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