Aggressive Central Giant Cell Granuloma in a Child: A Case Report and Review

Introduction: An aggressive variant of central giant cell granuloma in a paediatric patient is a localized benign osteolytic prolif- eration. The lesion consist of fibrous tissue with haemorrhage, hemosiderin deposits and presence of osteoclast-like giant cells with reactive bone formation. Clinically shown with rapid growth, resorption of roots, displacement of teeth and thinning or perforation of cortical bone, and marked recurrence. Case presentation: A 9-year-old boy reported with a 3 days history of asymptomatic soft tissue swelling in left mandibular pos- terior region which was diagnosed as central giant cell granuloma based on clinical, radiological and histopathological features. Management and Prognosis: Surgical resection was performed without any signs of recurrence on 9 months follow up. Conclusion: Prompt diagnosis and treatment of Central giant cell granuloma can significantly improve morbidity and long- term outcomes.

Aggressive central giant cell granuloma of the mandible: A case report and review of literature

Mandibular aggressive central giant cell granuloma is a rare non-neoplastic giant cell tumour characterised by pain, bone destruction, tooth root resorption, jawbone cortical perforation, and high recurrence rate. This is a case of a 10-year-old boy who presented to the Dental Surgical outpatient clinic of University of Uyo Teaching Hospital with a three-year history of left jaw swelling. The clinical diagnosis was fibrous dysplasia of the left hemi-mandible. Consequently, left hemi-mandibulectomy was performed, and subsequent histopathological diagnosis was aggressive central giant cell granuloma of the mandible. This article presents this rare diagnosis and explores its classification, aetiopathogenesis, clinico-pathological features and management.

Granuloma gigantocelular central: presentación de un caso / Central giant cell granuloma: report of a case

Objetivo: el objetivo de este estudio es describir y presentar el tratamiento para los granulomas gigantocelulares centrales con múltiples recidivas. Caso clínico: paciente femenina de 14 años que presenta granuloma gigantocelular central en maxilar inferior izquierdo, con múltiples recidivas luego del curetaje del mismo. Clínicamente se observa aumento de tamaño, desplazamiento dentario y, radiográficamente, una gran zona radiolúcida compatible con pérdida ósea. Se realizó la resección de la lesión en bloque con margen de seguridad, conservando la basal mandibular con colocación de placa de osteosíntesis de carga soportada. Conclusiones: el granuloma gigantocelular central es una lesión osteolítica, generalmente de crecimiento lento, asintomático y no agresivo. El tratamiento quirúrgico de resección con márgenes de seguridad es fundamental debido a su gran potencial de recidiva (AU)

Assessment of Efficacy of Oral Calcium Carbonate and Intralesional Triamcinolone Injections in the Management of Central Giant Cell Granuloma of Mandible

The common treatment of Central giant cell granuloma is surgery. Recently non-surgical treatments have been described and their benefits may be worthy of consideration. Hence; we assessed the efficacy of oral calcium carbonate and intralesional triamcinolone injections as a viable treatment option in the management of Central giant cell granuloma (CGCG) of mandible. Methods: A total of 20 patients with CGCG were included in the present study. Complete oral intra-oral and extra-oral examination was carried out in all the patients. Radiograph investigation was carried out in all the patients. In all the patients, intralesional infiltration of triamcinolone was done.Approximately eight to ten injections were given in all the patients over a period of two weeks. Assessment of lesion both clinically and radiographically was done at successive follow-ups upto two years. All the results were recorded in Microsoft excel sheet and were analysed by SPSS software. Results: Radiographic resolution of the lesion at 2 year follow-up was seen in 18 patents while clinical resolution of the lesion was seen in 19 patients. Clinical success of the treatment was seen in 95 percent of the cases while radiographic success of the treatment was seen in 90 percent of the cases. Conclusion: Although treatment of CGCG is still controversial, intralesional steroid injections are safer and effective line of treatment of CGCG.

Central giant cell granuloma – A case report

Central giant cell granuloma (CGCG) of the jaws is a benign, intraosseous, osteolytic lesion of debatable etiology. CGCG lacks in clinical and radiographical pathognomonic features to distinguish from common lesions occurring in this region. Histopathology still remains the predominant diagnostic modality to identify the disorder. Clinically aggressive lesions and atypical lesions can lead to early damage and may necessitate aggressive therapy to prevent recurrences. A case of an aggressive type of CGCG of the maxilla in a young adult male patient with diagnostic and treatment challenge is presented.

