Oral Juvenile Hyaline Fibromatosis: A Rare Entity

Abstract

Juvenilna hijalina fibomatoza iznimno je rijedak poremećaj kod dojenčadi i djece, a javlja se prema zakonima autosomno recesivnog nasljeđivanja. Izgleda poput multiple kožne ili subkutane tumorne tvorbe, sporo se razvija i češća je u području glave i vrata te gornjeg dijela trupa. Često je povezana s gingivnom hipertrofijom, teškom fleksularnom kontrakturom udova i koštanom lezijom. Nema mentalne retardacije. Histološki se te lezije sastoje od obilne eozinofilne osnovne tvari s neravnomjerno raspršenim fibroblastima. Ekscidirane lezije u ranim stadijima bogatije su stanicama. Točno podrijetlo eozine hijaline tvari nije poznato. Nedavno je pronađen defekt kromosoma 4q21 povezan s lokusom gena – 2 za kapilarnu morfogenezu. Diferencijalna dijagnoza za juvenilnu hijalinu fibromatozu uključuje i infantilnu sistemsku hijalinozu, za koju se zna da je alelna. Trenutačno nema široko prihvaćene učinkovite terapije ni za juvenilnu hijalinu fibromatozu ni za infantilnu sistemsku hijalinozu. Juvenilna hijalina fibromatoza i infantilna sistemska hijalinoza ponekad se teško razlikuju jer su vrlo slične. Mi izvještavamo o slučaju juvenilne hijaline fibromatoze kod 10-godišnje djevojčice s pretežno gingivalnom hiperplazijom.Juvenile hyaline fibromatosis is an exceedingly rare disorder of infants and children which appears to have autosomal recessive inheritance. It is characterized by multiple, slowly growing dermal or subcutaneous tumors, especially in the head and neck region and upper trunk, often associated with gingival hypertrophy, severe flexural limb contractures and bone lesions. There is no mental retardation. Histologically, these lesions are composed of copious eosinophilic, homogenous ground substance with unevenly dispersed fibroblasts. Lesions excised in early stages are more cellular. The precise nature of the eosinophilic hyaline material is not known. Recently, a defect on chromosome 4q21 associated with the locus of the capillary morphogenesis gene – 2, has been demonstrated. The differential diagnosis of juvenile hyaline fibromatosis includes infantile systemic hyalinosis, which is now known to be allelic. Currently, no widely accepted effective treatment exists for juvenile hyaline fibromatosis or infantile systemic hyalinosis. Infantile systemic hyalinosis and juvenile hyaline fibromatosis are sometimes difficult to separate since they show significant overlap. We report one such unusual case of juvenile hyaline fibromatosis in a 10 year old female presenting mainly with gingival hyperplasia