract
Cherubism is a self-limiting non-neoplastic autosomal dominant fibro-osseous disorder of the jaw usually found in children between 2-5 years of age. It occurs predominantly in boys and is characterized clinically by bilateral swelling of cheeks due to bony enlargement of the jaw that gives the patient a typical cherubic look. Cherubism may occur as solitary cases or in many members of family, often in multiple lesions. Radiographically the lesions appear as multilocular bilateral radiolucent areas. The present case report describes a 13-year-old female cherubic child with progressive swelling of cheeks.
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Affiliation(s)
- Babita Niranjan
- Department of Pedodontics and Preventive Dentistry, People's College of Dental Sciences and Research Centre, Bhopal, Madhya Pradesh, India
| | - Nd Shashikiran
- Department of Pedodontics and Preventive Dentistry, People's College of Dental Sciences and Research Centre, Bhopal, Madhya Pradesh, India
| | - Shilpy Singla
- Department of Pedodontics and Preventive Dentistry, People's College of Dental Sciences and Research Centre, Bhopal, Madhya Pradesh, India
| | - Sowmya Kasetty
- Department of Oral Pathology, People's College of Dental Sciences and Research Centre, Bhopal, Madhya Pradesh, India
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Abstract
Cherubism is an uncommon fibro-osseous disorder of the jaw that presents with varying degrees of involvement and tendency towards spontaneous remission. Children are normal at birth and the expanding jaw is noticed within the first year of life becoming progressively larger until the beginning of adolescence. Lesions are characterized by replacement of bone with fibrovascular tissue containing abundant multinucleated giant cells. Here, we describe a case of cherubism in a 4-year-old child with swelling on both sides of mandible with clinic radiographic features and suggestions for therapy.
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Affiliation(s)
- Vikas Elias Kuruvilla
- Department of Oral and Maxillofacial Surgery, PSM College of Dental Science, Akkikkavu, Thrissur, India
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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: 8] [Impact Index Per Article: 0.7] [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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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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25
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Mani S, Natarajan B, Rajaram K, Sahuthullah YA, Gokulanathan S, Sitra G. Rare form of cherubism: Case report with review of literature. J Pharm Bioallied Sci 2013; 5:S142-6. [PMID: 23956593 PMCID: PMC3740662 DOI: 10.4103/0975-7406.114309] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Revised: 05/24/2013] [Accepted: 05/24/2013] [Indexed: 11/24/2022] Open
Abstract
Cherubism was first described by Jones in 1933 as “familial multilocular cystic disease of jaws.” Renamed as cherubism in 1938 because of classical characteristics of full round cheeks and upward cast of the eyes to the angelic look of the cherubs immortalized by renaissance art. It is characterized by progressive painless bilateral swelling of jaws involving either maxilla or mandible producing chubby face. It is uncommon fibro-osseous disorder of bone. Mutation in the gene encoding SH3-binding protein 2 (SH3BP2) plays a role in the disease. There are indications that the gene SH3BP2 plays a role in regulating the increased osteoblast and osteoclast activities that are seen in normal tooth eruption and point mutations in the gene could cause pathologic activation of osteoclasts. The purpose of this paper is to present the uncommon form of cherubism and to review the clinicoradiographic, histopathologic features and treatment so as to facilitate diagnosis of disease.
