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.

Expresión Inmunohistoquímica de Ki-67 en Lesión Central de Células Gigantes / Immunohistochemical Expression of Ki-67 in Central Giant Cell Lesion

RESUMEN: La lesión central de células gigantes (LCCG) es una lesión osteolítica benigna que en algunos casos presenta un comportamiento agresivo, con recidiva y mal pronóstico. Ki-67 es una proteína nuclear cuya función general es la regulación de la proliferación celular. Este marcador es utilizado para el reconocimiento de células en proliferación y como herramienta de pronóstico en el diagnóstico de neoplasias. El objetivo de este estudio fue cuantificar la inmunoexpresión de Ki-67 en las diferentes poblaciones celulares de las LCCG y analizar su asociación con las características clínicas, demográficas y radiográficas. Se evaluó la inmunoexpresión de Ki-67 de 17 casos de LCCG en dos poblaciones celulares: células gigantes multinucleadas (CGM) y células mesenquimatosas estromales (CME). El análisis estadístico se efectuó con el programa SAS 9.0 y SPSS versión 23.0, con un nivel alfa impuesto de P<0,05. Las CME mostraron inmunoexpresión promedio de 9,4 % y las CGM de 0,65 %. No se encontró relación estadísticamente significativa entre las características clínicas, demográficas y radiográficas de las LCCG y la inmunoexpresión de Ki-67. La expresión de Ki-67 en CME sugiere que esta población se encuentra en constante actividad celular y que las LCCG son lesiones dinámicas y en constante proceso de diferenciación.

ABSTRACT: The central giant cell lesion (CGCL) is a benign osteolytic lesion which in some cases presents an aggressive behavior with recurrence and poor prognosis. Ki67 is a nuclear protein whose general function is the regulation of cell proliferation. This marker is used to identify proliferating cells and as a prognostic tool in the diagnosis of neoplasms. The aim of this study was to quantify the immune expression of Ki-67 in the different cell populations of CGCL and analyze its association with clinical, demographic and radiographic characteristics. The Ki-67 immune expression of 17 cases of LCCG was evaluated in two cell populations: multinucleated giant cells (CGM) and stromal mesenchymal cells (SMC). The statistical analysis was carried out with SAS 9.0 and SPSS version 23.0, with an alpha tax level of P <0.05. The CME showed average immune expression of 9.4 % and the CGM of 0.65 %. No statistically significant relationship was found between the clinical, demographic and radiographic characteristics of the CGCL and the immune expression of Ki-67. The expression of Ki-67 in CME suggests that this population is in constant cellular activity, and that the CGCL are dynamic lesions in a continuous differentiation process.

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.

Comparación de inmunoexpresión de receptores CD68 en células gigantes y mononucleadas en lesiones central y periférica de células gigantes de los maxilares / A comparison of immunoexpression of CD68 receptors in giant cell and mononuclear cells of central and peripheral giant cell lesions of the jaws

Introducción: La lesión central (LCCG) y periférica (LPCG) de células gigantes de los maxilares, son lesiones reactivas con comportamiento clínico diferente. Objetivo: Comparar la inmunoexpresión de CD68 en células gigantes (CGm) mononucleares (CMn) en lesiones central y periférica de los maxilares. Material y métodos: Se evaluaron 35 casos de LCCG y 24 de LPCG en bloques de parafi na que podían ser procesadas para la expresión del anticuerpo CD68. La inmunoexpresión se valoró en el citoplasma de ambas poblaciones celulares, obteniendo proporciones; la inmunoexpresión se categorizó en intensa, moderada, leve. Las proporciones se compararon con χ2, siendo signifi cativo p ≤ 0.05. Resultados: Para las CGm de LCCG, CD68 se expresó en una proporción de 96 versus 84.2% LPCG (p < 0.005). La proporción de la tinción de la expresión intensa y moderada fue más frecuente en las LCCG (p = 0.032). Las proporciones entre las CMn 59.3% LCCG versus 18.6% en la LPCG (p < 0.001). Hubo diferencia en intensidad de CD68, en las CMn de LCCG fue mayor (p = 0.002). Conclusiones: La alta expresión de CD68 en las CGM y CMn en la lesión central y periférica confi rma su fenotipo de macrófago. Las diferencias entre las proporciones y la tinción a CD68 refl eja mayor actividad fagocítica posiblemente relacionada con el comportamiento clínico (AU)

