An aggressive central giant cell granuloma in a pediatric. Central giant cell granuloma cgcg is a lesion that appears to be unique to the jaws, 1115 although the socalled giant cell reaction of the hands and feet shares many features. Clinically and radiologically, a differentiation between aggressive and nonaggressive lesions can be made. Radiologic features, including those seen with computed tomography of central giant cell granuloma of the jaws. The case reported here resembled a wide variety of conditions that led to a misdiagnosis both on clinical and radiographic examinations but was histopathologically diagnosed as cgcg. Giant cell granuloma an overview sciencedirect topics. Central giant cell granuloma of the jaws and giant cell. The aim of this study was to compare cgcg of the jaws and gct of long bones from clinicopathology, cytometry and immunohistochemistry aspects. Central giant cell granuloma cgcg is regarded as a benign tumour affecting the jaws. Central giant cell granuloma in a dialyzed patient. The term reparative giant cell granuloma was at one time widely accepted as. The appearance is generally distinctive with multinucleated giant cells spread throughout the lesion but often focal in distribution around areas of possible hemorrhage figure 4. Central giant cell granuloma is an uncommon benign intraosseus lesion of jaws. It is a noncancerous condition that is usually painless, but irritation and open lesions in the mouth can lead to an infection and uncomfortable swelling.
Giant cell lesions of the jaws were separated out from other jaw lesions by jaffe in 1953 when they were termed giant cell reparative granulomas. Their clinical behavior8,29, prognostic factors and the histogenesis have been subject of several studies. Assessment of cell cycle proteins several reports have demonstrated the presence of a high proliferative activity in central giant cell. Kaffe i, ardekian l, taicher s, litner mm, buchner a. Central giant cell granuloma of the maxilla bmj case reports. Diagnosis of central giant cell granuloma is normally made histologically from an incisional biopsy.
Multifocal central giant cell lesions of the maxillofacial skeleton. In addition, differentiating between aggressive and nonaggressive central giant cell granuloma cgcg of the jaws based on histopathologic features is still impossible and due to different treatment protocols for the two groups, correct diagnosis is necessary. Request pdf central giant cell granuloma of the jaws. In spite of that, these questions remain unclear 11,16,23,26 morphologic studies performed in order to compare cgcg and gct features have. Central giant cell granuloma of the mandible youtube. Interventions for central giant cell granuloma of the jaws. Central giant cell granuloma of the jaws and giant cell tumor of long bones are wellrecognized entities revealing benign nature16. The central giant cell granuloma cgcg was first described by jaffe in 1953 as a giantcell reparative granuloma of the jaw bones. Central giant cell granuloma cgcg is an uncommon benign bony lesion that occurs in the mandible and maxilla. Central giant cell granuloma of the jaws springerlink.
Central giant cell granuloma cgcg, formerly called giant cell reparative granuloma, is a nonneoplastic proliferative lesion of an unknown aetiology. The central giant cell granuloma cgcg of the jaws is a rare benign tumour of the mandible lower jaw and the maxilla upper jaw characterized by destruction of the bone, loss of symmetry of the face and displacement of teeth and tooth germs, especially in younger patients. Multinucleated giant cells and individual mononuclear cells cd68 positive in central giant cell granuloma of the jaws arrow sabc 200x figure 2. The central giant cell granuloma cgcg is an uncommon benign bony lesion that accounts for less than 7% of all benign lesions of the jaws in toothbearing areas. The diagnosis and management of giant cell lesions of the jaws.
The term central giant cell lesion has been proposed as a microscopic feature and not those of a true granulomatous process. For the previously reported cases in one female and three males, the mean age at presentation was 30 years. It occurs most frequently in young women aged 30 years underwent measurement of their calcium and. This case report describes a 19yearold female patient with a central giant cell granuloma in the left mandibular condyle, treated with en bloc resection.
A histological comparison of the giant cells in the central giant cell granuloma of the jaws and the giant cell tumor of long bone. The neoplastic status of the central giant cell granuloma of the jaws remains an unsolved contro versy in anatomic pathology. Central giant cell granuloma is a benign lesion of the jaws which is sometimes aggressive locally. Traditional treatment has been local curettage, although aggressive subtypes have a high tendency to recur. Recurrent central giant cell granuloma in the mandible.
Electronmicroscopic and immunohistological analyses. Cgcg usually occurs in patients younger than 30 years, is more common in females than in males, and is more common in the mandible than in the maxilla. Pimary hyperparathyroidism as central giant cell granuloma of the jaws. This patient report describes a recurrent central giant cell granuloma. Peripheral giant cell granuloma common tumor like growth in the oral cavity. Traditional treatment has been local curettage, although aggressive subtypes. Pre and posttreatment pattern of clinical and radiographic presentation nalini aswath 1, pravda chidambaranathan 2. The aim of this study was to determined demographic, clinical and radiographic features of central giant cell granuloma cgcg of the jaws, for the first time, in north east iran. Central giant cell granuloma of the jaw is considered a nonneoplastic lesion. Central giant cell granuloma of the mandible american. Central giant cell granuloma cgcg of the jaws and giant cell tumor gct of bone share a number of similarities and dissimilarities in respect of their histopathological, cytometric and immunohistochemical features. Central giant cell granuloma venkateshwarlu et, al 6.
