Peripheral giant cell granuloma is a relatively uncommon lesion of the oral cavity, arising mainly from the connective tissue of the gingiva, periodontal membrane, periosteum of alveolar ridge, or in response to local irritation. 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 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. Recurrent central giant cell granuloma in the mandible. The findings are consistent with central giant cell. The patient had a healing mycobacterial infection of the skin m. Central giant cell granulomas are more common in the anterior mandible, often crossing the midline and causing painless swellings. A central giant cell granuloma is a type of bone lesion that appears along the jaw.
The peripheral giant cell granuloma pgcg is a rare reactive exophytic lesion taking place on the gingiva and alveolar ridge usually as a result of local irritating factors such as trauma, tooth. Central giant cell granuloma cgcg is defined by the world health organization as an intraosseous lesion consisting of cellular fibrous tissue that contains multiple foci of hemorrhage, aggregations of multinucleated. Giant cell granuloma definition of giant cell granuloma by. 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.
Later the term gcrg was changed to cgcg, deleting the word reparative owing to the destructive rather than. These histopathological findings allowed the diagnosis of central giant cell granuloma of the condyle. Intracranial giant cell reparative granuloma arising from. Fourteen women and 8 men were included with the age range of. These three diseases are associated because they appear. An aggressive central giant cell granuloma in a pediatric patient. Granulation tissue with a poorly formed granuloma to the left of centre. 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. This is in contrast to the giant cell tumor of long bones, where the giant cells are more evenly distributed. There is a further population of bland, spindled, fibroblastslike cells with associated hemosiderin and scattered inflammation. Due to these lesions often being symptomatic, active management is usua.
Giant cell granuloma is an uncommon bony lesion in the head and neck region, most commonly affecting the maxilla and mandible. Calcitonin therapy for central giant cell granuloma. Peripheral giant cell granuloma or the socalled giant cell epulis is the most common oral giant cell lesion. 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 granulomas are benign tumours of the mandible. A retrospective analysis of a 20year database was performed regarding both clinical and radiological features of 22 patients affected with cgcgs of the jaws. 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. Some, however, consider it to be a giant cell tumor occurring in both benign and malignant forms, and others consider it to. Central giantcell granuloma cgcg is a localised benign condition of the jaws. The purpose of this study was to determine the ct characteristics and describe possible mr imaging features of gcg of the craniofacial bones. 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. Diagnosis, granuloma giant cell, gingival overgrowth, mandible, biopsy, recurrence. The central giant cell granuloma is an uncommon, benign and proliferative pathological condition accounting for less than 7% of all benign lesions of the jaws whose etiology is not clearly explained. The most common treatment is curettage,which has a high recurrence rate, particularly in more. Between the giant cells are monocluate variants with similar nuclear profiles. Central giant cell granuloma was 1st described in jaws by jaffe 1953. We present a case of an aggressive central giant cell granuloma cgcg in a six yearold female. Aggressive central giant cell granuloma mimicking peripheral.
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 is an uncommon benign intraosseus lesion of jaws. Educational video created by unmc college of dentistry class of 2016 dental students. 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. This patient report describes a recurrent central giant cell granuloma involving the body of the mandible in a 48yearoldwoman. Peripheral giant cell granuloma is a common benign and reactive gingival epulis in oral cavity. These tumors become severely invasive with the stimulus of surgery, resembling malignant tumors. Like pyogenic granuloma and peripheral ossifying fibroma, peripheral giant cell granuloma may represent an unusual response to tissue injury. Traditional treatment has been local curettage, although aggressive subtypes have a high tendency to recur. The usual localization for pgcg is the premolar region and the crest. Due to these lesions often being symptomatic, active management is usually performed. Nagargoje department of oral and maxillofacial surgery midsr dental college latur, maharashtra, india corresponding author a b s t r a c t. Central giant cell lesion cgcl is a benign lesion which has unpredictable biologic behaviour and is amenable to a plethora of treatment alternatives. Central giant cell granuloma cgcg is relatively an uncommon central bony lesion in the head and neck region, commonly affecting the jaw.
Initially, similar central lesions of the jaw were referred to as reparative lesions. 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 the free dictionary. Within this area there is a multinucleate giant cell of the langhans type. The objective was to investigate the clinical and radiological characteristics of central giant cell granulomas cgcgs of the jaws. 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. Peripheral giant cell granuloma or so called giant cell epulis is the most common oral giant cell lesion. 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. Interventions for central giant cell granuloma cgcg of the jaws source.
Giant cell reparative granulomas gcrg are benign, reparative, metabolic lesions that may exhibit local aggression and result in extensive tissue destruction in advanced cases. The giant cell granuloma of jaw is a wellvascularised lesion comprising a mononuclear cell infiltrate with a large number of giant cells. Although this relatively uncommon entity has been described most frequently involving the mandible and maxilla, it can also be found in the orbit, ethmoid sinus, and cranial vault. It is twice as common in females and is more likely to occur before age 30. Central giantcell granulomas are more common in the anterior mandible, often crossing the midline and causing painless swellings. The peripheral giant cell granuloma has an unknown etiology, with some dispute as to whether this lesion represents a reactive or neoplastic process. Intracranial giant cell reparative granuloma arising from the. It is distinguishable from pyogenic granuloma and peripheral ossifying fibroma only on the basis of its unique histomorphology, which is the same as central giant cell granuloma 8, 9. It is usually located in the mandible anterior region. It may become aggressive leading to expansion and perforation of the cortex. Discussion the central giant cell granuloma is a benign. It is often difficult to make a clinical diagnosis.
Intralesional corticosteroid injection for central giant. However, most authorities believe peripheral giant cell granuloma is a reactive lesion. Giant cell reparative granuloma, central the free dictionary. They result from a local inflammatory process, thought to be secondary to trauma.