Granuloma central de células gigantes: caso clínico y tratamiento quirúrgico / Central giant cell granuloma: a clinical case and surgical treatment

Objetivo: Describir y diagnosticar el granuloma central de células gigantes para poder seleccionar el tratamiento indicado, la enucleación, el curetaje o la resección en bloque de la lesión. Caso clínico: El paciente presentaba un granuloma central de células gigantes en el maxilar inferior derecho. Clínicamente, se observaba un aumento de tamaño y desplazamiento dentario, y radiográficamente, una gran zona radiolúcida compatible con pérdida ósea y piezas dentarias incluidas en el tumor. Se realizó la resección de la lesión en bloque con margen de seguridad, conservando la basal mandibular. Conclusión: El granuloma central de células gigantes requiere de un diagnóstico preciso, a fin de llevar a cabo el tratamiento adecuado. Consideramos que el tratamiento quirúrgico es la mejor opción, ya que minimiza el riesgo de recidiva (AU)

Aim: To describe and diagnose the central giant cell granuloma in order to select the indicated treatment, enucleation, curettage or block lesion resection. Case report: The patient presented a central giant cell granuloma in the lower jaw right side. An increase in size and dental displacement and a large radiolucent zone compatible with bone loss and dental pieces included in the tumor were clinically and radiographically detected. Resection of the lesion was performed in a block with safety margin preserving the mandibular basal bone. Conclusion: Central giant-cell granuloma requires an accurate diagnosis in order to perform the appropriate treatment. We consider surgical treatment as the best valid option, minimizing the risk of relapse (AU)

Evaluation of the osteopontin in oral peripheral and central giant cell granuloma

Aim: Peripheral giant cell granuloma (PGCG) and central giant cell granuloma (CGCG) of the jaws are benign proliferations of spindle-shaped mesenchymal cells and multinucleated giant cells. Despite the histopathologic similarities, they have markedly different clinical behavior. PGCG shows low recurrence rate whereas CGCG shows a variable clinical behavior ranging from nonaggressive lesions to aggressive lesions characterizing by pain, rapid growth, and high recurrence rate. Therefore, the aim of the study was to compare CGCG with PGCG by immunohistochemistry using Ki-67, osteopontin (OPN), and integrin ?vantibodies. Subjects and Methods: Twenty PGCG and 20 CGCG were selected for immunohistochemical evaluation of OPN, integrin ?v, and Ki-67 in multinucleated giant cells and mononucleated cells of PGCG and CGCG. Results: PGCG showed higher Ki-67 immunoreactivity in mononucleated cells compared to CGCG (P < 0.05). There was no reactivity with Ki-67 in multinucleated giant cells of both groups. Mononucleated cells in CGCGs demonstrated increased OPN and integrin ?vexpressions in comparison with PGCGs (P < 0.05). Conclusions: The clinic behavior of CGCG being more aggressive than PGCG might be explained by the high expression of OPN and integrin ?v. Further studies are necessary to evaluate the other OPN receptors and their role on the biologic behavior of these lesions.

Central giant cell granuloma in a child: case report / Granuloma central de células gigantes en un niño: reporte de un caso

This article describes a case of central giant cell granuloma in the right posterior region of the mandible in a 10- year-old boy. The lesion was removed by curettage and a histopathological examination was carried out.

En este artículo se describe un caso de granuloma central de células gigantes en la región posterior derecha de la mandíbula en un niño de 10 años de edad. La lesión se retiró por legrado y se realizó un examen histopatológico.

Central Giant Cell Granuloma.

World Health Organization (WHO) defines central giant cell granuloma (CGCG) as an intraosseous lesion consisting of cellular fibrous tissue and contains many foci of hemorrhage, aggregations of multinucleated giant cells, and occasionally trabeculae of woven bone. Clinically and histopathologically CGCG resembles many other jaw lesions hence it has to be differentiated from them for judicious management of the lesion. Here we present a case of CGCG of palate in a 21-year-old female patient.[Jigna SNJIRM 2016; 7(5):101-104]

Agressive central giant cell granuloma of the mandible: case report / Agressivo granuloma central de células gigantes de mandíbula: relato de caso

Granulomas de células gigantes (GCCG) são lesões benignas intra-ósseas proliferativas. Estas lesões podem aparecer na região anterior da maxila ou da mandíbula, porém mais frequentemente encontradas na mandíbula. A etiopatogenia permanece desconhecida, no entanto, alguns autores consideram como uma resposta reparadora, ao invés de uma condição neoplásica. Clinicamente, o CGCG é assintomático, podendo causar expansão com desvio ou a proliferação da cortical óssea. Esta condição é geralmente unifocal. A remoção cirúrgica é, na maioria dos casos, o tratamento de escolha. Embora, os métodos de tratamento não-cirúrgicos, tais como injeções intralesionais de corticoesteróides, administração sistêmica de calcitonina e interferon foram relatados. Este artigo descreve as características radiográficas de um CGCG extenso na região anterior mandibular em um paciente de 09 anos de idade. O tratamento incluiu ressecção óssea com substituição por tíbia e aplicação de fatores de crescimento ósseo.

Central giant cell granulomas (CGCG) are benign intraosseous proliferative lesions. Usually located are at the anterior region of the maxilla ormandible, although are more frequently found in the mandible. Etiopathogenesis of these lesions has remained unknown, however, some consider them as reparative response rather than neoplastic condition. Clinically CGCG present as asymptomatic, with expansive swelling causing deviation or proliferation of cortical bone. This condition is usually unifocal. Surgical removal is often the preferred treatment. Although nonsurgical treatment methods, such as intralesional corticosteroid injections, systemic calcitonin and interferon have been reported. This article describes the radiographic features of a large CGCG in the anterior mandibular region seen in a9 year-old patient. Treatment of this lesion included resection of the anterior region of the mandible and replacement by tibia with bone growth factors.

