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Published in: Head and Neck Pathology 2/2020

01-06-2020 | Bisphosphonate | Sine qua non Clinicopathologic Correlation

Central Giant Cell Granuloma Treated with Intralesional Corticosteroid Injections and Bisphosphonates: A Long-Term Follow-Up Case Study

Published in: Head and Neck Pathology | Issue 2/2020

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Abstract

Central giant cell granuloma (CGCG) is a benign intraosseous lesion of the head and neck with potential for aggressive and locally destructive behaviour. Lesions of the maxilla tend to expand more than those of the mandible due to the thinner cortices and spongy tissue of this location. Surgical removal is the most common treatment; however, it may be disfiguring in aggressive cases, especially for lesions located in the maxilla. Alternative treatments, such as intralesional corticosteroid injections, have been performed with satisfactory results. We report a case of a 12-year-old female patient with a CGCG of the left maxilla that was treated with 40 doses of intralesional triamcinolone acetonide infiltrations combined with alendronate sodium and calcium carbonate. Clinical and imaging follow-up over 12 years demonstrates improvement in the patient’s condition.
Literature
1.
go back to reference El-Naggar AK, Chan JKC, Grandis JR, Takata T, Slootweg PJ, editors. World Health Organization classification of head and neck tumours. Lyon: IARC Press; 2017. p. 256. El-Naggar AK, Chan JKC, Grandis JR, Takata T, Slootweg PJ, editors. World Health Organization classification of head and neck tumours. Lyon: IARC Press; 2017. p. 256.
2.
go back to reference Garg P, Jain J, De N, Chatterjee K. A central giant cell granuloma in posterior part of maxilla: a case report. Int J Surg Case Rep. 2017;30:222–5.CrossRef Garg P, Jain J, De N, Chatterjee K. A central giant cell granuloma in posterior part of maxilla: a case report. Int J Surg Case Rep. 2017;30:222–5.CrossRef
3.
go back to reference Jerkins D, Malotky M, Miremadi R, Dole M. Central giant cell granuloma of the mandible requiring multiple treatment modalities: a case report. J Oral Maxillofac Surg. 2016;74(8):1596–607.CrossRef Jerkins D, Malotky M, Miremadi R, Dole M. Central giant cell granuloma of the mandible requiring multiple treatment modalities: a case report. J Oral Maxillofac Surg. 2016;74(8):1596–607.CrossRef
4.
go back to reference Rawashdeh MA, Bataineh AB, Al-Khateeb T. Long-term clinical and radiological outcomes of surgical management of central giant cell granuloma of the maxilla. Int J Oral Maxillofac Surg. 2006;35(1):60–6.CrossRef Rawashdeh MA, Bataineh AB, Al-Khateeb T. Long-term clinical and radiological outcomes of surgical management of central giant cell granuloma of the maxilla. Int J Oral Maxillofac Surg. 2006;35(1):60–6.CrossRef
5.
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
6.
go back to reference Osterne RL, Araújo PM, de Souza-Carvalho AC, Cavalcante RB, Sant’Ana E, Nongueira RL. Intralesional corticosteroid injections in the treatment of central giant cell lesions of the jaws: a meta-analytic study. Med Oral Patol Oral Cir Bucal. 2013;18(2):e226–32.CrossRef Osterne RL, Araújo PM, de Souza-Carvalho AC, Cavalcante RB, Sant’Ana E, Nongueira RL. Intralesional corticosteroid injections in the treatment of central giant cell lesions of the jaws: a meta-analytic study. Med Oral Patol Oral Cir Bucal. 2013;18(2):e226–32.CrossRef
7.
