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Published in: Oral Radiology 1/2020

01-01-2020 | Digital Volume Tomography | Original Article

Central giant cell granulomas of the jaws: retrospective radiographic analysis of 13 patients

Authors: Meryem Etoz, Firdevs Asantogrol, Rıdvan Akyol

Published in: Oral Radiology | Issue 1/2020

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Abstract

Objective

This study was performed to retrospectively analyse the imaging features of 13 patients with central giant cell granulomas (CGCGs) examined at a single institution.

Methods

The orthopantomography and cone beam computed tomography images of 13 patients histopathologically diagnosed with CGCGs were retrospectively analysed. Patients aged > 30 years underwent measurement of their calcium and parathyroid hormone levels. No cases of hyperparathyroidism were identified in the study group.

Results

Thirteen lesions of 13 patients (7 female, 6 male) were included in this study. The patients’ ages ranged from 8 to 79 years at the time of presentation. Among the 13 lesions, 2 (15.4%) were in the maxilla and 11 (84.6%) were in the mandible. Eight lesions (61.5%) were unilocular and 5 lesions (38.5%) were multilocular with a soap bubble appearance. Three of the lesions were > 5 cm, and the remaining ten lesions were < 5 cm; five of these smaller lesions met at least three of the aggressiveness criteria. Therefore, according to these criteria, eight aggressive and five non-aggressive CGCGs were examined in this series.

