Multiple Mandibular Idiopathic Bone Cavities in a Patient with Immune Thrombocytopenia : A Case Report

면역성혈소판감소증 환자의 하악골에 발생한 다발성 특발성골강 : 증례보고

  • Baek, Young-Jae (Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University) ;
  • Geum, Dong-Ho (Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University) ;
  • Lee, Jung-Han (Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University) ;
  • Kim, Sung-Hee (Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University) ;
  • Ahn, Kyung-Yong (Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University) ;
  • Kim, Uk-Kyu (Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University)
  • 백영재 (부산대학교 치의학전문대학원 구강외과학교실) ;
  • 금동호 (부산대학교 치의학전문대학원 구강외과학교실) ;
  • 이정한 (부산대학교 치의학전문대학원 구강외과학교실) ;
  • 김성희 (부산대학교 치의학전문대학원 구강외과학교실) ;
  • 안경용 (부산대학교 치의학전문대학원 구강외과학교실) ;
  • 김욱규 (부산대학교 치의학전문대학원 구강외과학교실)
  • Received : 2012.11.13
  • Accepted : 2012.12.20
  • Published : 2013.01.01

Abstract

The immune thrombocytopenia(ITP) is defined as a platelet count of less than $100,000/{\mu}L$. It is gene rally known as characterized by the bleeding manifestations of skin and/or mucosa like ecchymosis due to low platelet count, but reports of the related intraosseous lesions are not common. The idiopathic bone cavity(IBC) is an empty space of the bone, which occurs mainly in the long bones. It is found predominantly in the mandible in case of the maxillofacial area. In general, it appears as an isolated unilocular lesion without the correlation of the teeth. Although the cause of the IBC is supposed to be associated with hemostatic problems, the etiology is unclear and it was not disclosed the relevance of specific systemic disease. In this present case, IBCs that occurred in mandible of patient who has IPT was treated by curettage with platelet transfusion.

