This peripheral giant cell granuloma involved the maxillary gingiva associated with an erupting central incisor of a 6yearold girl. Clinically and radiologically, a differentiation between aggressive and nonaggressive lesions can be made. This is in contrast to the giant cell tumor of long bones, where the giant cells are more. Central giant cell granuloma venkateshwarlu et, al 6.
It was jaffe who first introduced the term central giant cell reparative granuloma to distinguish this lesion from the giant cell. The incidence in the general population is very low and patients are generally younger than 30 years. Central giant cell granuloma was 1st described in jaws by jaffe 1953. Central giant cell granulomas are benign tumours of the mandible, presenting in children and young adults. Central giant cell granuloma cgcg is a benign intraosseous lesion that occurs in long bones. Full text pimary hyperparathyroidism as central giant cell. May 02, 2020 a central giant cell granuloma is a type of bone lesion that appears along the jaw. Formerly called giant cell reparative granuloma giant cell lesion primarily of jaw, also other craniofacial bones and short tubular bones of hands and feet may be response to injury but some cases behave aggressively giant cells have features of macrophages and osteoclasts. Central giant cell granuloma of the maxilla bmj case reports. Clinically and radiologically, a differentiation between aggressive and non.
It is often difficult to make a clinical diagnosis. Extremely aggressive behavior of central giant cell granuloma. Who defines this intraosseous lesions as a lesion that contains multiple foci of haemorrhage, consisting of cellular fibrous tissue and there is trabeculae of woven bone. It occurs most commonly on the mandible than in maxilla. Giant cell granuloma is an uncommon bony lesion in the head and neck region, most commonly affecting the maxilla and mandible. Its etiology is unknown and its biological behavior is poorly understood. Apr 17, 2015 central giant cell granuloma was 1st described in jaws by jaffe 1953. Full text pimary hyperparathyroidism as central giant.
The first type is nonaggressive, slow growing, does not show root resorption or cortical perforation, and often shows new bone formation. Simultaneous occurrence of central giant cell granuloma. 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. Aggressive central giant cell granuloma mimicking peripheral. Giant cell granuloma gcg is an uncommon, benign, proliferative, intraosseous lesion representing central giant cell granuloma cgcg is a relatively uncommon benign bony lesion of a variably aggressive nature. It is an uncommon, benign and proliferative non neoplastic process.
Diagnosis of central giant cell granuloma is normally made histologically from an incisional biopsy. Central giant cell granuloma cgcg formerly called giant cell reparative granuloma is a nonneoplastic proliferative lesion of unknown etiology. A retrospective analysis of a 20year database was performed regarding both clinical and radiological features of 22 patients affected with cgcgs of the jaws. An aggressive central giant cell granuloma in a pediatric patient. Central giant cell lesions granulomas, also known as giant cell reparative cystsgranulomas, occurs almost exclusively in the mandible, although cases in the skull and maxilla have been reported. Traditional treatment has been local curettage, although aggressive subtypes have a high tendency to recur. F stavropoulos and j katz central giant cell granulomas.
Central giant cell granuloma is a benign intraosseous lesion. Who has defined it as an intraosseous lesion consisting of cellular and fibrous tissue that contains multiple foci of. It usually presents as a purplishred soft tissue nodule consisting of multinucleated giant cells in a background of mononuclear stromal cells and extravasated red blood cells. We reported a very aggressive gcrg with intracranial invasion, which was treated surgically via a combined approach of a lateral rhinotomy with a craniotomy by bilateral. Giant cell reparative granuloma, features of cgcg is its ability to cross the midline of the traumatic bone cyst and fibrous fibrooseous mandible. The purpose of this study was to determine the ct characteristics and describe possible mr imaging features of gcg of the craniofacial bones. After this the lesion was completely excised and thorough curettage of the area was done under general anesthesia fig4. The neoplastic status of the central giant cell granuloma of the jaws remains an unsolved contro versy in anatomic pathology. We describe our experience in managing this lesion by intralesional triamci. Central giant cell granuloma of the mandible american. Achieving the correct diagnosis is reportedly difficult because cgcgs are very similar to odontogenic jaw tumors. We present a case of an aggressive central giant cell granuloma. Because of its overwhelming incidence on the gingiva, the condition is associated with two other diseases, pyogenic granuloma and peripheral ossifying fibroma. The case reported here resembled a wide variety of conditions that led to a misdiagnosis both on clinical and radiographic examination but was.