Conclusion

The distinction between aggressive and non-aggressive CGCGs is extremely important because it leads to changes in the individual treatment protocol that is applied. It may be possible to minimise recurrence after treatment by detecting findings such as cortical perforation or thinning, cortical bone expansion, and the presence of root resorption.
Literature
1.
go back to reference Jaffe HL. Giant-cell reparative granuloma, traumatic bone cyst, and fibrous (fibroosseous) dysplasia of the jawbones. Oral Surg Oral Med Oral Pathol. 1953;6:159–75.CrossRef Jaffe HL. Giant-cell reparative granuloma, traumatic bone cyst, and fibrous (fibroosseous) dysplasia of the jawbones. Oral Surg Oral Med Oral Pathol. 1953;6:159–75.CrossRef
2.
go back to reference Triantafillidou K, Venetis G, Karakinaris G, Iordanidis F. Central giant cell granuloma of the jaws: a clinical study of 17 cases and a review of the literature. Ann Otol Rhinol Laryngol. 2011;120:167–74.CrossRef Triantafillidou K, Venetis G, Karakinaris G, Iordanidis F. Central giant cell granuloma of the jaws: a clinical study of 17 cases and a review of the literature. Ann Otol Rhinol Laryngol. 2011;120:167–74.CrossRef
3.
go back to reference Austin L, Dahlın D, Royer R. Giant-cell reparative granuloma and related conditions affecting the jawbones. Oral Surg Oral Med Oral Pathol. 1959;12:1285–95.CrossRef Austin L, Dahlın D, Royer R. Giant-cell reparative granuloma and related conditions affecting the jawbones. Oral Surg Oral Med Oral Pathol. 1959;12:1285–95.CrossRef
4.
go back to reference Waldron CA, Shafer WG. The central giant cell reparative granuloma of the jaws. An analysis of 38 cases. Am J Clin Pathol. 1966;45:437–47.CrossRef Waldron CA, Shafer WG. The central giant cell reparative granuloma of the jaws. An analysis of 38 cases. Am J Clin Pathol. 1966;45:437–47.CrossRef
5.
go back to reference Rachmiel A, Emodi O, Sabo E, Aizenbud D, Peled M. Combined treatment of aggressive central giant cell granuloma in the lower jaw. J Craniomaxillofac Surg. 2012;40:292–7.CrossRef Rachmiel A, Emodi O, Sabo E, Aizenbud D, Peled M. Combined treatment of aggressive central giant cell granuloma in the lower jaw. J Craniomaxillofac Surg. 2012;40:292–7.CrossRef
6.
go back to reference Kurtz M, Mesa M, Alberto P. Treatment of a central giant cell lesion of the mandible with intralesional glucocorticosteroids. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;91:636–7.CrossRef Kurtz M, Mesa M, Alberto P. Treatment of a central giant cell lesion of the mandible with intralesional glucocorticosteroids. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;91:636–7.CrossRef
7.
go back to reference Stavropoulos F, Katz J. Central giant cell granulomas: a systematic review of the radiographic characteristics with the addition of 20 new cases. Dentomaxillofac Radiol. 2002;31:213–7.CrossRef Stavropoulos F, Katz J. Central giant cell granulomas: a systematic review of the radiographic characteristics with the addition of 20 new cases. Dentomaxillofac Radiol. 2002;31:213–7.CrossRef
8.
go back to reference De Lange J, Van Den Akker HP. Clinical and radiological features of central giant-cell lesions of the jaw. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;99:464–70.CrossRef De Lange J, Van Den Akker HP. Clinical and radiological features of central giant-cell lesions of the jaw. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;99:464–70.CrossRef
9.
go back to reference Chuong R, Kaban LB, Kozakewich H, Perez-Atayde A. Central giant cell lesions of the jaws: a clinicopathologic study. J Oral Maxillofac Surg. 1986;44:708–13.CrossRef Chuong R, Kaban LB, Kozakewich H, Perez-Atayde A. Central giant cell lesions of the jaws: a clinicopathologic study. J Oral Maxillofac Surg. 1986;44:708–13.CrossRef
10.
go back to reference Lucas RB. Pathology of tumours of the oral tissues. London: Churchill Livingstone; 1984. Lucas RB. Pathology of tumours of the oral tissues. London: Churchill Livingstone; 1984.
11.
go back to reference Cohen MA, Hertzanu Y. Radiologic features, including those seen with computed tomography, of central giant cell granuloma of the jaws. Oral Surg Oral Med Oral Pathol. 1988;65:255–61.CrossRef Cohen MA, Hertzanu Y. Radiologic features, including those seen with computed tomography, of central giant cell granuloma of the jaws. Oral Surg Oral Med Oral Pathol. 1988;65:255–61.CrossRef
12.
go back to reference Kaffe I, Ardekian L, Taicher S, Littner MM, Buchner A. Radiologic features of central giant cell granuloma of the jaws. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;81:720–6.CrossRef Kaffe I, Ardekian L, Taicher S, Littner MM, Buchner A. Radiologic features of central giant cell granuloma of the jaws. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;81:720–6.CrossRef
