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. Case report giant cell reparative granuloma of temporal. Revisiting the role of the granuloma in tuberculosis lalita ramakrishnan abstract the granuloma, which is a compact aggregate of immune cells, is the hallmark structure of tuberculosis. 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. Giant cell reparative granuloma of the mandible discussion giant cell reparative granuloma is an uncommon lesion that is a reactive process and not a neoplasm. Case report giant cell granuloma of the maxilla usman haider uzbek, iram mushtaq oral and maxillofacial unit, department of dentistry, ayub medical college, abbottabad. Because of its overwhelming incidence on the gingiva, the condition is associated with two other diseases, pyogenic granuloma and peripheral ossifying fibroma. Giant cell reparative granuloma, temporal bone, magnetic resonance imaging introduction giant cell reparative granuloma is a rare disease with variable behaviors and clinical presentations, ranging from large lesions with aggressive behaviors to small isolated lesions 1. Central giant cell granuloma was 1st described in jaws by jaffe 1953. Central giant cell granuloma of the jaws springerlink. A case of a 36yearold male with a central giant cell lesion. It is often difficult to make a clinical diagnosis. Central giant cell granuloma of the anterior maxilla. Later the term gcrg was changed to cgcg, deleting the word reparative owing to the destructive rather than the reparative.
Central giant cell granuloma cgcg is a benign lesion of the jaws with an unknown etiology. It affects females more often than males, mandible than. Eight cases of cgcg of the jaws were retrieved from the files of the oral. These granulomas occur in the jaws and have giant cells as their. Lytic lesion of mandibular ramus centered over the retromolar trigone may be consistent with giant cell granuloma. The clinical behavior of cgcg of the jaws is variable and difficult to predict. Pdf central giant cell granuloma is an uncommon, benign, and proliferative lesion whose etiology is not defined. These three diseases are associated because they appear frequently on gingiva. Prathibha prasad department of oral and maxillofacial pathology.
Central giant cell granulomas are benign tumours of the mandible, presenting in children and young adults. Finally, the epithelial cells surrounding the granuloma are now thought to also participate in its formation23. Central giant cell granuloma cgcg is an uncommon benign bony lesion that occurs in the mandible and maxilla. At histologic analysis, giant cell reparative granulomas demonstrate plump, bland fibroblasts and multinucleated giant cells surrounding foci of hemorrhage. Central giant cell lesions are benign intraosseous proliferative lesions that have considerable local aggressiveness. 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. Clinicopathological profile of central giant cell granulomas. The peripheral giant cell granuloma pgcg was first described by jaffe in 1953. Also called giant cell epulis, giant cell reparative granuloma, osteoclastoma, myeloid epulis epidemiology. Central giantcell granuloma cgcg is a localised benign condition of the jaws. 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. It is known to be a reactive soft tissue lesion that develops only within the oral cavity, with a slightly predilection for female sex.
The sample consisted of 26 giant cell lesions diagnosed in 22 patients divided into two groups, one of them including 17 patients who were not. 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. It is historically regarded as a hostprotective structure that walls off the infecting mycobacteria. It was first described as central giant cell reparative granuloma by jaffe h l in the year 1953. Fourteen women and 8 men were included with the age range of 781 years mean 31. Central giant cell granuloma cgcg, formerly called giant cell reparative granuloma, is a nonneoplastic proliferative lesion of unknown etiology. 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. Achieving the correct diagnosis is reportedly difficult because cgcgs are very similar to odontogenic jaw tumors. A central giant cell granuloma is a type of bone lesion that appears along the jaw. 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. We use your linkedin profile and activity data to personalize ads and to show you more relevant ads.
The appearance is generally distinctive with multinucleated giant cells spread throughout the lesion but often focal in distribution around areas of possible hemorrhage. Peripheral giant cell granuloma pgcg is a nonneoplastic lesion representing a local hyperplastic reaction to injury or inflammation. Interventions for central giant cell granuloma cgcg of the jaws source. Central giantcell granulomas are more common in the anterior mandible, often crossing the midline and causing painless swellings. It is predominantly found in children and young adults.
The central giant cell granulomacgcg of bone constitutes about 10% of benign jawbone lesions. The peripheral giant cell granuloma has an unknown etiology, with some dispute as to whether this lesion represents a reactive or neoplastic process. Central giant cell granuloma appears references as poorly defined unilocular radiolucency or multilocular radiolucency with scalloped borders. It does not constitute a true neoplasm, but rather a reactive lesion caused by local irritation or trauma. Pdf on jun 7, 2019, nilotpol kashyap and others published central giant cell granuloma find, read and cite all the research you need on. Central giant cell granuloma cgcg is a benign tumor that is found exclusively in the maxilla and mandible. Giantcell reparative granuloma, features of cgcg is its ability to cross the midline of the traumatic bone cyst and fibrous fibrooseous mandible.
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. Extremely aggressive behavior of central giant cell. Recently, bisphosphonates have been used to treat central giant cell lesions. The pgcg is a reactive, exophytic lesion that occurs primarily in gingival tissue and alveolar mucosa in both dentate and edentulous areas. Giant cell reparative granuloma definition of giant cell. The present study was aimed at evaluating main radiological and epidemiological aspects of giant cell lesions central giant cell granuloma and brown tumors of hyperparathyroidism. Revisiting the role of the granuloma in tuberculosis. Pathology outlines peripheral giant cell granuloma. Giant cell granulomas are benign intraosseous lesions, typically occurring in young females. Peripheral giant cell granuloma or so called giant cell epulis is the most common oral giant cell lesion. Peripheral giantcell granuloma pgcg is an oral pathologic condition that appears in the mouth as an overgrowth of tissue due to irritation or trauma. It is rare in the nasal cavity, and it might be misdiagnosed. We present an unusual case of a giant cell reparative granuloma arising from the left temporal lobe area of a 38yearold man and provide clinical and mr findings.