Central giant cell granuloma is a benign, proliferative, intraosseous and non odontogenic lesion of unknown etiology. Case report giant cell granuloma of the maxilla usman haider uzbek, iram mushtaq oral and maxillofacial unit, department of dentistry, ayub medical college, abbottabad. A clinical and histomorphologic comparison of the central giant cell granuloma and the giant cell. We present a case of an aggressive central giant cell granuloma cgcg in a six yearold female. Intralesional corticosteroid injection for central giant cell. This is in contrast to the giant cell tumor of long bones, where the giant. Divided into non and aggressive subtypes, the aggressive subtype is relatively rare and can occasionally progress rapidly, resulting in significant morbidity.
Central giant cell granuloma is a benign intraosseous lesion of the jaws. Central giant cell granuloma appears references as poorly defined unilocular radiolucency or multilocular radiolucency with scalloped borders. Giant cell granuloma an overview sciencedirect topics. Pdf on jun 7, 2019, nilotpol kashyap and others published central giant cell granuloma find, read and cite all the research you need on. We herein describe an intriguing case of a 21yearold male patient who was. Intralesional steroid treatment of central giant cell.
Central giant cell granuloma of the jaw is considered a nonneoplastic lesion. It is the most frequent giant cell lesion of the jaws, and originates from the connective tissue of the periosteum or from the periodontal. Central giant cell granuloma cgcg, also termed as reparative giant cell granuloma, is an uncommon benign intraosseous lesion affecting the maxilla and mandible, which consists of massive fibrohistiocytic proliferation and heavily hemosiderin laden multinucleated giant. 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 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. 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. Central giant cell granuloma cgcg is a benign aggressive destructive osteolytic lesion of osteoclastic origin. Although central giant cell granulomas cgcgs appear to be benign, their radiographic findings are active. Central giant cell granulomas of the condyle are rare. It occurs most frequently in young women aged giant.
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. Central giant cells lesion cgcl is defined as a benign intraosseous. A clinical, radiologic and histopathologic study of 26 cases ooo 2006. Discussion the central giant cell granuloma is a benign. Central giant cell granuloma cgcg is an intraosseous lesion which occurs as an uncommon benign condition in jaws. Central giant cell granuloma of the mandibular condyle. Thought to represent a reparative response to intrabony haemorrhage and. Mar 21, 2012 central giant cell granuloma is a non neoplastic proliferation of unknown etiology. Follow up of one year was done and during this period no recurrence of the lesion was noticed fig5. Cgcg was formerly regarded as a reparative process and was, accordingly, called central giant cell reparative granuloma. These lesions occur 23 times more frequently in mandible than in maxilla.
The objective was to investigate the clinical and radiological characteristics of central giant cell granulomas cgcgs of the jaws. For the previously reported cases in one female and three males, the. It was described first by jaffe h l as central giant cell reparative granuloma. Central giant cell granuloma cgcg is a localised benign condition of the jaws. It was first described as central giant cell reparative granuloma by jaffe h l in the year 1953. Central giant cell granuloma cgcg of the jaw is a benign osteolytic lesion.
