Radiologically, it is usually a welldefined radiolucent defect with hazy opacity, classically described. Recently, bisphosphonates have been used to treat central giant cell lesions. Hence, this study was designed to provide a demographic data on the odontogenic tumors and giant cell lesions reported from. These tumors become severely invasive with the stimulus of surgery, resembling. Fibrous dysplasia is a benign fibroosseous lesion arising in an intramedullary location. Ct and mr imaging of giant cell granuloma of the craniofacial. Aug 22, 2012 central giant cell lesions are benign intraosseous proliferative lesions that have considerable local aggressiveness. Central giant cell granuloma cgcg is a benign intraosseous lesion of the. Management of central giant cell granulomas of the jaws. It is twice as common in females and is more likely to occur before age 30. Central giant cell granuloma, benign jaw tumor, molar, recurrent pericoronitis, multinucleated giant cells. Combined treatment of aggressive central giant cell granuloma in the. Peripheral giant cell granuloma is an infrequent reactive, exophytic lesion of the oral cavity, also known as giantcell epulis, osteoclastoma, giant cell reparative granuloma, or giant cell hyperplasia. It is an uncommon tumor in jaws, its etiology and pathogenesis is unknown.
Central giant cell granuloma cgcg is a benign bone lesion which can be locally aggressive or may be asymptomatic in nature. Histological features that are considered to be suggestive of aggressive. Oct 19, 2015 we report the results of the intralesional steroid injections for the management of central giant cell granuloma cgcg of the jaws. Intralesional corticosteroid injection for central giant cell. Also called giant cell reparative granuloma central if intraosseous. F stavropoulos and j katz central giant cell granulomas. Central giant cell granulomas are more common in the anterior mandible, often crossing the midline and causing painless swellings. Alternative pharmacologic therapy for aggressive central.
The first description of this tumor was presented by jaffe and recommended surgical management for these lesions. Extremely aggressive behavior of central giant cell granuloma. Unusual aggressive behavior of central giant cell granuloma. Clinically and radiologically, a differentiation between aggressive and non aggressive lesions can be made. Central giant cell granuloma of the jaws and giant cell tumor of long bones are wellrecognized entities revealing benign nature 16. These tumors become severely invasive with the stimulus of surgery, resembling malignant tumors. An aggressive central giant cell granuloma in a pediatric. The purpose of this study was to determine the ct characteristics and describe possible mr imaging features of gcg. Central giant cell granuloma cgcg is a benign tumor that is found exclusively in the maxilla and mandible. Aggressive central giant cell granuloma mimicking peripheral. Central giant cell granuloma is a benign lesion of the jaws which is sometimes aggressive locally.
The incidence in the general population is very low and patients are generally younger than 30 years. Aggressive central giant cell granuloma of the mandible, a diagnostic dilemma pavitra baskaran 1, margathavalli gopal 2, varun rastogi 3, satya ranjan misra 4 1 department of oral medicine and radiology, saveetha dental college and hospitals, chennai, tamil nadu, india 2 department of oral medicine and radiology, meenakshi ammal dental college, chennai, tamil nadu, india 3 department of oral. Clinically and radiologically, a differentiation between aggressive and nonaggressive lesions can be made. Pdf agressive central giant cell granuloma of the mandible. Peripheral giantcell granuloma pgcg is an oral pathologic condition that appears in the mouth as an overgrowth of tissue due to irritation or trauma. Giant cell granuloma definition of giant cell granuloma by. Diagnosis was made using a combination of imaging and pathology. The first description of this tumor was presented by jaffe and recommended. Peripheral giant cell granuloma intelligent dental. Case report aggressive giant cell reparative granuloma of. Central giantcell granulomas are more common in the anterior mandible, often crossing the midline and causing painless swellings. The peripheral giant cell granuloma, also known as giant cell epulis.
Central giant cell granuloma cgcg is a benign lesion of the jaws with an unknown etiology. However, it is now considered to be a true neoplasm. Unusual aggressive behavior of central giant cell granuloma following tooth extraction suwarna dangorekhasbage, shirish s degwekar, rahul r bhowate, alka h hande, vidya k lohe suwarna dangorekhasbage, shirish s degwekar, rahul r bhowate, oral medicine and radiology, sharad pawar dental college, datta meghe institute of medical sciences. Central giant cell granuloma venkateshwarlu et, al 6. The peripheral giant cell granuloma has an unknown etiology, with some dispute as to whether this lesion represents a reactive or neoplastic process. Apr 17, 2015 central giant cell granuloma was 1st described in jaws by jaffe 1953.
