Central Giant Cell Granuloma

Central Giant Cell Granuloma

Central Giant Cell Granuloma 1. O’Connell JE, Kearns GJ: Aggressive giant cell granuloma of the jaws treated with interferon alpha: a report of two ca...

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Central Giant Cell Granuloma 1. O’Connell JE, Kearns GJ: Aggressive giant cell granuloma of the jaws treated with interferon alpha: a report of two cases. Ir J Med Sci. 2013 Jun;182(2):163-70. http://dx.doi.org/10.1007/s11845-012-0858-x. Epub 2012 Oct 26. Review. PMID:23099991 A combination of curettage and interferon alpha-2a resulted in complete remission of two lesions with decreased morbidity. There are good references for interferon treatment for central giant cell granuloma. 2. Moskovszky L, Idowu B, Taylor R, Mertens F, Athanasou N, Flanagan A: Analysis of giant cell tumour of bone cells for Noonan syndrome/cherubism-related mutations. J Oral Pathol Med. 2013 Jan;42(1):95-8. http://dx. doi.org/10.1111/j.1600-0714.2012.01194.x. Epub 2012 Jun 22. PMID:22725657 DNA sequencing suggests that the molecular pathways involved in the central giant cell tumor of bone are different from those in Noonan’s syndrome and cherubism. They may, therefore, respond differently to treatment. 3. Nogueira RL, Faria MH, Osterne RL, Cavalcante RB, Ribeiro RA, Rabenhorst SH: Glucocorticoid and calcitonin receptor expression in central giant cell lesions: implications for therapy. Int J Oral Maxillofac Surg. 2012 Aug;41(8):994-1000. http://dx.doi.org/10.1016/j.ijom.2012.01.017. Epub 2012 Feb 23. PMID:22365107 18 patients with central giant cell granulomas (9 aggressive and 9 nonaggressive) were tested for calcitonin receptors and glucocorticoid receptor expression. There was no difference in calcitonin receptor expression, but the glucocorticoid receptor expression in the multinucleated giant cells was higher in patients with a good response to calcitonin. A score of greater than 48 for glucocorticoid receptors in multinucleated giant cells predicted a good response to calcitonin treatment. 4. Peacock ZS, Jordan RC, Schmidt BL: Giant cell lesions of the jaws: does the level of vascularity and angiogenesis correlate with behavior? J Oral Maxillofac Surg. 2012 Aug;70(8):1860-6. http://dx.doi.org/10.1016/j.joms. 2011.08.020. Epub 2011 Nov 21. PMID:22104131 The vascularity and levels of angiogenesis with aggressive central giant cell granulomas are higher than those in nonaggressive lesions. 5. de Matos FR, de Moraes M, Nonaka CF, de Souza LB, de Almeida Freitas R: Immunoexpression of TNF-a and TGF-ß in central and peripheral giant cell lesions of the jaws. J Oral Pathol Med. 2012 Feb;41(2):194-9. http://dx.doi.org/10.1111/j.1600-0714.2011.01075.x. Epub 2011 Sep 13. PMID:2191399 The central giant cell granuloma demonstrates that interaction between TGF-ß and TNF-a is important for osteoclastogenesis and bone resorption. The peripheral giant cell granuloma has a lower expression of TGF-beta, probably because bone resorption is not present in these cases. 6. Etoz OA, Dolanmaz D, Gunhan O: Treatment of cherubism with salmon calcitonin: a case report. Eur J Dent. 2011 Aug;5(4):486-91. PMID:21912506 A 14-year-old boy with cherubism was treated with internasal administration of calcitonin. After 30 months of calcitonin therapy, the lesions in the mandible significantly regressed. 7. 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 Apr;40(3):292-7. http://dx.doi.org/10.1016/j.jcms. 2011.04.002. Epub 2011 May 12. PMID:21570312 A 24-year-old patient had a combination of intralesional injection of corticosteroid, calcitonin by nasal spray and curettage for a central giant cell granuloma. There were no signs of recurrence at five years. 8. Yanik S, Aras MH: Management of central giant cell granuloma of mandible using intralesional corticosteroids: case report and review of literature. J Oral Maxillofac Surg. 2013 Apr;71(4):721-2. http://dx.doi.org/10.1016/ j.joms.2012.10.013. Epub 2012 Dec 21. No abstract available. PMID:23265848




A good review article on the management of central giant cell granulomas of the mandible utilizing intralesional corticosteroids. 9. Manor E, Kachko L, Brennan PA, Bodner L: Cytogenetics of central giant cell granuloma of the mandible. J Oral Maxillofac Surg. 2013 Sep;71(9):1541-4. http://dx.doi.org/10.1016/j.joms.2013.03.026. Epub 2013 May 22. PMID:23706277 A cytogenetic analysis of central giant cell granulomas of the mandible and the results reported. Since there are no other studies to compare it with, the significance of this study is unclear, but it is the first report of a genetic analysis of the central giant cell granuloma and did show a number of numerical chromosomal changes. M. ANTHONY POGREL, DDS, MD SECTION EDITOR, PATHOLOGY