It is a noncancerous condition that is usually painless, but irritation and open lesions in the mouth can lead. Thought to represent a reparative response to intrabony haemorrhage and inflammation, cgcg was once regarded as a reactive lesion. 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. Central giant cell granuloma condyle mandible intraosseous abstract introduction. Who categorize it as a bonerelated lesion, not a tumor, although its clinical behavior and radiographic features often are those. Giant cell central granuloma gccg is an uncommon pseudotumor of the maxilla. Giant cell granuloma gcg is an uncommon, benign, proliferative, intraosseous lesion representing 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 case report is of a 30 year old male, who complained of a slowly expanding swelling in the maxilla in the left premolar region. Central giant cell lesions granuloma radiology reference. It is a nonodontogenic tumor never seen in any other bone of the skeleton. 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. The condition was first identified in 1953 by jaffe, who initially termed this lesion as a central giant cell reparative granuloma. Who categorize it as a bonerelated lesion, not a tumor, although its clinical behavior and.
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. It is twice as common in females and is more likely to occur before age 30. Intralesional corticosteroid injection for central giant cell granuloma. Interventions for central giant cell granuloma of the jaws. Central giant cell granuloma cgcg, formerly called giant cell reparative granuloma, is a nonneoplastic proliferative lesion of an unknown aetiology. Belonging to the group of giant and cystic cell lesions of the 4th edition of the head and neck tumours classification by who, the central giant cell gran uloma is an intraosseous osteolytic lesion, with an unknown etiology, characterized by a benign pro liferation of fibroblasts and osteoclastlike giant. Central giant cell lesions granulomas, also known as giant cell reparative cystsgranulomas, occurs. Also called giant cell reparative granuloma central if intraosseous. Peripheral giant cell granuloma in a child associated with. It accounts for 7% benign maxillary tumors, and females are predominantly affected in 23ofcases before age 20years 1. The peripheral giant cell granuloma, also known as giant cell epulis, pgcl or giant cell hyperplasia, is the most common giant cell lesion in the oral cavity. The central giant cell granuloma is an uncommon, benign and proliferative lesion whose etilogy is not well defined.
Central giant cell granuloma of the jaws and giant cell. Peripheral giant cell granuloma or so called giant cell epulis is the most common oral giant cell lesion. Central giant cell granuloma cgcg is an uncommon, benign, and proliferative lesion of the jaw with an unknown etiology. Tumorinduced rickets in a child with a central giant cell. Radiotherapy for recurrent central giant cell granuloma. Adrenal cortex hormones, central giant cells granuloma, giant cells. 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. Yutaka nemoto, yuichi inoue, takahiko tashiro, tokuro mochizuki, junsuke katsuyama, akira hakuba, and yasuto onoyama subject. Pdf central giant cell granuloma is an uncommon, benign, and proliferative lesion whose etiology is not defined. It is rare in the nasal cavity, and it might be misdiagnosed. Giant cell granuloma is a rare bony lesion in the head and neck region. Jaffe hl 1953 giant cell reparative granuloma, traumatic bone cyst and. A central giant cell granuloma is a type of bone lesion that appears along the jaw. The lesion principally affects the mandible and maxilla.
Central giant cell granuloma of the anterior maxilla. The term central giant cell lesion has been proposed as a. Central giant cell lesion cgcl is a benign lesion which has unpredictable biologic behaviour and is amenable to a plethora of treatment alternatives. 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 occurring in children. 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.
We present a child with symptoms of rickets as the first clinical sign of a central giant cell granuloma. Pimary hyperparathyroidism as central giant cell granuloma of the jaws. 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. Central giant cell lesions granuloma dr yuranga weerakkody and assoc prof frank gaillard et al. Central giant cell granulomas are more common in the anterior mandible, often crossing the midline and causing painless swellings. 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. Peripheral giant cell granuloma is a common benign and reactive gingival epulis in oral cavity. Central giant cell granuloma, benign jaw tumor, molar, recurrent pericoronitis, multinucleated giant cells. The central giant cell granuloma cgcg, a distinct entity, is a benign tumor of nonodontogenic origin that exhibits locally destructive behavior affecting the bones of the craniofacial complex3. Surgery is the most accepted method of treating the condition 2.
