Nagehan Burcu BAYRAK, BOZKURT KUBİLAY IŞIK, Özgür Hilal ERİNANÇ, Doğan DOLANMAZ

MANDİBULADA GÖRÜLEN SANTRAL DEV HÜCRELİ GRANÜLOMUN SİSTEMİK KALSİTONİN UYGULAMASI İLE TEDAVİSİ: BİR OLGU SUNUMU

Amaç: Çene kemiklerinde görülen santral dev hücreli granulom (SDHG) çoğunlukla kadınlarda ve 30 yaş öncesinde görülen, iyi huylu, agresif seyreden, intraosseöz bir lezyondur. Tedavisinde sıklıkla küretaj tercih edilmesinin yanında, son yıllarda intralezyonel steroid ve interferon- α (IFN-α) uygulaması, sistemik kalsitonin kullanılması gibi yöntemlerden de faydalanılmaktadır. Bu olgu raporunda 11 yaşında erkek hastanın, mandibular molar bölgesinde teşhis edilen SDHG’ ye tedavi yaklaşımından bahsedilecektir.Gereç ve Yöntemler:Hasta klinik ve radyolojik değerlendirildikten sonra, hiperparatiroidizmin (brown tumor) elimine edilmesi için kan testi de yaptırılmış ve kan değerleri normal bulunmuştur. Kesin teşhis konulması için mevcut lezyondan insizyonel biyopsi yapılmış ve ön teşhisde düşünülen SDHG doğrulanmıştır. Hastanın tedavisi haftada 1 kez beş hafta süreyle intralezyonel steroid uygulaması şeklinde başlamıştır. Ancak kontrol radyograflarında lezyonda herhangi bir rezolusyona veya yeni kalsifiye alana rastlanmamıştır. Bu sebeple alternative tedavi olarak hasta 6 ay boyunca günde bir kez olacak şekilde intranasal kalsitonin kullanmaya başlamıştır. Bulgular:6 ayın sonunda alınan son kontrol radyografında lezyonda belirgin küçülme olduğu ve kallus formasyonunun başladığı gözlenmiştir. 6 yıllık takipte herhangi bir rekürrense rastlanmamıştır.Sonuçlar:Genç hastalarda fonksiyonel ve estetik deformitelerden kaçınmak için sistemik kalsitonin ile SDHG tedavisi, cerrahi olmayan, minimal girişimsel ve tercih edilebilir bir tedavi yöntemidir.Anahtar Kelimeler: Kalsitonin, santral dev hücreli granulom, mandibula

Anahtar Kelimeler:

Kalsitonin, santral dev hücreli granulom, mandibula

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