Central giant cell granuloma cgcg has unpredictable biologic behavior, nonspecific radiographic features and is amenable to a plethora of treatment alternatives. The central giant cell granulomacgcg of bone constitutes about 10% of benign. Incidence of central giant cell granuloma of the jaws with clinical and histological confirmation. Because of its overwhelming incidence on the gingiva, the condition is associated with two other diseases, pyogenic granuloma and peripheral ossifying fibroma. Controversy exists over the histogenesis of cgcg of. Unusual aggressive behavior of central giant cell granuloma following tooth extraction suwarna dangorekhasbage, shirish s degwekar, rahul r bhowate, alka h hande, vidya k lohe suwarna dangore. Central giant cell granuloma cgcg is a localised benign condition of the jaws. Central giant cell granuloma of the jaws and giant cell tumor. Central giant cell granuloma is a benign intraosseous lesion of the jaws. Giant cell granuloma gcg is not an uncommon lesion. Peripheral giant cell granuloma pgcg is a nonneoplastic lesion that may affect any region of the gingiva or alveolar mucosa of edentulous and toothed areas, preferentially in the mandible and rarely. Central giant cell granuloma cgcg is an uncommon, benign but aggressive osteolytic neoplasm of the craniomaxillofacial region, histologically characterized. An aggressive central giant cell granuloma treated. The findings are consistent with central giant cell.
Clinicopathological profile of central giant cell granulomas. Fibrous dysplasia is a benign fibroosseous lesion arising in an. There is a further population of bland, spindled, fibroblastslike cells with associated hemosiderin and scattered. Ct scan showing an aggressive mass extending from hardpalate and soft mallate erosing the right maxillary sinus. Central giant cell granuloma cgcg is a benign intraosseous lesion that occurs in long. The diagnosis and management of giant cell lesions of the jaws. It is the most frequent giant cell lesion of the jaws, and originates from the connective tissue of the periosteum or from the periodontal. Up to now, there are no reliable histologic or molecular methods to differentiate aggressive from nonaggressive central giant cell granuloma of the jaw. Giant cell granuloma is an uncommon bony lesion in the head and neck region, most commonly affecting the maxilla and mandible. For 100 years following pagets description of giant cell tumors of long bones, the jaw lesions were considered identical.
The central giant cell granuloma cgcg is a relatively common lesion of the jaws. Because of its overwhelming incidence on the gingiva. Central giant cell granuloma definition of central giant. An aggressive central giant cell granuloma treated successfully by conventional surgery mariam mezzour, karima elharti and wafaa elwady abstract central giant cell granuloma is a rather rare lesion of the jaws aetiology of which is still completely unknown but thought to be of a reactive process to some unknown stimuli. We herein describe an intriguing case of a 21yearold male patient who was. Cases involving the sphenoid and temporal bones have been reported. Despite this, a recurrence rate of 1520% is often quoted, and in. Central giant cell granuloma and fibrous dysplasia occurring. Nonsurgical treatment methods, such as intralesional. Aggressive central giant cell granuloma occurring as peripheral one is a very rare case and the treatment of aggressive central giant cell granuloma with curettage has shown a high recurrence rate within a span of six months, but in our case even after one year followup, no recurrence of the lesion was noticed. A reactive response to trauma is the most accepted etiopathogenesis of cgcg 1 3. A definite geographic variation has been observed in the frequency of odontogenic tumors and giant cell lesions of the jaws reported from different parts of the world. Odontogenic tumors and giant cell lesions of jaws a nine.
An aggressive central giant cell granuloma in a pediatric patient. There is a further population of bland, spindled, fibroblastslike cells with associated hemosiderin and scattered inflammation. Central giantcell granuloma is a localised benign condition of the jaws. Central giant cell granuloma is accepted as a nonneoplastic lesion but some of them demonstrate aggressive behavior similar to that of a neoplasm 2. Ct and mr imaging of giant cell granuloma of the craniofacial bones j. Although its aetiology and pathogenesis is even unknown, its histology and. Central giant cell granuloma is accepted as a nonneoplastic lesion but some. Seven cgcgs were treated with intralesional injection of. Conventional management is surgical and consists of enucleation and curettage. Jul 20, 20 central giant cell granuloma cgcg is a relatively uncommon benign bony lesion of a variably aggressive nature, accounting for less than 7% of all benign jaw lesions. We describe our experience in managing this lesion by intralesional triamci.
Although its aetiology and pathogenesis is even unknown, its histology. Recurrent central giant cell granuloma in the mandible introduction central giant cell granuloma cgcg is an uncommon benign intraosseus lesion that occurs almost exclusively in jaws, introduced for the first time by jaffe in 1953 1. A 5year populationbased study estimated its incidence at 0. An aggressive central giant cell granuloma treated successfully by conventional surgery mariam mezzour, karima elharti and wafaa elwady abstract central giant cell granuloma is a rather rare lesion. Aggressive central giant cell granuloma occurring as peripheral one is a very rare case and the treatment of aggressive central giant cell granuloma with curettage has shown a high recurrence rate within a. Treatment of central giant cell lesions using bisphosphonates. This peripheral giant cell granuloma involved the maxillary gingiva associated with an erupting central incisor of a 6yearold girl. Combined treatment of aggressive central giant cell granuloma in the lower jaw. Central giant cell granuloma cgcg is a relatively uncommon benign bony lesion of a variably aggressive nature, accounting for less than 7% of all benign jaw lesions. Imaging radiolucent destructive lesion with faint trabeculation and loculation.
