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. There is a further population of bland, spindled, fibroblastslike cells with associated hemosiderin and scattered inflammation. The term giant cell reparative granuloma gcrg was first used by jaffe in 1953, to distinguish these lesions from giant cell tumor of long bones. It is the most frequent giant cell lesion of the jaws, and originates from the connective tissue of the periosteum or from the periodontal. Because of its overwhelming incidence on the gingiva, the condition is associated with two other diseases, pyogenic granuloma and peripheral ossifying fibroma. Central giant cell granuloma cgcg is an uncommon benign bony lesion that occurs in the mandible and maxilla. These tumors become severely invasive with the stimulus of surgery, resembling malignant tumors. Peripheral giant cell granuloma pubmed central pmc. Although central giant cell granulomas cgcgs appear to be benign, their radiographic findings are active. Central giant cell granuloma cgcg is defined by the world health organization as an intraosseous lesion consisting of cellular fibrous tissue that contains. This peripheral giant cell granuloma involved the maxillary gingiva associated with an erupting central incisor of a 6yearold girl. Central giant cell granuloma formerly called as giant cell reparative granuloma is a non neoplastic proliferative lesion of unknown etiology. Giant cell tumour of the jaw central giant cell granuloma.
The clinical behaviour of cgcg ranges from a slowgrowing asymptomatic swelling to an. F stavropoulos and j katz central giant cell granulomas. An aggressive central giant cell granuloma in a pediatric. Traditional treatment has been local curettage, although aggressive subtypes have a high tendency to recur. This website is intended for pathologists and laboratory personnel, who understand that medical information is imperfect and must be interpreted using reasonable medical judgment. 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. 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. The central and peripheral types are histologically identical, composed of a cellular fibroblastic stroma that includes multinucleated giant cells. Central giant cell granulomas are benign tumours of the mandible.
Surgery was performed with the patient under general anaesthesia after nasal intubation, using a right preauricular approach. Extremely aggressive behavior of central giant cell. Central giant cell granuloma venkateshwarlu et, al 6. The histological distinction between these lesions depends on quite subtle differences. Aggressive variant of central giant cell granuloma austin. Some, however, consider it to be a giant cell tumor occurring in both benign and malignant forms, and others consider it to be a. 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.
Conventional management is surgical and consists of enucleation and curettage. The purpose of this paper is to report a case in which the patient presented with. Fibrous dysplasia is a benign fibroosseous lesion arising in an intramedullary location. Peripheral giant cell granuloma or so called giant cell epulis is the most common oral giant cell lesion. 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. Central giant cell granuloma is a benign condition of the jaws which may present an aggressive behavior. Central giant cell granuloma cgcg is a benign, proliferative, intraosseous and nonodontogenic lesion of unknown etiology. Central giant cell lesions granuloma dr yuranga weerakkody and assoc prof frank gaillard et al. Although there is not enough evidence that this lesion promotes reparative process, it was denominated reparative giant cell granuloma2, 2530. The term giant cell lesion gcl defines a group of intraosseous nonodontogenic benign lesions with multinucleated giant cells gcs. The peripheral giant cell granuloma is a relatively common tumorlike growth that develops on the gingiva or alveolar ridge.
Peripheral giant cell granuloma intelligent dental. The findings are consistent with central giant cell. But the term reparative is obsolete, as cgcg causes the destruction of involved bones. Giant cell reparative granuloma, central definition of. Although it is a benign disease process, it can also be locally destructive. Central giant cell granuloma is an uncommon benign proliferative lesion occurring more commonly in the anterior mandible. Central giant cell granuloma in anterior maxilla shwetang goswami1, haripriya2, yashwanth yadav3, ram mohan4 abstract.
Achieving the correct diagnosis is reportedly difficult because cgcgs are very similar to odontogenic jaw tumors. Central giant cell granuloma of the temporal bone author yutaka nemoto, yuichi inoue, takahiko tashiro, tokuro mochizuki, junsuke katsuyama, akira hakuba, and yasuto onoyama. Peripheral giantcell granuloma pgcg is an oral pathologic condition that appears in the mouth as an overgrowth of tissue due to irritation or trauma. Traditional treatment has been local curettage, although aggressive subtypes. Pdf central giant cell granuloma is an uncommon, benign, and proliferative lesion whose. The central giant cell granuloma cgcg was first described by jaffe in 1953 as a giantcell reparative granuloma of the jaw bones. Recurrent central giant cell granuloma in the mandible.
A 9yearold boy was complaining of swelling in the floor of the mouth. 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. Peripheral giant cell granuloma is a tumor like growth occurring relatively commonly in the oral cavity that represents a reactive process rather than a neoplasm. We herein describe an intriguing case of a 21yearold male patient who. True giant cell tumor gct should be distinguished from cgcg. A solid swelling was observed in the area of the lower incisors. Giant cell granulomas gcgs of the jaws are lesions that arise either peripherally in periodontal ligament, mucoperiosteum, or centrally in the bone. Although its aetiology and pathogenesis is even unknown, its histology. These three diseases are associated because they appear frequently on gingiva.
