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. The central giant cell granuloma cgcg was first described by jaffe in 1953 as a giantcell reparative granuloma of the jaw bones. Surgically treated central giant cell granuloma in sixyearold. Central giant cell granulomas cgcg are benign intraosseous proliferative lesions. Traditional treatment has been local curettage, although aggressive subtypes. Central giant cell granuloma is a benign, proliferative, intraosseous and non odontogenic lesion of unknown etiology. Recently, bisphosphonates have been used to treat central giant cell lesions. Central giant cell lesion cgcl is a benign lesion which has unpredictable biologic behaviour and is amenable to a plethora of treatment alternatives. Limited regression of central giant cell granuloma by interferon alpha after failed calcitonin therapy. Incisional biopsy results led to diagnosis of central giant cell granuloma. An aggressive central giant cell granuloma in a pediatric patient.
Central giant cell granuloma of the anterior maxilla. Central giant cell granuloma cgcg is a benign intraosseous lesion that occurs in long bones. Central giant cell granuloma cgcg is an uncommon benign lesion that was described by jaffe in 1993. Although relatively common in the dentate mandible, only 5 cases of central giant cell granuloma in the mandibular condyle have so far been reported. The central giant cell granuloma is an uncommon destructive lesion of the jaws comprised of osteoclastlike multinucleated giant cells. Cgcgs are more commonly found in the mandible and mainly in 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. If a mouth sore opens, it becomes susceptible to infection.
Usually located are at the anterior region of the maxilla or mandible, although are more frequently found in the. In 1953, jaffe described it as reparative granuloma of jaw bones. Central giantcell granuloma is a localised benign condition of the jaws. The microscopic appearance of the central giant cell granuloma of the jaws is similar to that of lesions which occur in for which of the. Nonsurgical treatment methods, such as intralesional corticosteroid injections, systemic calcitonin and interferon have been reported. Its etiology is unknown and its biological behavior is poorly. Interventions for central giant cell granuloma cgcg of the jaws source. Although there is not enough evidence that this lesion promotes reparative process, it was denominated reparative giant cell granuloma 2, 2530. Langhanstype giant cells are seen in many types of granulomas, and are not specific for tuberculosis.
After 1 year of followup, the patient presented recurrence of the lesion, and. Central giantcell granulomas are more common in the anterior mandible, often crossing the midline and causing painless swellings. Based on its clinical and radiological features,the. Central giant cell granuloma cgcg is a benign bone lesion which can be locally aggressive or may be asymptomatic in nature. 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. 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. This group of lesions includes central giant cell granuloma cgcg, giant cell. Achieving the correct diagnosis is reportedly difficult because cgcgs are very similar to odontogenic jaw tumors.
Several entities in the jaws can share this histology, including. Pdf on jun 7, 2019, nilotpol kashyap and others published central. Pdf central giant cell granuloma is an uncommon, benign, and proliferative lesion whose etiology is not defined. Peripheral giantcell granuloma pgcg is an oral pathologic condition that appears in the mouth as an overgrowth of tissue due to irritation or trauma.
Recurrent central giant cell granuloma in the mandible. Central giant cell granulomas are more common in the anterior mandible, often crossing the midline and causing painless swellings. Combined treatment of aggressive central giant cell granuloma in the lower jaw. Surgery is considered the best course of treatment. Central giant cell granuloma cgcg formerly called giant cell reparative granuloma is a nonneoplastic proliferative lesion of unknown etiology. A central giant cell granuloma is a type of bone lesion that appears along the jaw. Although central giant cell granulomas cgcgs appear to be benign, their radiographic findings are active. F stavropoulos and j katz central giant cell granulomas. Antibiotics may be prescribed in the case of infection associated with a central giant cell granuloma. Giant cell granulomas are benign intraosseous lesions, typically occurring in young females. Pdf agressive central giant cell granuloma of the mandible. Pdf the central giant cell granuloma cgcg is an uncommon benign bony.