Central giant cell lesions are benign intraosseous proliferative lesions that have considerable local aggressiveness. Although benign, it may be locally aggressive, causing extensive bone. But the term reparative is obsolete, as cgcg causes the destruction of involved bones. Giant cell granuloma is an uncommon bony lesion in the head and neck region. Despite this, a recurrence rate of 1520% is often quoted, and in these cases treatment may need to be more aggressive and may need to consist of an en bloc resection. Giant cell granulomas are benign intraosseous lesions, typically occurring in young females.
An osteodestructive lesion of uncertain pathogenesis, which most commonly occurs in the young female mandible, and is more lytic than peripheral giant cell granuloma. The condition was first identified in 1953 by jaffe, who initially termed this lesion as a central giant cell reparative granuloma, but nowadays the reparative word has been. Alternative pharmacologic therapy for aggressive central giant cell granuloma. A clinical, radiologic and histopathologic study of 26 cases ooo 2006. Achieving the correct diagnosis is reportedly difficult because cgcgs are very similar to odontogenic jaw tumors. It affects predominantly but not exclusively the jaws. Management of central giant cell granuloma of the jaws with. Divided into non and aggressive subtypes, the aggressive subtype is relatively rare and can occasionally progress rapidly, resulting in significant morbidity. The referring doctor had suggested a diagnosis of eruption cyst. Although central giant cell granulomas cgcgs appear to be benign, their radiographic findings are active. Their clinical behavior 8,29, prognostic factors and the histogenesis.
Aggressive variant of central giant cell granuloma austin. Central giant cell granuloma cgcg is a benign intraosseous lesion that occurs in long bones. Jun 19, 2018 the peripheral giant cell granuloma has an unknown etiology, with some dispute as to whether this lesion represents a reactive or neoplastic process. Radiologic features, including those seen with computed tomography, of central giant cell granuloma of the jaws. Central giant cell granuloma cgcg of the jaw bones is a rare. Diffdx giant cell bone tumour, pthinduced brown tumour. However, there are a few studies on these lesions, especially giant cell lesions, reported from india. Combined management of large aggressive central giant cell. The most common treatment is curettage,which has a high recurrence rate, particularly in more.
General and oral pathology for the dental hygienist. Interventions for central giant cell granuloma cgcg of the jaws source. Jun 19, 2018 this peripheral giant cell granuloma involved the maxillary gingiva associated with an erupting central incisor of a 6yearold girl. Casereport munzenmayer j1, tapia p2, zeballos j2, martinez a3, compan a4, urra a5, spencer ml6 summary this case report describes a 19yearold female patient with a central giant cell granuloma in the left mandibular condyle, treated with en bloc resection and reconstruction with fibula graft. Evaluation of cyclin d1 expression in aggressive and. A case of a 36yearold male with a central giant cell lesion.
Although it is a benign disease process, it can also be locally destructive. Central giant cell lesion cgcl is a benign lesion which has unpredictable biologic behaviour and is amenable to a plethora of treatment alternatives. Central giant cell granuloma was 1st described in jaws by jaffe 1953. Recurrent central giant cell granuloma in the mandible. Central giant cell granuloma of the mandibular condyle. Peripheral giant cell granuloma pgcg is an oral pathologic condition that appears in the mouth as an overgrowth of tissue due to irritation or trauma. Aggressive central giant cell granuloma of the mandible, a diagnostic dilemma pavitra baskaran 1, margathavalli gopal 2, varun rastogi 3, satya ranjan misra 4 1 department of oral medicine and. Between the giant cells are monocluate variants with similar nuclear profiles. We report the results of the intralesional steroid injections for the management of central giant cell granuloma cgcg of the jaws. Central giant cell granulomas are benign tumours of the mandible, presenting in children and young adults. However, most authorities believe peripheral giant cell granuloma is a reactive lesion. Central giant cell granuloma cgcg is a rare benign osteolytic lesion of the jawbone.
Central giant cell granuloma in anterior maxilla shwetang goswami1, haripriya2, yashwanth yadav3, ram mohan4 abstract. Aggressive central giant cell granuloma of the mandible, a. They result from a local inflammatory process, thought to be secondary to trauma. It was first described as central giant cell reparative granuloma by jaffe h l in the year 1953. Peripheral giant cell granuloma is an infrequent reactive, exophytic lesion of the oral cavity, also known as giant cell epulis, osteoclastoma, giant cell reparative granuloma, or giant cell hyperplasia. The referring doctor had suggested a diagnosis of eruption. Seven cgcgs were treated with intralesional injection of corticosteroids. A timely en bloc resection of the hemimandible was performed with. Due to these lesions often being symptomatic, active management is usua. In 1953, jaffe described it as reparative granuloma of jaw bones.
Central giant cell granuloma cgcg is a benign intraosseous lesion of the jaws that is found predominantly in children and young adults. Aggressive lesion can cause jaw to swell, and loosen teeth the central giant cell granuloma cgcg is considered a benign, nonneoplastic lesion of bone found in a younger age group who are usually less than 30 years of age. We describe our experience in managing this lesion. Nonsurgical treatment methods, such as intralesional corticosteroid injections, systemic calcitonin and interferon have been reported. Peripheral giant cell granuloma in a child associated with.
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