go back to reference Dolanmaz D, Esen A, Mihmanlı A, Işık K. Management of central giant cell granuloma of the jaws with intralesional steroid injection and review of the literature. Oral Maxillofac Surg. 2016;20(2):203–9.CrossRef Dolanmaz D, Esen A, Mihmanlı A, Işık K. Management of central giant cell granuloma of the jaws with intralesional steroid injection and review of the literature. Oral Maxillofac Surg. 2016;20(2):203–9.CrossRef
8.
go back to reference de Oliveira JP, Olivete F, de Oliveira ND, et al. Combination therapies for the treatment of recurrent central giant cell lesion in the maxilla: a case report. J Med Case Rep. 2017;11(1):74.CrossRef de Oliveira JP, Olivete F, de Oliveira ND, et al. Combination therapies for the treatment of recurrent central giant cell lesion in the maxilla: a case report. J Med Case Rep. 2017;11(1):74.CrossRef
9.
go back to reference Wendt FP, Torriani MA, Gomes AP, de Araujo LM, Torriani DD. Intralesional corticosteroid injection for central giant cell granuloma: an alternative treatment for children. J Dent Child. 2009;76(3):229–32. Wendt FP, Torriani MA, Gomes AP, de Araujo LM, Torriani DD. Intralesional corticosteroid injection for central giant cell granuloma: an alternative treatment for children. J Dent Child. 2009;76(3):229–32.
10.
go back to reference da Rosa MRP, de Sá JL, Martins VB, de Oliveira MV. Central giant cells lesion: report of a conservative management. Eur J Dent. 2018;12(2):305–10.CrossRef da Rosa MRP, de Sá JL, Martins VB, de Oliveira MV. Central giant cells lesion: report of a conservative management. Eur J Dent. 2018;12(2):305–10.CrossRef
11.
go back to reference Schreuder WH, van den Berg H, Westermann AM, Peacock ZS, de Lange J. Pharmacological and surgical therapy for the central giant cell granuloma: a long-term retrospective cohort study. J Craniomaxillofac Surg. 2017;45(2):232–43.CrossRef Schreuder WH, van den Berg H, Westermann AM, Peacock ZS, de Lange J. Pharmacological and surgical therapy for the central giant cell granuloma: a long-term retrospective cohort study. J Craniomaxillofac Surg. 2017;45(2):232–43.CrossRef
12.
go back to reference Naidu A, Malmquist MP, Denham CA, Schow SR. Management of central giant cell granuloma with subcutaneous denosumab therapy. J Oral Maxillofac Surg. 2014;72(12):2469–84.CrossRef Naidu A, Malmquist MP, Denham CA, Schow SR. Management of central giant cell granuloma with subcutaneous denosumab therapy. J Oral Maxillofac Surg. 2014;72(12):2469–84.CrossRef
13.
go back to reference Vered M, Buchner A, Dayan D. Immunohistochemical expression of glucocorticoid and calcitonin receptors as a tool for selecting therapeutic approach in central giant cell granuloma of the jawbones. Int J Oral Maxillofac Surg. 2006;35(8):756–60.CrossRef Vered M, Buchner A, Dayan D. Immunohistochemical expression of glucocorticoid and calcitonin receptors as a tool for selecting therapeutic approach in central giant cell granuloma of the jawbones. Int J Oral Maxillofac Surg. 2006;35(8):756–60.CrossRef
14.
go back to reference Ananchenko G, Novakovic J, Tikhomirova A. Alendronate sodium. Profiles Drug Subst Excip Relat Methodol. 2013;38:1–33.CrossRef Ananchenko G, Novakovic J, Tikhomirova A. Alendronate sodium. Profiles Drug Subst Excip Relat Methodol. 2013;38:1–33.CrossRef
15.
go back to reference Sambrook PN, Kotowicz M, Nash P, et al. Prevention and treatment of glucocorticoid-induced osteoporosis: a comparison of calcitriol, vitamin D plus calcium, and alendronate plus calcium. J Bone Miner Res. 2003;18(5):919–24.CrossRef Sambrook PN, Kotowicz M, Nash P, et al. Prevention and treatment of glucocorticoid-induced osteoporosis: a comparison of calcitriol, vitamin D plus calcium, and alendronate plus calcium. J Bone Miner Res. 2003;18(5):919–24.CrossRef