Granuloma with central necrosis in a lung of a person with tuberculosis. Central giant cell granuloma cgcg is an uncommon benign bony lesion. The diagnosis and management of giant cell lesions of the 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. The incidence in the general population is very low and patients are generally younger than 30 years. There is a further population of bland, spindled, fibroblastslike cells with associated hemosiderin and scattered. Extremely aggressive behavior of central giant cell. The microscopic appearance of the central giant cell. Note the langhanstype giant cells with many nuclei arranged in a horseshoelike pattern at the edge of the cell around the.
May 02, 2020 a central giant cell granuloma is a type of bone lesion that appears along the jaw. Peripheral giant cell granuloma or so called giant cell epulis is the most common oral giant cell lesion. Who defines this intraosseous lesions as a lesion that contains multiple foci of. Case report giant cell granuloma of the maxilla usman haider uzbek, iram mushtaq oral and maxillofacial unit, department of dentistry, ayub medical college, abbottabad. Central giant cell granuloma of the mandible american. Also called giant cell reparative granuloma central if intraosseous. It is a noncancerous condition that is usually painless, but irritation and open lesions in the mouth can lead. Dec 23rd, 2015 aggressive lesion can cause jaw to swell, and loosen teeth. The central giant cell granuloma cgcg is a relatively common lesion of the jaws.
It was first described as central giant cell reparative granuloma by jaffe h l in the year 1953. Reparative giant cell granuloma in a pediatric patient. We describe our experience in managing this lesion by intralesional triamci. Apr 17, 2015 central giant cell granuloma was 1st described in jaws by jaffe 1953. Giant cell reparative granuloma, features of cgcg is its ability to cross the midline of the traumatic bone cyst and fibrous fibrooseous mandible. Giant cell reparative granuloma, central definition of.
Oral surgery or traumatic injury to the area often precedes the development of a central giant cell granuloma. Central giant cell granuloma is an uncommon benign intraosseus lesion of jaws. Central giant cell granuloma cgcg is an intraosseous lesion which occurs as an uncommon benign condition in jaws. The findings are consistent with central giant cell.
Clinically and radiologically, a differentiation between aggressive and nonaggressive lesions can be made. Central giant cell granuloma cgcg, formerly called giant cell reparative granuloma, is a benign lesion of unknown etiology but there are indications that genetic abnormalities are implicated. Symptoms progressed over the next week, and antibiotics were prescribed for a presumed odontogenic infection. Although relatively common in the dentate mandible, only 5 cases of central giant cell granuloma in. The central giant cell granuloma, also known as cgcl or giant cell lesion, was first described by jaffe in 1953.
But the term reparative is obsolete, as cgcg causes the destruction of involved bones. Central giant cell granuloma is a benign, proliferative, intraosseous and nonodontogenic lesion of unknown etiology. The central giant cell granuloma is a benign and sometimes aggressive osteolytic proliferation. The lesion was removed by curettage and a histopathological. Central giant cell granuloma cgcg is a relatively uncommon benign. Granulomata definition of granulomata by medical dictionary. Central giant cell granuloma in anterior maxilla shwetang goswami1, haripriya2, yashwanth yadav3, ram mohan4 abstract. This article describes a case of central giant cell granuloma in the right posterior region of the mandible in a 10 yearold boy. It usually presents as a purplishred soft tissue nodule consisting of multinucleated giant cells in. Central giant cell granuloma of the mandibular condyle. The central giant cell granuloma cgcg is a nonneoplastic entity,which may be able to cause considerable osseous destruction. Central giant cell granuloma appears references as poorly defined unilocular radiolucency or multilocular radiolucency with scalloped borders. Nonsurgical treatment methods, such as intralesional.
Note the langhanstype giant cells with many nuclei arranged in a horseshoelike pattern at the edge of the cell around the periphery of the granuloma. We herein describe an intriguing case of a 21yearold male patient who was. 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. Aug 22, 2012 central giant cell lesions are benign intraosseous proliferative lesions that have considerable local aggressiveness. 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. Radiological and epidemiological aspects of central giant cell. Central giant cell lesion, giant cell reparative granuloma, osteoclast, giant cell.