13.
go back to reference Barnes L, Eveson JW, Reichart P, Sidransky D. Pathology and genetics of head and neck tumours. Lyon: IARC; 2005. p. 9. Barnes L, Eveson JW, Reichart P, Sidransky D. Pathology and genetics of head and neck tumours. Lyon: IARC; 2005. p. 9.
14.
go back to reference Farrier SL, Farrier JN, Smart MK, Nash ES. A 10-year review of the occurrence and treatment of central giant cell granulomas, in a District General Hospital. J Oral Pathol Med. 2006;35:332–7.CrossRef Farrier SL, Farrier JN, Smart MK, Nash ES. A 10-year review of the occurrence and treatment of central giant cell granulomas, in a District General Hospital. J Oral Pathol Med. 2006;35:332–7.CrossRef
15.
go back to reference Nackos JS, Wiggins RH, Harnsberger HR. CT and MR imaging of giant cell granuloma of the craniofacial bones. Am J Neuroradiol. 2006;27:1651–3.PubMed Nackos JS, Wiggins RH, Harnsberger HR. CT and MR imaging of giant cell granuloma of the craniofacial bones. Am J Neuroradiol. 2006;27:1651–3.PubMed
16.
go back to reference Dos Santos LAN, Campos PSF, Laranjeira AL, Bonan PRF, Martelli H, Cardoso SV. Effectiveness of computed tomography to evaluate central giant cell lesion. Dentomaxillofac Radiol. 2007;36:522–5.CrossRef Dos Santos LAN, Campos PSF, Laranjeira AL, Bonan PRF, Martelli H, Cardoso SV. Effectiveness of computed tomography to evaluate central giant cell lesion. Dentomaxillofac Radiol. 2007;36:522–5.CrossRef
17.
go back to reference Chrcanovic BR, Gomes CC, Gomez RS. Central giant cell lesion of the jaws: an updated analysis of 2270 cases reported in the literature. J Oral Pathol Med. 2018;47:731–9.CrossRef Chrcanovic BR, Gomes CC, Gomez RS. Central giant cell lesion of the jaws: an updated analysis of 2270 cases reported in the literature. J Oral Pathol Med. 2018;47:731–9.CrossRef
18.
go back to reference Kaban LB, Troulis MJ, Ebb D, August M, Hornicek FJ, Dodson TB. Antiangiogenic therapy with interferon alpha for giant cell lesions of the jaws. J Oral Maxillofac Surg. 2002;60:1103–11.CrossRef Kaban LB, Troulis MJ, Ebb D, August M, Hornicek FJ, Dodson TB. Antiangiogenic therapy with interferon alpha for giant cell lesions of the jaws. J Oral Maxillofac Surg. 2002;60:1103–11.CrossRef
19.
go back to reference Bezak B, Lehrke H, Elvin J, Gay L, Schembri-Wismayer D, Viozzi C. Comprehensive genomic profiling of central giant cell lesions identifies clinically relevant genomic alterations. J Oral Maxillofac Surg. 2017;75:955–61.CrossRef Bezak B, Lehrke H, Elvin J, Gay L, Schembri-Wismayer D, Viozzi C. Comprehensive genomic profiling of central giant cell lesions identifies clinically relevant genomic alterations. J Oral Maxillofac Surg. 2017;75:955–61.CrossRef
20.
go back to reference Csillag A, Pharoah M, Gullane P, Mancer K, Disney TV. A central giant cell granuloma influenced by pregnancy. Dentomaxillofac Radiol. 1997;26:357–60.CrossRef Csillag A, Pharoah M, Gullane P, Mancer K, Disney TV. A central giant cell granuloma influenced by pregnancy. Dentomaxillofac Radiol. 1997;26:357–60.CrossRef
21.
go back to reference Kruse-Lösler B, Diallo R, Gaertner C, Mischke KL, Joos U, Kleinheinz J. Central giant cell granuloma of the jaws: a clinical, radiologic, and histopathologic study of 26 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101:346–54.CrossRef Kruse-Lösler B, Diallo R, Gaertner C, Mischke KL, Joos U, Kleinheinz J. Central giant cell granuloma of the jaws: a clinical, radiologic, and histopathologic study of 26 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101:346–54.CrossRef
22.
go back to reference Sun Z-J, Cai Y, Zwahlen RA, Zheng Y-F, Wang S-P, Zhao Y-F. Central giant cell granuloma of the jaws: clinical and radiological evaluation of 22 cases. Skeletal Radiol. 2009;38:903–9.CrossRef Sun Z-J, Cai Y, Zwahlen RA, Zheng Y-F, Wang S-P, Zhao Y-F. Central giant cell granuloma of the jaws: clinical and radiological evaluation of 22 cases. Skeletal Radiol. 2009;38:903–9.CrossRef
23.
go back to reference Tosco P, Tanteri G, Iaquinta C, Fasolis M, Roccia F, Berrone S, et al. Surgical treatment and reconstruction for central giant cell granuloma of the jaws: a review of 18 cases. J Craniomaxillofac Surg. 2009;37:380–7.CrossRef Tosco P, Tanteri G, Iaquinta C, Fasolis M, Roccia F, Berrone S, et al. Surgical treatment and reconstruction for central giant cell granuloma of the jaws: a review of 18 cases. J Craniomaxillofac Surg. 2009;37:380–7.CrossRef
24.