16.
go back to reference Papapoulos SE. The role of bisphosphonates in the prevention and treatment of osteoporosis. Am J Med. 1993;95(5A):48S–52S.CrossRef Papapoulos SE. The role of bisphosphonates in the prevention and treatment of osteoporosis. Am J Med. 1993;95(5A):48S–52S.CrossRef
17.
go back to reference da Silva NG, Carreira AS, Pedreira EN, Tuji FM, Ortega KL, de Jesus Viana Pinheiro J. Treatment of central giant cell lesions using bisphosphonates with intralesional corticosteroid injections. Head Face Med. 2012;8:23.CrossRef da Silva NG, Carreira AS, Pedreira EN, Tuji FM, Ortega KL, de Jesus Viana Pinheiro J. Treatment of central giant cell lesions using bisphosphonates with intralesional corticosteroid injections. Head Face Med. 2012;8:23.CrossRef
18.
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
19.
go back to reference Ruggiero SL, Dodson TB, Fantasia J, et al. American Association of Oral and Maxillofacial Surgeons position paper on medication-related osteonecrosis of the jaw: 2014 update. J Oral Maxillofac Surg. 2014;72(10):1938–56.CrossRef Ruggiero SL, Dodson TB, Fantasia J, et al. American Association of Oral and Maxillofacial Surgeons position paper on medication-related osteonecrosis of the jaw: 2014 update. J Oral Maxillofac Surg. 2014;72(10):1938–56.CrossRef
20.
go back to reference Sarinho ESC, Melo VMPP. Glucocorticoid-induced bone disease: mechanisms and importance in pediatric practice. Rev Paul Pediatr. 2017;35(2):207–15.CrossRef Sarinho ESC, Melo VMPP. Glucocorticoid-induced bone disease: mechanisms and importance in pediatric practice. Rev Paul Pediatr. 2017;35(2):207–15.CrossRef
21.
go back to reference Rudge S, Hailwood S, Horne A, Lucas J, Wu F, Cundy T. Effects of once-weekly oral alendronate on bone in children on glucocorticoid treatment. Rheumatology. 2005;44(6):813–8.CrossRef Rudge S, Hailwood S, Horne A, Lucas J, Wu F, Cundy T. Effects of once-weekly oral alendronate on bone in children on glucocorticoid treatment. Rheumatology. 2005;44(6):813–8.CrossRef
22.
go back to reference Hernandez M, Phulpin B, Mansuy L, Droz D. Use of new targeted cancer therapies in children: effects on dental development and risk of jaw osteonecrosis: a review. J Oral Pathol Med. 2017;46(5):321–6.CrossRef Hernandez M, Phulpin B, Mansuy L, Droz D. Use of new targeted cancer therapies in children: effects on dental development and risk of jaw osteonecrosis: a review. J Oral Pathol Med. 2017;46(5):321–6.CrossRef
23.
go back to reference Nogueira RL, Teixeira RC, Cavalcante RB, Ribeiro RA, Rabenhosrt SH. Intralesional injection of triamcinolone hexacetonide as an alternative treatment for central giant-cell granuloma in 21 cases. Int J Oral Maxillofac Surg. 2010;39(12):1204–10.CrossRef Nogueira RL, Teixeira RC, Cavalcante RB, Ribeiro RA, Rabenhosrt SH. Intralesional injection of triamcinolone hexacetonide as an alternative treatment for central giant-cell granuloma in 21 cases. Int J Oral Maxillofac Surg. 2010;39(12):1204–10.CrossRef
Metadata
Title
Central Giant Cell Granuloma Treated with Intralesional Corticosteroid Injections and Bisphosphonates: A Long-Term Follow-Up Case Study
Publication date
01-06-2020
Keyword
Bisphosphonate
Published in
Head and Neck Pathology / Issue 2/2020
Electronic ISSN: 1936-0568
DOI
https://doi.org/10.1007/s12105-019-01053-x

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