Tratamento de Lesão Central de Células Gigantes Recidivante: relato de caso / Treatment of Recurrent Central Giant Cell Granuloma: a case report.

A lesão central de células gigantes (LCCG) é uma alteração óssea rara, não neoplásica, encontrada nos ossos gnáticos. Sua etiologia é desconhecida, e seu comportamento biológico, pobremente estudado. Manifesta-se, principalmente, em adultos jovens do gênero feminino. Geralmente é assintomático e descoberto em exames radiográficos de rotina. O caso descrito mostra uma lesão óssea em região de corpo de mandíbula do lado esquerdo, assintomática e com expansão das corticais vestibular e lingual, em uma menina de 8 anos de idade. Após biópsia incisional e análise histológica, confirmou-se o diagnóstico de LCCG. O tratamento proposto foi a curetagem da lesão, sob anestesia geral e a manutenção dos germens dentários dos pré-molares. Com a recidiva da lesão, houve necessidade de extração dos elementos 32, 34, 35 e 36. Mesmo após essa abordagem, uma nova recidiva ocorreu, levando a paciente a ser submetida à ressecção em bloco da região. Após três anos, há indicativo de sucesso de tratamento tanto nos exames clínicos quanto nos radiográficos.

Central giant cell lesion (CGCL) is rare, non-neoplastic bone lesion that appears in gnathic bone. Its etiology is unknown and its biological behavior has been little studied. It is manifested mostly in young adult females. It is usually asymptomatic and discovered on a routine radiographic examination. The case described, an 8-year-old girl, shows a bone lesion in a region of the mandibular body, on the left side, asymptomatic, with a buccal and lingual cortical plate expansion. After incisional biopsy, the diagnosis of CGCL was confirmed. The treatment proposed was curettage, under general anesthesia, preserving the premolar germs. With the recurrence of the disease, the extraction of the teeth 32, 34, 35, 36 was necessary. Even after this management, a new relapse occurred, causing the patient to undergo a further procedure: segmental resection. After 3 years, both the clinical and radiographic examinations indicate the success of the treatment.

Non aggressive yet massive central giant cell granuloma of the mandible (a rare case report with surgical management).

Central giant cell granuloma (CGCG) is an uncommon benign intraosseous lesion of the jaws accounting for approximately 7% of all benign tumors of the jaws. The traditional treatment of CGCG is surgical removal. However, the extent of tissue removal ranges from simple curettage to en bloc resection and reconstruction. This article describes a massive yet nonaggressive type of central giant cell granuloma involving the body of the mandible in a 32 years old female with its surgical management.

Granuloma central de células gigantes / Giant cells central granuloma

El granuloma reparativo central de células gigantes es una lesión proliferativa no neoplásica de etiología desconocida. Se presenta un paciente masculino de 40 años de edad, portador de prótesis parcial superior. Fue remitido al Servicio de Cirugía Maxilofacial del Hospital V I Lenin por presentar aumento de volumen en reborde alveolar superior, de color rojo grisáceo y que provocaba expansión de corticales óseas. Una vez analizados los exámenes clínicos, radiográficos e histopatológicos se diagnosticó un granuloma reparativo central de células gigantes Se realizó exéresis quirúrgica de la lesión y extracción de dientes adyacentes con una evolución satisfactoria sin señales de recidivas luego de tres años del tratamiento. El granuloma reparativo central de células gigantes se presentó como respuesta a un trauma. La correcta interpretación de los datos clínicos, radiográficos e histopatológicos nos permitió llegar al correcto diagnóstico y plan de tratamiento(AU)

Giant-cell central reparative granuloma is non neoplastic proliferative lesion of unknown etiology. We report a 40 years old male patient who was admitted at the Maxillofacial Service of the V I Lenin Hospital. The patient had partial upper prosthesis and was complaining of red-grey volume increase lesion in upper alveolar ridge which led to the expansion of cortical bone. Having analyzed clinical, radiographic and histopathological findings the case was concluded as a giant-cell central reparative granuloma. Surgical exeresis and adjunct tooth extraction were done. After three years of treatment, satisfactory follow up without recurrence is reported(AU)

Lesão central de células gigantes agressiva: relato de caso e revisão dos aspectos atuais / Aggressive central giant cell granuloma: a case report and review of the current aspects

A lesão central de células gigantes (LCCG) é considerada uma lesão rara de natureza proliferativa, de etiologia e patogenia desconhecidas. Ocorre mais em região de mandíbula e no gênero feminino. Este artigo relata um caso de LCCG em uma paciente do gênero feminino, 30 anos, melanoderma, e aborda aspectos atuais desta lesão, no tocante ao comportamento clínico, etiopatogenia e tratamento.

The central giant cell granuloma (CGCG) is regarded as a rare proliferative lesion of unknown etiology and pathogenesis. It occurs frequently in the jaw region and in females. This article reports a case of CGCG in a female patient, 30 years-old, black and addresses current aspects of this lesion with regard to clinical behavior, pathogenesis and treatment.