Peripheral giant cell granuloma pgcg is an infrequent exophytic lesion of the oral cavity, also known as giant cell epulis, osteoclastoma, giant cell reparative. This case report describes a 19yearold female patient with a central giant cell granuloma in the left mandibular condyle, treated with en bloc resection. Peripheral giant cell granuloma pubmed central pmc. Giant cell granuloma, central circumscribed ddmfr oral. Full text pimary hyperparathyroidism as central giant. Peripheral giant cell granuloma article about peripheral. Gerdes 1 1 division of molecular immunology, department of immunology and cell biology and 2division of cellular allergology, department of clinical medicine, research center borstel, germany summary. Apr 17, 2015 today i have no problem, i even had an emotional time over the weekend where i did eat a little too much but it didnt affect me at all. Aggressive central giant cell granuloma of the mandible, 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. 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. Central giant cell granuloma is a benign lesion of the jaws which is sometimes aggressive locally. Giant cell granuloma an overview sciencedirect topics.
Central giant cell granuloma and fibrous dysplasia occurring in the. 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. Achieving the correct diagnosis is reportedly difficult because cgcgs are very similar to odontogenic jaw tumors. Although it is a benign disease process, it can also be locally destructive. Peripheral giantcell granuloma pgcg is an oral pathologic condition that appears in the mouth as an overgrowth of tissue due to irritation or trauma. Current diagnosis and treatment options are also discussed. Although central giant cell granulomas cgcgs appear to be benign, their radiographic findings are active. 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 is a localised benign condition of the jaws. Central giant cell granuloma of the mandibular condyle. Extremely aggressive behavior of central giant cell granuloma. Also called giant cell epulis resembles pyogenic granuloma but may erode alveolar bone or involve periodontal membrane usually women, mean age 30 years, although may involve children or elderly patients without teeth. The true nature of this lesion is controversial and remains unknown. An aggressive central giant cell granuloma in a pediatric.
Conventional treatment for the central giant cell granuloma cgcg has been local curettage, and this has been associated with a high success rate and a low recurrence rate. Peripheral giant cell granuloma adlakha v k, chandna p. Central giant cell granuloma cgcg, formerly called giant cell reparative granuloma, is a nonneoplastic proliferative lesion of unknown etiology. Peripheral giant cell granuloma pgcg is a nonneoplastic lesion representing a local hyperplastic reaction to injury or inflammation.
We describe our experience in managing this lesion by intralesional triamci. The diagnosis and management of giant cell lesions of the jaws. It is an uncommon tumor in jaws, its etiology and pathogenesis is unknown. Cgcg is the most common giant cell lesion of the jaws. Divided into non and aggressive subtypes, the aggressive subtype is relatively rare and can occasionally progress rapidly, resulting in significant morbidity. Giant cell granulomas are benign intraosseous lesions, typically occurring in young females. We herein describe an intriguing case of a 21yearold male patient who was.
Peripheral giant cell granuloma in a child associated with. Intralesional corticosteroid injection for central giant cell granuloma. Central giant cell lesions of the mandible and maxilla. Cgcg is described as a benign lesion affecting the mandible and maxilla that consists of a massive fibrohistiocytic prolife ration. 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 is an uncommon benign proliferative lesion occurring more commonly in the anterior mandible. The decision to not reconstruct with a bony free tissue flap was made in. Central giant cell granuloma, benign jaw tumor, molar, recurrent pericoronitis, multinucleated giant cells. The diagnosis and management of giant cell lesions of the. Extremely aggressive behavior of central giant cell. Central giant cell granuloma cgcg is a benign intraosseous lesion of the jaws that is found predominantly in children and young adults. Central giant cell granuloma in anterior maxilla shwetang goswami1, haripriya2, yashwanth yadav3, ram mohan4 abstract. It will attempt to point out the differences between these lesions and giant cell lesions elsewhere in. 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 granulomas are benign tumours of the mandible, presenting in children and young adults. Auclair pj, cuenin p, kratochvil fj, slater lj, ellis gl. Intralesional corticosteroid injection for central giant cell. Aggressive variant of central giant cell granuloma austin. This is in contrast to the giant cell tumor of long. Medical school giant cell temporal arteritis made easy duration. Follow up of one year was done and during this period no recurrence of the lesion was noticed fig5. The true nature of these lesions is unknown but, as they are invariably destructive, the term reparative giant cell granuloma would appear to be inappropriate. Diagnosis of central giant cell granuloma is normally made histologically from an incisional biopsy. Its etiology is unknown and its biological behavior is poorly understood. Langhans giant cells are large cells found in granulomatous conditions they are formed by the fusion of epithelioid cells macrophages, and contain nuclei arranged in a horseshoeshaped pattern in the cell periphery although traditionally their presence was associated with tuberculosis, they are not specific for tuberculosis or even for mycobacterial disease. After this the lesion was completely excised and thorough curettage of the area was done under general anesthesia fig4.
The central giant cell granuloma is an uncommon lesion only seen in the toothbearing regions of the jaws, most commonly in the mandible and typically in the second and third decades. 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 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 granuloma cgcg is a benign intraosseous lesion that occurs in long bones. Giant cell granuloma of the jaw is a benign lesion that may cause local destruction of bone and displacement of teeth. 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. 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. A human in vitro granuloma model for the investigation of multinucleated giant cell and granuloma formation u. 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. I did not binge eat or get worried i just let the food digest, had a good rest and was back to myself the next day, just what normal people experience. Katz, giant cell reparative granuloma outside the jaw bone. Review a human in vitro granuloma model for the investigation.
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