Cgcg was formerly regarded as a reparative process and was, accordingly, called central giant cell reparative granuloma. A clinical, radiologic and histopathologic study of 26 cases ooo 2006. Central giant cell granulomas cgcgs are jaw tumors of unknown origin that often exhibit an aggressive, though unpredictable, clinical course. Odontogenic cysts, odontogenic tumors, fibroosseous, and. This condition is a slowgrowing, asymptomatic lesion that usually affects children and young adults, predominantly females. Central giant cell granuloma cgcg is a benign lesion of the jaws with an unknown etiology. The purpose of this study was to determine the immunoprofile of the mononuclear cells that seem to be responsible for the biologic behavior of these tumors.
Central giant cell granuloma of the mandibular condyle. Pdf objective this study was performed to retrospectively analyse the imaging features of patients with central giant cell granulomas. Multinucleated giant cells and individual mononuclear cells cd68 positive in giant cell tumor of long bones arrow sabc 400x fibronectin and tenascin. Full text pimary hyperparathyroidism as central giant. A central giant cell granuloma is a type of bone lesion that appears along the jaw. We present a case of an aggressive central giant cell granuloma cgcg in a six yearold female. The first description of this rare lesion was introduced by jaffe in 1953.
The clinical behavior of cgcg of the jaws is variable and difficult to predict. Central giant cell granuloma was classified by the world health organization in 2005 as a rarely aggressive idiopathic benign intraosseous lesion that occurs almost exclusively in the jaws. Radiologic features of central giant cell granuloma of the jaws. The lesions occur more frequently in females than in males and are more often located in the mandible than in the maxilla. Recurrent central giantcell granuloma in the mandible. Harris m 1993 central giant cell granulomas of the jaws regress with calcitonin therapy. Also called giant cell reparative granuloma central if intraosseous. Aggressive types of tumours are usually expansive and rapidly grow, causing pain, bleeding, and. Central giant cell granuloma cgcg appears to be a lesion that is unique to the jaws, although socalled giant cell reaction of the hands and feet shares many features. Shows preop considerations, the operative removal, and properties of the giant cell granuloma. In this retrospective study, records of patients with definitive diagnosis of cgcg were extracted from the. Central giant cell granuloma is a benign intraosseous lesion of the jaws. Central giant cell granulomas of the condyle are rare. F stavropoulos and j katz central giant cell granulomas.
It is an uncommon, benign and proliferative non neoplastic process. Radiologic features of central giant cell granuloma of jaws. The most common treatment is curettage,which has a high recurrence rate, particularly in more. Central giant cell granulomas are benign tumours of the mandible, presenting in children and young adults. Central giant cell granuloma of the anterior maxilla.
Central giant cell granuloma, fibrous dysplasia introduction central giant cell granuloma and. Central giant cell granuloma and fibrous dysplasia occurring in the same jaw is rarely reported in the literatures. The concept at that time was that these lesions only seemed to occur in the jaws, they were found in the first two decades of life, more frequently in females approximately 2. Uses microscopic slides and shows postops of 1,4,and 7. Quantification of bone gain in central giant cell granuloma of the jaws submitted to intralesional corticotherapy results in the present study, from a universe of 32 patients, 16 met the inclusion criteria of the study and had their panoramic radiographs undergoing analysis for bone gain quantification. Central giant cell granuloma and fibrous dysplasia. Central giant cell granuloma cgcg is an intraosseous lesion consisting of cellular fibrous tissue that contains multiple foci of hemorrhage, aggregations of multinucleated giant cells and occasionally trabeculae of woven bone. Cgcg, as described by jaffe in 1953 is an idiopathic nonneoplastic proliferative lesion. Divided into non and aggressive subtypes, the aggressive subtype is relatively rare and can occasionally progress rapidly, resulting in significant morbidity. Its etiology is unknown and its biological behavior is poorly understood.
Intralesional steroid treatment of central giant cell. Central giant cell granuloma was 1st described in jaws by jaffe 1953. Giant cell granuloma gcg is an uncommon, benign, proliferative, intraosseous lesion representing clinicalpathological considerations and report of a case. Central giant cell granuloma was first described by jaffe in 1953. It was first described as central giant cell reparative granuloma by jaffe h l in the year 1953. An aggressive central giant cell granuloma in a pediatric patient.