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Affiliation(s)
- Sudhaa Mani
- Department of Oral Medicine and Radiology, Vivekanandha Dental College for Women, Thiruchengodu, Namakkal, Tamil Nadu, India
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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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27
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Papadaki ME, Lietman SA, Levine MA, Olsen BR, Kaban LB, Reichenberger EJ. Cherubism: best clinical practice. Orphanet J Rare Dis 2012; 7 Suppl 1:S6. [PMID: 22640403 PMCID: PMC3359956 DOI: 10.1186/1750-1172-7-s1-s6] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Cherubism is a skeletal dysplasia characterized by bilateral and symmetric fibro-osseous lesions limited to the mandible and maxilla. In most patients, cherubism is due to dominant mutations in the SH3BP2 gene on chromosome 4p16.3. Affected children appear normal at birth. Swelling of the jaws usually appears between 2 and 7 years of age, after which, lesions proliferate and increase in size until puberty. The lesions subsequently begin to regress, fill with bone and remodel until age 30, when they are frequently not detectable. Fibro-osseous lesions, including those in cherubism have been classified as quiescent, non-aggressive and aggressive on the basis of clinical behavior and radiographic findings. Quiescent cherubic lesions are usually seen in older patients and do not demonstrate progressive growth. Non-aggressive lesions are most frequently present in teenagers. Lesions in the aggressive form of cherubism occur in young children and are large, rapidly growing and may cause tooth displacement, root resorption, thinning and perforation of cortical bone. Because cherubism is usually self-limiting, operative treatment may not be necessary. Longitudinal observation and follow-up is the initial management in most cases. Surgical intervention with curettage, contouring or resection may be indicated for functional or aesthetic reasons. Surgical procedures are usually performed when the disease becomes quiescent. Aggressive lesions that cause severe functional problems such as airway obstruction justify early surgical intervention.
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Affiliation(s)
- Maria E Papadaki
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, USA
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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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Kumar VV, Ebenezer S, Narayan T, Wagner W. Clinicopathologic conference: Multiquadrant expansile fibro-osseous lesion in a juvenile. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 113:286-92. [DOI: 10.1016/j.tripleo.2011.08.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2011] [Revised: 07/07/2011] [Accepted: 08/07/2011] [Indexed: 10/14/2022]
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Woo SB. Nonodontogenic Intraosseous Lesions. ORAL PATHOLOGY 2012:382-431. [DOI: 10.1016/b978-1-4377-2226-0.00016-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Abstract
PURPOSE OF REVIEW To review the current literature of sterile bone inflammation in childhood and to evaluate the evidence for clinical care including diagnostic methods and treatment. RECENT FINDINGS Chronic noninfectious osteomyelitis includes several different entities marked by sterile bone inflammation associated with histologic evidence of a predominant neutrophil infiltration in the absence of autoantibodies and autoreactive T cells, some of which are associated with a genetic mutation. Whole body MRI is helpful in detecting asymptomatic lesions. Initial treatment with NSAIDs is usually sufficient to control symptoms as the bone heals. However, if the lesions persist and do not respond to first-line treatment, or involve the spine or hip, treatment with bisphosphonate will usually lead to a resolution of symptoms. Rarely, treatment with anti-TNF agents is required. SUMMARY This review summarizes recent information on diagnosis, treatment and prognosis of disorders involving sterile bone inflammation in childhood. It also addresses the evolving differential diagnosis for autoinflammatory disorders that include sterile bone inflammation and presents a treatment algorithm for management.
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Multidisciplinary Surgical Management of Cherubism Complicated by Neurofibromatosis Type 1. J Craniofac Surg 2011; 22:2318-22. [DOI: 10.1097/scs.0b013e318232a779] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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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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Orthognathic surgery in cherubism. J Oral Maxillofac Surg 2011; 69:541-5. [PMID: 21238849 DOI: 10.1016/j.joms.2010.07.065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2010] [Revised: 07/16/2010] [Accepted: 07/27/2010] [Indexed: 11/22/2022]
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Preda L, Dinca O, Bucur A, Dragomir C, Severin E. Identical Mutation in SH3BP2 Gene Causes Clinical Phenotypes with Different Severity in Mother and Daughter - Case Report. Mol Syndromol 2010; 1:87-90. [PMID: 21045962 DOI: 10.1159/000314268] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Cherubism is a particular form of fibrous dysplasia of the jaws. Familial occurrence was reported in most cases. The condition is a rare hereditary disorder with autosomal dominant inheritance, with complete penetrance in males and incomplete penetrance in females and variable expressivity. It is known to be caused by mutations in the gene encoding SH3-domain binding protein 2, SH3BP2 gene. Major diagnostic criteria are cherubic facial appearance, painless hard enlargement of the jaws, and frequently associated dental abnormalities. The aim of the study was to analyze clinical and genetic features of cherubism in a family with 3 daughters in which the youngest one was affected. Clinical and radiographic examinations, hematological and biochemical evaluations and biopsy were performed. Molecular genetic analysis consisted of PCR amplification and direct sequencing of selected exons of the SH3BP2 gene. Cherubism was suspected based on clinical and radiographic examinations of the 9-year-old daughter. She presented asymmetrical enlargement of the mandible, speech and swallowing problems and dental abnormalities on the lower jaw. There was no history of similar clinical findings in any of the daughters or the parents of the affected girl. Abnormal results were obtained by genetic analysis. A c.1244G>A mutation was identified in exon 9 of the SH3BP2 gene in the asymptomatic mother and her affected daughter. The identified mutation in the SH3BP2 gene is probably disease-causing. The asymptomatic mother transmitted the gene mutation to her affected daughter. Our results confirm the reduced penetrance and variable expression of the gene mutation.