Keywords

References

  1. McCRAE K. Immune thrombocytopenia: No longer "idiopathic". Cleve Clin J Med. 2011 Jun;78(6) :358-73. https://doi.org/10.3949/ccjm.78gr.10005
  2. Patton LL. The ADA Practical Guide to Patients with Medical Conditions. Wiley-Blackwell. 2012.
  3. Neville BW, Damm DD, Allen C, Bouquot JE. Oral and Maxillofacial Pathology. 3rd ed. Saunders. 631-36. 2008.
  4. Kuhmichel A, Bouloux GF. Multifocal Traumatic Bone Cysts: Case Report and Current Thoughts on Etioogy. J Oral Maxillofac Surg. 2010 Jan ;68(1): 208-12. https://doi.org/10.1016/j.joms.2009.07.024
  5. Magliocca KR, Edwards SP, Helman Jl. Traumatic Bone Cyst of the Condylar Region: Report of 2 Cases. J Oral Maxillofac Surg. 2007 Jun; 65(6) : 1247-50. https://doi.org/10.1016/j.joms.2005.08.026
  6. Otsuka GG, Saito KK, Yoshida TT, Suzuki YY, Yoshida JJ. Hemorrhagic skull pseudotumor associated with idiopathic thrombocytopenic purpura. Case illustratkon. J Neurosurg. 1998 Apr;88(5) :929-9. https://doi.org/10.3171/jns.1998.88.5.0929
  7. Oda Y, Kagami H, Tohnai I, Ueda M. Asynchronously occurring bilateral mandibular hemorrhagic bone cysts in a patient with idiopathic thrombocytopenic purpura. J Oral Maxillofac Surg. 2002 Jan; 60(1): 95-9. https://doi.org/10.1053/joms.2002.29084
  8. Abrahamson PE, Hall SA, Feudjo-Tepie M, Mitrani-Gold FS, Logie J. The incidence of idiopathic thrombocytopenic purpura among adults: a population-based study and literature review. Hematologica. 2009 Aug;83(2) :83-9.
  9. Neyion AJ, Saunders PWG, Howard MR, Proctor SJ, Tayior PRA, Northern Region Haematology Group. Clinically significant newly presenting autoimmune thrombocytopenic purpura in adults: a prospective study of a population-based cohort of 245 patients. Br J Haemal. 2003 Sep; 122(6):968-74.
  10. 질병관리본부. 2011년 수혈 가이드라인. 2011.
  11. British Committee for Standards in Haematology General Haematology Task Force. Guidelines for the investigation and management of idiopathic thrombocytopenic purpura in adults, children and in pregnancy. Br J Haematol. 2003.
  12. Schlenke P, Hagenah W, lrsch J, Sundin D, Corash L, Lin L. Safety and clinical efficacy of platelet components prepared with pathogen inactivation in routine use for thrombocytopenic patients. Ann Hematol. 2011 Dec;90(12): 1457-65. https://doi.org/10.1007/s00277-011-1222-3
  13. Lucas C, Blum T. Do all cysts of the jaws originate from the dental system. J Am Dent Assoc. 1929; 16: 659-61.
  14. Marx RE, Stern D. Oral and Maxilkofacial Pathology. 2nd ed. Quintessence Publishing. 215-7. 2012.
  15. Discacciati ED, de Faria VM, Garcia NG, Sakai VT, Pereira AA, Hanemann JA. Idiopathic bone cavity: case series involving children and adolescents. J Investig Clin Dent. 2012 Apr; 3(2) : 103-8. https://doi.org/10.1111/j.2041-1626.2011.0087.x
  16. de Souza Noronha VR, Sette-Dias AC, Abdo EN, Gomez RS, de Mesquita RA. Asynchronous idiopathic bone cavity: A case report. J Craniomaxillofac Surg. 2012 Dec;40(8) :e328-30. https://doi.org/10.1016/j.jcms.2012.02.001
  17. Perdigo PF, Silva EG, Sakurai E, Soares de Araja N, Gomez RS. Idiopathic bone cavity: a clinical, radiographic, and histological study. Br J Oral Maxillofac Surg. 2003 Dec:41(6):4079.
  18. Horne RP, Meara DJ, Granite EL. Idiopathko bone cavities of the mandible: an update on recurrence rates and case report. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012 Aug; in Press
  19. Marx RE, Stern D. Oral and Maxillofacial Pathology. 2nd ed. Quintessence Publishing. 938. 2012.
  20. Cohen JJ. Simple bone cysts. Studies of cyst fluid in six cases with a theory of pathogenesis. J Bone Joint Surg Am. 1960 May:42-A:609-16.
  21. Dellinger TM, Holder R, Livingston HM, Hill WJ. Alternative treatments for a traumatic bone cyst: a longitudinal case report. Quintessence Int. 1998 Jul ; 29( 8) : 497-502.
  22. Kraut R, Robin C. Idiopathic bone cavity. A report of recurrent lesions and their management. N Y State Dent J. 2003 Mar;69(3) :30-3.
  23. Lokiec F, Wientroub S. Simple bone cyst: etiology, dassification, pathology, and treatment modalities. J Pediatr Orthop B. 1998;7(4) :262-73. https://doi.org/10.1097/01202412-199810000-00004
  24. Wright JG, Yandow S, Donaldson S, Marley L. A randomized clinical trial comparing intralesional bone marrow and steroid injections for simple bone cysts. J Bone Joint Surg Am. 2008 Mar;90(4) :722-30. https://doi.org/10.2106/JBJS.G.00620
  25. Sapp JP , Stark ML. Self-healing traumatic bone cysts. Oral Surg Oral Med Oral Pathol. 1990 Apr;69(5) :597-602. https://doi.org/10.1016/0030-4220(90)90243-L
  26. Suei Y, Taguchi A Tanimoto K. Simple Bone Cyst of the Jaws: Evaluation of Treatment Outcome by Review of 132 Cases. J Oral Maxillofac Surg. 2007 May;65(5) :918-23. https://doi.org/10.1016/j.joms.2006.06.297
  27. Schreuder HW, Conrad EU, Bruckner JD, Howlett AT, Sorensen LS. Treatment of simple bone cysts in children with curettage and cryosurgery. J Pediatr Orthop. 1997 Oct; 17(6) :814-20.
  28. Marx RE, Stern D. Oral and Maxilkofacial Pathology. 2nd ed. Quintessence Publishing. 836-41. 2012.
  29. de Lange J, van den Akker HP, Veldhuijzen van Zanten GO, Engelshove HA, van den Berg H, Klip H. Calcitonin therapy in central giant cell granuloma of the jaw: a randomized double-blind placebo-controlled study. Int J Oral Maxillofac Surg. 2008 Sep;35(9):791-5.