This condition is a slowgrowing, asymptomatic lesion that usually affects children and young adults, predominantly females. Interventions for central giant cell granuloma cgcg of the jaws source. Ct and mr imaging of giant cell granuloma of the craniofacial. Central giant cell granuloma of the jaws springerlink.
This report describes the clinical and histopathological findings of a pgcg diagnosed in the maxilla of a 9yearold boy associated with a tooth erupting improperly and a. It may exhibit aggressive biologic behavior, characterized by localized swelling, pain, rapid growth, bony expansion, cortical. Aggressive giant cell reparative granuloma of the nasal cavity. Auclair pj, cuenin p, kratochvil fj, slater lj, ellis gl. Central giant cell granuloma cgcg is a benign lesion of the jaws with an unknown etiology. Central giant cell granuloma cgcg is a rare, nonneoplastic, benign lesion that exhibits expansive and osteolytic biological behavior. Central giant cell lesions of the mandible and maxilla. 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. Central giant cell granuloma of the temporal bone author. Pdf central giant cell granuloma of mandible mohit.
A central giant cell granuloma in posterior part of maxillaa. This case report describes a 19yearold female patient with a central giant cell granuloma in the left mandibular condyle, treated with en bloc resection. An aggressive central giant cell granuloma in a pediatric. However, most authorities believe peripheral giant cell granuloma is a reactive lesion. May 16, 2014 educational video created by unmc college of dentistry class of 2016 dental students. Central giant cell granuloma cgcg, formerly called giant cell reparative granuloma, is a nonneoplastic proliferative lesion of unknown etiology. These tumors become severely invasive with the stimulus of surgery, resembling malignant tumors. Central giant cell granuloma central giant cell granuloma is an uncommon benign bony lesion that occurs in the mandible and maxilla and accounts for approximately 7% of all benign tumours of the. Central giant cell granuloma cgcg is an intraosseous lesion consisting of fibrous cellular tissue that contains multiple foci of hemorrhage, multinucleated giant cells, and occasional trabeculae of woven. Radiologic features, including those seen with computed tomography, of central giant cell granuloma of the jaws. Cgcg accounts for less than 7 % of all benign lesions of mandible and maxilla. Central giant cell granuloma is an uncommon benign intraosseus lesion of jaws. Central giant cell granuloma in anterior maxilla shwetang goswami1, haripriya2, yashwanth yadav3, ram mohan4 abstract. Giant cell reparative granuloma gcrg is an uncommon and nonneoplastic reactive tumor that involves the maxilla and mandible in the region of the head and neck.
Central giantcell granuloma cgcg is a localised benign condition of the jaws. It is an uncommon tumor in jaws, its etiology and pathogenesis is unknown. Tumorinduced osteomalaciarickets is a rare paraneoplastic disorder associated with a tumorproducing fibroblast growth factor 23 fgf23. Cgcg, as described by jaffe in 1953 is an idiopathic nonneoplastic proliferative lesion. 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.
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. Central giant cell granuloma cgcg is an uncommon, benign, proliferative, and nonodontogenic lesion whose etiology is not defined. The diagnosis and management of giant cell lesions of the jaws. It usually presents as a purplishred soft tissue nodule consisting of multinucleated giant cells. It does not constitute a true neoplasm, but rather a reactive lesion caused by local irritation or trauma. Central, giant cell, granuloma, aggressive, jaws introduction central giant cell granuloma cgcg of the jaw is one of the relatively rare pathologic processes and encountered, in less than 7% of all of the jaw lesions. Giantcell reparative granuloma of short tubular bones of the hands and feet. 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. Central giant cell granuloma cgcg is a benign intraosseous lesion of the jaws that is found predominantly in children and young adults. Although it is a benign disease process, it can also be locally destructive. It most commonly affects maxilla followed by the mandible. Central giant cell granuloma cgcg is a relatively uncommon benign bony lesion of a variably aggressive nature.
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