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Affiliation(s)
- L Preda
- Oral Surgery Department, and 'Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania
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36
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LNU A, Peter S, Nampoothiri S, Rao L, Nambiar A, Veeraraghavan R, Puthalath U. Ramon's Syndrome: A Rare Entity. ACTA ACUST UNITED AC 2010. [DOI: 10.5005/jp-journals-10015-1039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
ABSTRACT
Introduction
Ramon et al in 1967 described a condition, which included mental retardation, fibrous dysplasia of the maxilla and stunted growth. De Pino et al described a Brazilian family of four who had the same features as that of Ramon's syndrome in association with juvenile arthritis. Cherubism was first described in 1933 by Jones as ‘familial multilocular cystic lesion of the jaws’, a rare benign fibroosseous disease of the jaws, which is transmitted as an autosomal dominant trait. Affected children usually present before five years of age with painless progressive swelling of the cheeks, frequently associated with dental malformations. It progresses until puberty, and shows partial or complete spontaneous involution in adulthood; therefore, management is mostly conservative. The condition was initially characterized as familial, particularly as a form of craniofacial fibrous dysplasia. The children affected with cherubism do not usually show mental or physical deformities, but when cherubism is associated with other syndromes like Noonan-like syndrome, Ramon syndrome, and Fragile X syndrome, mental and physical deformities may be seen.
Case Report
This is a case report of a 12-year-old boy who reported with a massive painless bilateral swelling of the face, which has been increasing since the age of 2 years. The patient had multiple unerupted teeth, gingival hyperplasia, hearing loss and mental retardation. A detailed case report, including the histopathology, radiographic features (extraoral, CT and MDCT), and management of the case will be discussed in detail.
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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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Theoret CM, Packota GV, Leswick DA. Answer to Case of the Month #153. Can Assoc Radiol J 2009; 60:213-6. [DOI: 10.1016/j.carj.2009.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Christina M. Theoret
- Department of Medical Imaging, Royal University Hospital, Saskatoon, Saskatchewan, Canada
| | - Garnet V. Packota
- College of Dentistry, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - David A. Leswick
- Department of Medical Imaging, Royal University Hospital, Saskatoon, Saskatchewan, Canada
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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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Holst AI, Hirschfelder U, Holst S. Diagnostic potential of 3D-data-based reconstruction software: an analysis of the rare disease pattern of cherubism. Cleft Palate Craniofac J 2007; 46:215-9. [PMID: 19254051 DOI: 10.1597/07-015.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Cherubism is an autosomal-dominant syndrome characterized by bilateral maxillomandibular bony degeneration, fibrous connective tissue hyperplasia, and displacement of permanent tooth germs. Reossification of the cystic lumen occurs spontaneously, but dislocated teeth must be realigned orthodontically. Advancements in virtual 3D reconstruction of anatomic structures based on computed tomography (CT) or cone beam CT data have provided for more predictable individual treatment planning. We evaluated two software programs for making densitometry and volume measurements of cystic areas in the mandibles, and for 3D visualization of permanent tooth germs within the cystic lumen, in two siblings with cherubism.
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Affiliation(s)
- Alexandra Ioana Holst
- Department of Orthodontics, Friedrich-Alexander-University of Erlangen, Nuremberg, Germany.
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