Peripheral giant cell granuloma or the socalled giant cell epulis is the most common oral giant cell lesion. Central giant cell granuloma is a fairly common lesion in the jaws aetiology of which is still completely unknown but thought to be of a reactive process to some unknown stimuli. Although central giant cell granulomas cgcgs appear to be benign, their radiographic findings are active. Peripheral giant cell granuloma pubmed central pmc. Usually women, 30s to 50s, although may involve children or elderly patients without teeth. Intracranial giant cell reparative granuloma arising from. This is in contrast to the giant cell tumor of long bones, where the giant cells are more. Pyogenic granuloma pg is a relatively common benign vascular lesion of the skin and mucosa. Central giant cell granuloma definition in the cambridge. The diagnosis and management of giant cell lesions of the jaws. These tumors become severely invasive with the stimulus of surgery, resembling malignant tumors.
Hence, this study was designed to provide a demographic data on the odontogenic tumors and giant cell lesions reported from. Radiologic features, including those seen with computed tomography, of central giant cell granuloma of the jaws. Genetic and rare diseases information center gard po box 8126, gaithersburg, md 208988126 tollfree. 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. The pg typically evolves rapidly over a period of few weeks.
Central giant cell lesions granuloma dr yuranga weerakkody and assoc prof frank gaillard et al. The objective was to investigate the clinical and radiological characteristics of central giant cell granulomas cgcgs of the jaws. Granulomas definition of granulomas by medical dictionary. Earlier, it was called giant cell reparative granuloma, a misnomer, or even giant cell lesion. A retrospective analysis of a 20year database was performed regarding both clinical and radiological features of 22 patients affected with cgcgs of the jaws. The exact cause is not known but multiple factors have been implicated in the etiology of pyogenic granuloma. The diagnosis and management of giant cell lesions of the. 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.
The purpose of present study was to investigate and correlate the histological findings in central giant cell granuloma and peripheral giant cell. The clinical behaviour of cgcg ranges from a slowgrowing asymptomatic swelling to an aggressive lesion that presents pain. They result from a local inflammatory process, thought to be secondary to trauma. Current diagnosis and treatment options are also discussed. Combined management of large aggressive central giant cell. For language access assistance, contact the ncats public information officer. Cgcg is the most common giant cell lesion of the jaws.
Central giant cell granuloma cgcg is relatively an uncommon central bony lesion in the head and neck region, commonly affecting the jaw. It is twice as common in females and is more likely to occur before age 30. Cgcg, as described by jaffe in 1953 is an idiopathic nonneoplastic proliferative lesion. The purpose of this study was to determine the ct characteristics and describe possible mr imaging features of gcg of the craniofacial bones. Odontogenic tumors and giant cell lesions of jaws a nine. Aggressive central giant cell granuloma of the mandible, a. However, most authorities believe peripheral giant cell granuloma is a reactive lesion. Granuloma annulare genetic and rare diseases information. Central giant cell granuloma cgcg is a benign, proliferative, intraosseous and nonodontogenic lesion of unknown etiology. Peripheral giant cell granuloma is a common benign and reactive gingival epulis in oral cavity. Central giant cell granuloma of the jaw is considered a nonneoplastic lesion.
If you have problems viewing pdf files, download the latest version of adobe reader. However, there are a few studies on these lesions, especially giant cell lesions, reported from india. The usual localization for pgcg is the premolar region and the crest. Central giant cell granuloma is a benign intraosseous lesion of the jaws. An aggressive central giant cell granuloma in a pediatric patient.
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 central giant cell granuloma or cgcg is a relatively uncommon pathological condition accounting for less than 7% of all benign lesions of the jaws. Aggressive variant of central giant cell granuloma austin. Full text pimary hyperparathyroidism as central giant. Radiological and epidemiological aspects of central giant. We herein describe an intriguing case of a 21yearold male patient who was. It can mimic a number of malignant tumors making the histopathological. 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 term reparative giant cell granuloma was at one time widely accepted as.
Clinically and radiologically, a differentiation between aggressive and nonaggressive lesions can be made. Peripheral giant cell granuloma pgcg is the most common oral giant cell lesion appearing as a soft tissue extraosseous purplishred nodule consisting of multinucleated giant cells in a background of mononuclear stromal cells and extravasated red blood cells. Diagnosis of central giant cell granuloma is normally made histologically from an incisional biopsy. Aggressive giant cell reparative granuloma of the nasal cavity. Central giant cell granuloma of the jaws and giant cell tumor of long. Nonsurgical treatment methods, such as intralesional corticosteroid injections, systemic calcitonin and interferon have been reported. Giant cell granuloma has been reported at the implantation site of absorbable gelatin product in the brain2, and compression of the brain and spinal cord resulting from an accumulation of sterile fluid3 has been reported following use of absorbable gelatin sponge in closed space. Doctors do not fully understand what causes these lesions to. 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. The first description of this tumor was presented by jaffe and recommended surgical management for these lesions. Giant cell granuloma definition of giant cell granuloma. This is in contrast to the giant cell tumor of long bones, where the giant cells are more evenly distributed.
174 95 1193 855 1340 448 1072 859 1589 1384 405 644 96 292 838 1025 345 1042 606 113 479 298 1182 495 84 1031 1467 1440 981 236 1344