Central giant cell granuloma and fibrous dysplasia occurring in the. Peripheral giant cell granuloma or the socalled giant cell epulis is the most common oral giant cell lesion. Incision was followed by blunt dissection with preservation of the facial nerve. Central giantcell granuloma is a localised benign condition of the jaws. Central giant cell granuloma and fibrous dysplasia. A central giant cell granuloma is a type of bone lesion that appears along the jaw. The differential is discussed including peripheral giant cell granuloma, brown tumor of hyperparathyroidism, and giant cell tumor of bone. Giant cell granuloma is an uncommon bony lesion in the head and neck region, most commonly affecting the maxilla and mandible. In 1953, jaffe described it as reparative granuloma of jaw bones. A clinical, radiologic and histopathologic study of 26 cases ooo 2006. An aggressive central giant cell granuloma in a pediatric patient. Two major histological features are diagnostic in cgcg. Central giant cell granuloma of the mandibular condyle.
An aggressive central giant cell granuloma treated successfully by. The referring doctor had suggested a diagnosis of eruption cyst. It occurs most commonly in mandible, but can also occur in maxilla. Incidence of central giant cell granuloma of the jaws with clinical and histological confirmation. Radiologically, it is usually a welldefined radiolucent defect with hazy opacity, classically described. The neoplastic status of the central giant cell granuloma of the jaws remains an unsolved contro versy in anatomic pathology. A classic case of central giant cell lesion cgcl is presented with emphasis on clinical, radiologic, and histologic features. However, most authorities believe peripheral giant cell granuloma is a reactive lesion. It normally presents as a soft tissue purplishred nodule consisting of multinucleated giant cells in a background of mononuclear stromal cells and extravasated red blood cells. The diagnosis and management of giant cell lesions of the jaws. Granulomata definition of granulomata by medical dictionary. Central giant cell granuloma and fibrous dysplasia are relatively uncommon lesions 1. Aggressive central giant cell granuloma of the mandible, a. Central giant cell granuloma is an uncommon benign intraosseus lesion of jaws.
From the radiographic exam, we observed a radiolucent image in the mandibular bone with welldefined limits extending from the apical region of. Intralesional corticosteroid injection for central giant. Peripheral giant cell granuloma in a child associated with. Histologically, both peripheral and central giant cell granuloma cgcg are characterized by the presence of numerous multinucleated. Giant cell granuloma an overview sciencedirect topics. Between the giant cells are monocluate variants with similar nuclear profiles. 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 extractions has been suggested to contribute to the development of the lesion. Aggressive lesions were also larger in size and histologically. Pdf the central giant cell granuloma cgcg is an uncommon benign bony lesion. Giant cells are a conglomeration of epithelioid cells which share the same cytoplasm and have multiple nuclei. Clinicopathological profile of central giant cell granulomas.
Multiple bone lesions each of different histologic appearance are extremely rare. Peripheral giant cell granuloma is, for all practical purposes, a sitespecific variant of pyogenic granuloma embedded with osteoclastlike multinucleated giant cells and arising exclusively from the periodontal ligament enclosing the root of a tooth. Central giant cell granuloma definition in the cambridge. The case described here involved maxilla which was treated with surgical excision.
Central giant cell granuloma is an uncommon, benign, and proliferative lesion whose etiology is not defined. Case report giant cell granuloma of the maxilla usman haider uzbek, iram mushtaq oral and maxillofacial unit, department of dentistry, ayub medical college, abbottabad. The histopathological diagnosis was central giant cell granuloma. 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 giantcell granulomas are more common in the anterior mandible, often crossing the midline and causing painless swellings. Central giant cell granuloma cgcg is an uncommon, benign, and proliferative. Several entities in the jaws can share this histology, including hyperparathyroidism, cherubism and the central giant cell granuloma cgcg 1. There are often giant cells in the central part of the granuloma. The lesions occur more frequently in females than in males and are more often located in the mandible than in the maxilla.
It is considered widely to be a nonneoplastic lesion although formerly designated as giant cell reparative granuloma these lesions were found to be destructive rather than reparative. Central giant cell lesions the central giant cell granuloma, also known as cgcl or giant cell lesion, was first described by jaffe in 1953. 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. 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 treatment consisting of surgical curettage with reconstruction and local delivery of steroid was done. The purpose of this study was to determine the ct characteristics and describe possible mr imaging features of gcg of the craniofacial bones. It is microscopically similar to the central giant cell granuloma of bone, being characterized by a proliferation of multinucleated giant cells that resemble osteoclasts. At first most have randomly distributed nuclei foreign body type giant cell but later the nuclei are arranged in the periphery langhans type giant cell. Central giant cell granuloma is a rather rare lesion of the jaws aetiology of which is still. Central giant cell lesions granulomas, also known as giant cell reparative cysts granulomas, occurs almost exclusively in the mandible, although cases in the skull and maxilla have been reported. Central giant cell granuloma cgcg is a benign bone lesion which can be locally aggressive or may be asymptomatic in nature. Radiologic features, including those seen with computed tomography, of central giant cell granuloma of the jaws. 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. Giant cell tumour of soft tissue peripheral giant cell granuloma.
1044 11 813 1242 545 1615 56 201 826 190 995 460 1443 805 1338 1520 1528 545 513 12 1611 1202 1287 1343 780 1058 118 265 1159 108 369 133 540 69 1408