Jun 19, 2018 this peripheral giant cell granuloma involved the maxillary gingiva associated with an erupting central incisor of a 6yearold girl. May 16, 2014 educational video created by unmc college of dentistry class of 2016 dental students. Giant cell granuloma an overview sciencedirect topics. The referring doctor had suggested a diagnosis of eruption cyst. This is in contrast to the giant cell tumor of long bones, where. The term giant cell lesion gcl defines a group of intraosseous nonodontogenic benign lesions with multinucleated giant cells gcs. 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. The microscopic appearance of the central giant cell granuloma of the jaws is similar to that of lesions which occur in for which of the following pathological conditions would a lower central incisor tooth be expected to respond to heat, cold and electric pulp test. A retrospective analysis of a 20year database was performed. 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. A case of a 36yearold male with a central giant cell lesion. These tumors become severely invasive with the stimulus of surgery, resembling malignant tumors. Central giant cell granuloma cgcg is a localised benign condition of the jaws. Some, however, consider it to be a giant cell tumor occurring in both benign and.
Giant cell granuloma is an uncommon bony lesion in the head and neck region. The lesion was removed by curettage and a histopathological examination was carried out. This peripheral giant cell granuloma involved the maxillary gingiva associated with an erupting central incisor of a 6yearold girl. Extremely aggressive behavior of central giant cell granuloma. Because of its overwhelming incidence on the gingiva. Giant cell granulomas gcgs of the jaws are lesions that arise either peripherally in periodontal ligament, mucoperiosteum, or centrally in the bone. All of the 26 lesions caused expansion of bone, 15. Central giant cell granuloma, benign jaw tumor, molar, recurrent pericoronitis, multinucleated giant cells. A clinical, radiologic and histopathologic study of 26 cases ooo 2006. 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. Between the giant cells are monocluate variants with similar nuclear profiles. 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. Central giant cell granuloma cgcg is a benign lesion of the jaws with an unknown etiology. 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 giant cell lesions are benign intraosseous proliferative lesions that have considerable local aggressiveness. 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. There is a further population of bland, spindled, fibroblastslike cells with associated hemosiderin and scattered inflammation. Central giant cell granuloma is a benign intraosseous lesion of the jaws. 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.
The cause of peripheral giant cell granuloma is unknown, although local irritation due to dental plaque or calculus, periodontal disease, poor dental restorations, illfitting dental appliances, or dental. Central giant cell lesion, intralesional triamcinolone, nonsurgical management, mandibular pathology. Its etiology is unknown, but most of the authors consider the lesion to be an unusual proliferative response of the tissues to injury caused by. It is an uncommon tumor in jaws, its etiology and pathogenesis is unknown. Diagnosis of central giant cell granuloma is normally made histologically from an incisional biopsy. The appearance is generally distinctive with multinucleated giant cells. The objective was to investigate the clinical and radiological characteristics of central giant cell granulomas cgcgs of the jaws. The referring doctor had suggested a diagnosis of eruption. Central giant cell lesion of mandible managed by intralesional triamcinolone.
Treatment of central giant cell lesions using bisphosphonates. It is twice as common in females and is more likely to occur before age 30. They result from a local inflammatory process, thought to be secondary to trauma. Central giant cell granuloma venkateshwarlu et, al 6. It is rare in the nasal cavity, and it might be misdiagnosed. The case reported here resembled a wide variety of conditions that led to a misdiagnosis both on clinical and radiographic examination but was. Educational video created by unmc college of dentistry class of 2016 dental students. Due to these lesions often being symptomatic, active management is usua. 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.
Central giant cell granuloma was 1st described in jaws by jaffe 1953. Central giant cell granuloma cgcg is a benign intraosseous lesion that occurs in long. Because of its overwhelming incidence on the gingiva, the condition is associated with two other diseases, pyogenic granuloma and peripheral ossifying fibroma. Giant cell granuloma gcg is an uncommon, benign, proliferative, intraosseous lesion representing lesion is unknown, and there is debate whether it represents a reactive process or a benign neoplasm. Aggressive giant cell reparative granuloma of the nasal cavity. Central giant cell granuloma cgcg is an uncommon, benign, and proliferative lesion of the jaw with an unknown etiology. Histologically, both peripheral and central giant cell granuloma cgcg are characterized by the presence of numerous multinucleated.
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