Introduction: Central (CGCL) and Peripheral (PGCL) giant cell lesions of jaws are reactive lesions displaying diff erent behavior patterns. Objective: To compare CD68 immunoexpression between CGCL and PCGL in giant multinucleated and mononuclear cells. Material and methods: 35 CGCL and 24 PGCL were retrieved from paraffi n-embedded biopsy, as well as the feasibility to analyze CD68 immunoexpression. The immunoexpression was analyzed in cytoplasm both cell populations cellular, for and staining intensity was categorized as intense, moderate or faint. Proportions were compared by χ2, making a p ≤ 0.05 value signifi cate. Results: In 96% of CGCL's in GMCs displayed CD68, as compared to 84.2% in PGCL, (p < 0.005). The proportion of stained cells, intense to moderate staining was more frequent in CGCL (p = 0.032). The proportion CD68 was expressed in 59.3% or CGCL mononuclear cells, as compared to 18.6% in PGCL, (p < 0.001). There was diff erence in staining CD68 intensity between mononuclear cells in CGCL, (p = 0.002). Conclusions: The high CD68 expression frequency in GMCs and mononuclear cells in central and peripheral GCL confi rm a macrophage phenotype; a more intense staining in CGML and GMCs suggests a more active phagocytic activity, and possibility underline the diff erent clinical behavior (AU)

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.

Central Giant Cell Granuloma ; A Case Report.

Central giant cell granuloma ( CGCG) was classified as rarely aggressive idiopathic benign intraosseous lesion that occurs mostly exclusively in the jaws. It occurs most frequently in young women. It is usually slow growing and non neoplastic lesion which exhibits a spectrum of clinical behavior ranging from non aggressive to aggressive variants. The striking feature of this case is its aggressive nature and presence of this lesion in the anterior part of maxilla which considers being a rare finding as the lesion commonly occurs in the mandibular region anterior to first molar.

Análise comparativa da imunoexpressão de GLUT-1, GLUT-3 e M-CSF em lesão periférica e central de células gigantes / Comparative analysis of GLUT-1, GLUT-3 and M-CSF immunoexpression in peripheral and central giant cell lesions

A lesão periférica de células gigantes (LPCG) e a lesão central de células gigantes (LCCG) são patologias histologicamente semelhantes que acometem a região de cabeça e pescoço. O estudo objetivou analisar a expressão imuno-histoquímica dos marcadores GLUT-1, GLUT-3 e M-CSF em uma série de casos de LPCG e LCCG, na tentativa de compreender os diferentes comportamentos biológicos destas entidades patológicas. A amostra foi constituída por 20 espécimes teciduais de LPCG, 20 de lesão central de células gigantes não agressivas (LCCGNA) e 20 de lesão central de células gigantes agressivas (LCCGA), oriundos do Serviço de Anatomia Patológica da Disciplina de Patologia Oral do Departamento de Odontologia da UFRN. Foi realizada a análise semiquantitativa e qualitativa da expressão imuno-histoquímica dos marcadores nas células gigantes e nas células mononucleares. Em relação ao GLUT-1, verificou-se uma diferença estatisticamente significativa na quantidade de células mononucleares imunomarcadas entre a LPCG e a LCCGNA e entre a LPCG e a LCCGA. Em relação à intensidade da marcação também foi verificado uma diferença estatisticamente significativa tanto para as células mononucleares quanto para as células gigantes entre LPCG e LCCGNA e entre LPCG e LCCGA, nas células gigantes também ocorreu uma diferença estatisticamente significativa entre a LCCGNA e a LCCGA. Em relação ao GLUT-3, foi encontrada uma diferença estatisticamente significativa entre LPCG e LCCGA e entre LCCGNA e LCCGA na quantidade de células mononucleares imunomarcadas. No que concerne à intensidade de marcação para a referida proteína foi verificado uma diferença estatisticamente significativa nas células gigantes entre LPCG e LCCGA. Para o M-CSF foi observada apenas uma diferença estatisticamente significativa na intensidade de marcação nas células mononucleares entre LPCG e LCCGNA e entre LPCG e LCCGA. Com base nestes resultados, pode-se concluir a participação do GLUT-1, GLUT-3 e do M-CSF na patogênese das lesões estudadas. A maior imunomarcação destas proteínas nas células mononucleares evidenciam que tais células desempenham uma maior atividade metabólica e osteoclastogênica, principalmente nas LCCGA. Constatou-se que as células mononucleares estavam mais relacionadas à patogênese das lesões estudadas do que propriamente as células gigantes (AU).