go back to reference de Lange J, van den Akker HP, van den Berg H. Central giant cell granuloma of the jaw: a review of the literature with emphasis on therapy options. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104:603–15.CrossRef de Lange J, van den Akker HP, van den Berg H. Central giant cell granuloma of the jaw: a review of the literature with emphasis on therapy options. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104:603–15.CrossRef
25.
go back to reference Franco RL, Tavares MG, Bezerril DDL, Lacerda S, Xavier S. Granuloma de células gigantes central. Rev Bras Patol Oral. 2003;2:10–6. Franco RL, Tavares MG, Bezerril DDL, Lacerda S, Xavier S. Granuloma de células gigantes central. Rev Bras Patol Oral. 2003;2:10–6.
26.
go back to reference Dos Santos LAN, Campos PSF, Laranjeira AL, Bonan PRF, Martelli HJ, Cardoso SV. Effectiveness of computed tomography to evaluate central giant cell lesion. Dentomaxillofac Radiol. 2007;36:522–5.CrossRef Dos Santos LAN, Campos PSF, Laranjeira AL, Bonan PRF, Martelli HJ, Cardoso SV. Effectiveness of computed tomography to evaluate central giant cell lesion. Dentomaxillofac Radiol. 2007;36:522–5.CrossRef
27.
go back to reference Bodner L, Bar-Ziv J. Radiographic features of central giant cell granuloma of the jaws in children. Pediatr Radiol. 1996;26:148–51.CrossRef Bodner L, Bar-Ziv J. Radiographic features of central giant cell granuloma of the jaws in children. Pediatr Radiol. 1996;26:148–51.CrossRef
28.
go back to reference Whitaker SB, Waldron CA. Central giant cell lesions of the jaws. A clinical, radiologic, and histopathologic study. Oral Surg Oral Med Oral Pathol. 1993;75:199–208.CrossRef Whitaker SB, Waldron CA. Central giant cell lesions of the jaws. A clinical, radiologic, and histopathologic study. Oral Surg Oral Med Oral Pathol. 1993;75:199–208.CrossRef
29.
go back to reference Edwards PC, Fox J, Fantasia JE, Goldberg J, Kelsch RD. Bilateral central giant cell granulomas of the mandible in an 8-year-old girl with Noonan syndrome (Noonanlike/multiple giant cell lesion syndrome). Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;99:334–40.CrossRef Edwards PC, Fox J, Fantasia JE, Goldberg J, Kelsch RD. Bilateral central giant cell granulomas of the mandible in an 8-year-old girl with Noonan syndrome (Noonanlike/multiple giant cell lesion syndrome). Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;99:334–40.CrossRef
30.
go back to reference Abdelkarim AZ, Abu el Sadat SM, Chmieliauskaite M, Syed A. Radiographic diagnosis of a central giant cell granuloma using advanced imaging: cone beam computed tomography. Cureus. 2018;10:e2735.PubMedPubMedCentral Abdelkarim AZ, Abu el Sadat SM, Chmieliauskaite M, Syed A. Radiographic diagnosis of a central giant cell granuloma using advanced imaging: cone beam computed tomography. Cureus. 2018;10:e2735.PubMedPubMedCentral
31.
go back to reference Choi JWK, Kraut RA. Management of central giant granuloma of mandible with intralesional triamcinolone injections: a case report. N Y State Dent J. 2013;79:34–6.PubMed Choi JWK, Kraut RA. Management of central giant granuloma of mandible with intralesional triamcinolone injections: a case report. N Y State Dent J. 2013;79:34–6.PubMed
32.
go back to reference Oda T, Sue M, Okada Y, Kanri Y, Ono J, Ogura I. Central giant cell lesion of the mandible in a 2-year old girl. Imaging Sci Dent. 2017;47:209–13.CrossRef Oda T, Sue M, Okada Y, Kanri Y, Ono J, Ogura I. Central giant cell lesion of the mandible in a 2-year old girl. Imaging Sci Dent. 2017;47:209–13.CrossRef
33.
go back to reference Pinheiro LR, Pinheiro JJV, Sérgio Júnior A, Guerreiro N, Cavalcanti MGP. Clinical and imagiological findings of central giant cell lesion and cherubism. Braz Dent J. 2013;24:74–9.CrossRef Pinheiro LR, Pinheiro JJV, Sérgio Júnior A, Guerreiro N, Cavalcanti MGP. Clinical and imagiological findings of central giant cell lesion and cherubism. Braz Dent J. 2013;24:74–9.CrossRef
34.
go back to reference Aghbali A, Sina M, Vahid Pakdel SM, Emamverdizadeh P, Kouhsoltani M, Mahmoudi SM. Correlation of histopathologic features with demographic, gross and radiographic findings in giant cell granulomas of the jaws. J Dent Res Dent Clin Dent Prospect. 2013;7:225–9. Aghbali A, Sina M, Vahid Pakdel SM, Emamverdizadeh P, Kouhsoltani M, Mahmoudi SM. Correlation of histopathologic features with demographic, gross and radiographic findings in giant cell granulomas of the jaws. J Dent Res Dent Clin Dent Prospect. 2013;7:225–9.
Metadata
Title
Central giant cell granulomas of the jaws: retrospective radiographic analysis of 13 patients
Authors
Meryem Etoz
Firdevs Asantogrol
Rıdvan Akyol
Publication date
01-01-2020
Publisher
Springer Singapore
Published in
Oral Radiology / Issue 1/2020
Print ISSN: 0911-6028
Electronic ISSN: 1613-9674
DOI
https://doi.org/10.1007/s11282-019-00380-7

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