Cherubism in 12 year young female: a case report
The present case has been reported in the Annals of Maxillofacial Surgery. A 12-year-old female reported with painless swelling over both sides of the face. History revealed that it had started as a small swelling at 5 years of age and progressively increased to the present size. None of her family members reported such type of swelling. On extraoral clinical examination, we noticed roughly oval shape, painless swelling involving all four quadrants of the jaws, that was hard in consistency with poorly defined margins.

Swelling on the left side was slightly larger than the right side of the face. On palpation, the temperature of the overlying skin was normal and no tenderness was elicited on palpation. The swelling extended below the lower border of the mandible. Intraorally, there was a marked expansion of buccal cortex with a shallow palate. There were a few remaining teeth that were rotated and malposed while the rest of the teeth had fallen out.

An OPG showed multilocular appearance of the maxilla and mandible (excluding condyle) with numerous unerupted and displaced teeth appears to be floating in numerous cyst-like spaces. On the basis of clinical and radiographic findings, a provisional diagnosis of cherubism of jaw was given. The laboratory values of serum calcium, phosphorus, and alkaline phosphatase were found to be within the normal range.

Incisional biopsy was taken from one site in the left mandible which on histopathological examination revealed a highly cellular mature fibrous connective tissue with numerous endothelial cell proliferations along with multinucleated giant cells. There was evidence of prevascular eosinophilic cuffing of collagen around small capillaries.

Thus, the final diagnosis of cherubism was established. Surgical resection and recontouring of lesion was planned after puberty. Until then, medicinal therapy was prescribed in the form of salmon calcitonin nasal spray (Calcispray, Zydus Cadila), alternating nostrils daily, in the dosage of 200 UI. After the surgical procedure, the patient submitted to radiographic examinations annually during 4 years' recall evaluation.

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