The peripheral giant cell lesion (PGCL) and the central giant cell lesion (CGCL) are lesions histologically similar affecting the head and neck region. The study aimed to analyze the immunohistochemical expression of markers GLUT-1, GLUT-3 and MCSF in a series of cases of PGCL and CGCL, in trying to understand the different biological behavior of these pathologies. The sample consisted of 20 tissue specimens of PGCL 20 central lesion of not aggressive giant cell (CLNAGC) and 20 central lesion of aggressive giant cell (CLAGC), coming from the Pathology Unit of Oral Pathology of the Department of Dentistry of UFRN. Was performed the semi-quantitative and qualitative analysis of immunohistochemical expression of the markers in giant cells and mononuclear cells. In relation to the GLUT-1, it was found a statistically significant difference (p <0.05) in the number of mononuclear cells immunomarked between the PGCL and the CLNAGC and between the PGCL and CLAGC. Regarding the intensity of staining was also observed a statistically significant difference both at the mononuclear cells as in giant cells between PL and CLNAGC and between PGCL and CLAGC, at the giant cells there was also a statistically significant difference between the CLNAGC and CLAGC. In relation to GLUT-3, was found a statistically significant difference between PGCL and CLAGC and between CLAGC and CLNAGC in amount of mononuclear cells immunomarked. Regarding the intensity of labeling for such protein was found a statistically significant difference at the giant cells between PL and CLAGC. To the M-CSF was observed only a statistically significant difference in the intensity of labeling at the mononuclear cells between PGCL and CLNAGC and between PGCL and CLAGC. Based on these results, we can conclude the participation of GLUT-1, GLUT-3 and M-CSF in the pathogenesis of the lesions studied. The bigger immunostaining of these proteins in mononuclear cells show that these cells perform a higher metabolic activity and osteoclastogenic, especially in CLAGC. It was found that the mononuclear cells were more related to the pathogenesis of the studied lesions than properly the giants cells (AU).

Lesión híbrida conformada por una lesión central de células gigantes y un fibroma osificante central: reporte de un caso y revisión de la literatura / Hybrid lesión composes by a central giant cell lesion and central ossifying fibroma: a case report and review of literature

Las lesiones híbridas son entidades poco frecuentes conformadas por elementos histopatológicos de distintas lesiones, la asociación de un Fibroma Osificante Central (FOC) con una Lesión Central de Células Gigantes (LCCG) es un ejemplo de ellas y representa el tipo más frecuentemente reportado en la literatura con diez casos hasta la fecha. A continuación presentamos el caso de una paciente de 24 años de edad, quien es referida al servicio de clínica estomatológica de la Facultad de Odontología, por presentar un aumento de volumen en la zona mandibular derecha que ocasiona asimetría facial, al examen intrabucal se observó una lesión tumoral de aproximadamente 2,5 cms. de diámetro y recubierta por mucosa bucal sana, que se extendía desde el canino inferior derecho hasta el segundo premolar del mismo lado (de 43 al 45). La paciente refiere una evolución de 3 meses y aparición posterior a un trauma. Se indican pruebas hematológicas y de vitalidad pulpar de los dientes involucrados, tomografía computarizada y biopsia Incisional, la cual concluye: LCCG asociada a FOC. Se trata con recesión quirúrgica total previo tratamiento endodóntico de los dientes involucrados y después de dos años la paciente se mantiene libre de recidiva. El reporte de este tipo de lesiones híbridas permitirá entender mejor en el futuro su comportamiento y a su vez brindar el tratamiento más adecuado a estos pacientes.

Hybrid lesions are rare entities formed by histopathological elements of different lesions, the association of a Central Ossifying Fibroma (COF) with a Central Giant Cell Lesion (CGCL) is an example of them and represents the most frequently reported type in the literature, only ten cases to date. We present the case of a 24 years female patient, who is referred to the dental clinic service to present a swelling in the right mandibular region causing facial asymmetry, the intra oral examination revealed a 2,5 cm lesion covered with healthy oral mucosa which extended from the distal aspect of lower right canine to the right second bicuspid, with 3 months evolution and associated to a trauma. Haematological tests, pulp vitality of involved teeth, CT scan and incisional biopsy were indicated, concluding a diagnosis of COF associated to CGCL. The decision was made to go for the surgical approach of the lesion with previous endodontic treatment of involved teeth and after two years the patient remains free of recurrence. The report of this type of hybrid lesions helps to understand their behavior and guides to the best treatment for these patients.

Tratamento combinado de granuloma central de células gigantes através de corticoterapia e enucleação: relato de caso / Combined Treatment of central giant cell granuloma through corticotherapy and enucleation: case report

O granuloma central de células gigantes (GCCG) é uma lesão com predileção pelo sexo feminino, geralmente antes dos 30 anos, que se apresenta radiograficamente uni ou multilocular, mais frequentemente, em região anterior de mandíbula, podendo causar deslocamento dentário e reabsorção radicular, expansão ou destruição das corticais ósseas. As formas de tratamento incluem ressecção, curetagem, aplicações intralesionais de corticoides, calcitonina, interferon ou uma combinação de técnicas. O objetivo deste trabalho é relatar o caso de um paciente portador de GCCG tratado através de injeções intralesionais de triancinolona seguidas de curetagem e ostectomia periférica... (AU)

Central giant cell granuloma (GCCG) is a lesion with a predilection for females, usually before the age of 30, which radiographically presents uni or multilocular, more frequently in the anterior region of the mandible, and may cause tooth displacement and root resorption, expansion or destruction of cortical bone. Forms of treatment include resection, curettage, intralesional applications of corticosteroids, calcitonin, interferon or a combination of techniques. The objective of this study is to report the case of a patient with GCCG treated with intralesional injections of triamcinolone followed by curettage and peripheral ostectomy... (AU)

Peripheral and central giant cell lesions: etiology, origin of giant cells, diagnosis and treatment / Lesão periférica e lesão central de células gigantes: etiologia, origem das células gigantes, diagnóstico e tratamento

INTRODUCTION AND OBJECTIVE: The peripheral and central giant cell lesions (PGCL and CGCL) are a group of pathological entities with similar histopathological features and whose origin has not been fully elucidated. The former is reactive and the latter exhibits a non-neoplastic proliferative behavior. This article aims to review the literature on peripheral giant cell lesions (PGCL) and central giant cell lesions (CGCL) by discussing the most important aspects pertaining to each of them. RESULTS: These lesions are found in different locations and show diverse clinical signs despite having the same histopathological features. The treatment consists in the surgical resection by different techniques depending on the type of the lesion and clinical conditions. In the case of CGCL, drug therapy may also be employed. CONCLUSION: Although there is no consensus in the literature, it is essential to know the etiology of these lesions as well as the exact origin of the giant cells. Due to their singular biological behavior, it is of utmost importance to establish a differential diagnosis between the two lesions and other processes that have similar clinical, radiological and histological characteristics, inasmuch as this procedure is essential to provide a suitable treatment and establish a prognosis.

INTRODUÇÃO E OBJETIVO: As lesões periféricas e centrais de células gigantes (LPCG e LCCG) constituem um grupo de entidades patológicas com características histopatológicas semelhantes e natureza incompletamente elucidadas. A primeira lesão apresenta caráter reacional, enquanto a segunda, comportamento proliferativo de natureza não neoplásica. O artigo tem como objetivo fazer revisão de literatura sobre as LPCGs e as LCCGs, discutindo os aspectos mais importantes inerentes a cada uma delas. RESULTADOS: As duas lesões apresentam localização e comportamento clínico distintos, apesar de exibirem as mesmas características histopatológicas. O tratamento para ambas as lesões consiste na remoção cirúrgica, mas com técnicas distintas, dependendo do tipo da lesão e do estado clínico, sendo que no caso da LCCG uma terapêutica medicamentosa também pode ser empregada. CONCLUSÃO: Embora não haja um consenso na literatura, é fundamental que se conheça a etiologia dessas lesões, bem como a exata origem das células gigantes. Por causa de seus comportamentos biológicos diferentes, torna-se importante realizar o diagnóstico diferencial entre ambas as lesões e outros processos que apresentem características clínicas, radiográficas ou histológicas semelhantes, visto que esse procedimento é essencial para executar um tratamento adequado e estabelecer um prognóstico.

Central giant cell granuloma of the mandibular condyle: case-report

This case report describes a 19-year-old female patient with a central giant cell granuloma in the left mandibular condyle, treated with en bloc resection and reconstruction with fibula graft. This occurrence is considered very unusual.

Clinical and imagiological findings of central giant cell lesion and cherubism

Cone beam computed tomography (CBCT) is the best examination for bone lesions of the maxilla, allowing the dentist to evaluate precisely the behavior and components of the lesion and their relationship to the surrounding structures. Central giant cell lesion and cherubism are histologically very similar lesions. Therefore clinical and radiological examinations are fundamentally important for the diagnosis. The aim of this paper is to report two cases diagnosed as central giant cell lesions and cherubism using CBCT. This imaging modality was very important for the diagnosis of the lesions presented in the current study. It also allowed observing precisely the limits of the lesions, the components, the behavior and the exact relationship to adjacent structures.

A tomografia computadorizada de feixe cônico (TCFC) é o melhor exame para lesões ósseas da maxila, permitindo que o dentista possa avaliar com mais confiabilidade o comportamento, os componentes da lesão, e sua relação com estruturas adjacentes. A Lesão central de células gigantes e o querubismo são patologias muito semelhantes histologicamente, portanto, exames clínicos e radiológicos são de fundamental importância para o diagnóstico. O objetivo deste trabalho é relatar dois casos diagnosticados usando TCFC, um de lesões centrais de células gigantes e um de querubismo. Esta modalidade de imagem foi muito importante para o diagnóstico das patologias apresentadas neste estudo. Também permitiu observar com mais confiabilidade os limites das lesões, os componentes, o comportamento e a relação exata com as estruturas adjacentes.

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.