Surgical and reconstructive treatment of central giant cell lesion in the mandible: Case report

Authors

DOI:

https://doi.org/10.33448/rsd-v10i9.18350

Keywords:

Disease mandibular; Bone diseases; Granuloma, giant cell.

Abstract

Introduction: The central giant cell lesion, also known as central giant cell granuloma, is considered to be a non-neoplastic lesion, which consists of fibrous tissue with multiple foci of hemorrhage, aggregation of multinucleated giant cells and, in some cases, trabeculae of bone tissue, it frequently affects the central region of the mandible, crossing the midline, and corresponds to 7% of all benign lesions of the jaws. Although it can affect a wide age group, it is more common to be seen in patients between 2 and 30 years of age. It has a slight preference for the female sex, with an incidence peak in the age group between 10 and 25 years. Objective: To report the clinical case, as well as discuss the therapeutic approach used, of a central giant cell lesion in the mandible, which worsened after the proposed conservative treatment. Discussion: The treatment of LCCG is traditionally by surgical removal followed or not by curettage. There are also supplementary measures such as cryosurgery or peripheral osteotomy. In cases where major mutilations are predictable, alternative treatments can be used, such as intralesional injections of corticosteroids, calcitonin, subcutaneous or nasal, subcutaneous alpha-2a interferon, imatinib and bisphosphonates. Final considerations: Surgical treatment with partial resection associated with bone reconstruction with autogenous iliac crest bone proved to be efficient in cases of failure of conservative therapy.

References

Spini, R., Juchli, M., Fernández, M., & Ramírez, Z. (2019). Granuloma gigantocelular de mandíbula en un niño de 6 años de edad: Reporte de un caso. Arch. argent. pediatr, 173-177.

Neville, B. (2009). Patologia oral e maxilofacial. Elsevier Brasil.

Bocchialini, G., Salvagni, L., Guerini, A., & Castellani, A. (2020). Central giant cell granuloma of the mandibular condyle: A rare case and a literature review. Heliyon, 6(1), e03085.

Loureiro, A. M. L. C., da Silva, C. L., de Oliveira Nunes, L. S., Theotonio, P. E. S., Santana, S. F., de Melo Franco, Á. V., & de Carvalho Nogueira, P. T. B. (2019). Abordagem farmacológica em lesão central de células gigantes: Relato de caso. Revista Eletrônica Acervo Saúde, (37), e2111-e2111.

Tecco, S., Caruso, S., Nota, A., Leocata, P., Cipollone, G., Gatto, R., & Cutilli, T. (2018). Bilateral Central Giant Cell Granuloma of the mandibular angle in three females from the same family. Head & face medicine, 14(1), 14.

Lima, E. C. G., Cardoso, M. S., Barbosa, G. M., de Souza Neto, F. J., da Silva, B. B. P., Xavier, T. B., & Pontes, H. A. R. (2019). Tratamento de lesão central de células gigantes Recidivante: relato de caso/Giant cell central injury treatment Relapse: case report. Brazilian Journal of Health Review, 2(6), 5382-5395.

Wang, Y., Le, A., El Demellawy, D., Shago, M., Odell, M., & Johnson-Obaseki, S. (2019). An aggressive central giant cell granuloma in a pediatric patient: case report and review of literature. Journal of Otolaryngology-Head & Neck Surgery, 48(1), 32.

Orzechowski, P. R., Takashima, M., Romeiro, R. D. L., Santana, J. B., & Campos, M. S. (2012). Granuloma Central de Células Gigantes: Relato de Caso Clínico. Revista de Cirurgia e Traumatologia Buco-maxilo-facial, 12(4), 61-68.

Nagar, S. R., Bansal, S., Jashnani, K., Sinha, A., & Desai, R. S. (2020). A Comparative Analysis of p63 Expression in Giant Cell Tumour (GCT), Central Giant Cell Granuloma (CGCG) and Peripheral Giant Cell Granuloma (PGCG). Head and neck pathology, 14(3), 733–741.

Silva, W. S., Moreira, G., Marques, I. P., & Silva, Â. F. (2019). Lesão Central de Células Gigantes–Relato de Caso. Revista Eletrônica Acervo Saúde, (17), e192-e192.

Zhang, Q., He, Z., Wang, G., & Jiang, H. (2019). Radiotherapy for recurrent central Giant cell granuloma: a case report. Radiation oncology (London, England), 14(1), 130.

Ramesh V. (2020). "Central giant cell granuloma" - An update. Journal of oral and maxillofacial pathology : JOMFP, 24(3), 413–415.

Choe, M., Smith, V., Okcu, M. F., Wulff, J., Gruner, S., Huisman, T., & Venkatramani, R. (2021). Treatment of central giant cell granuloma in children with denosumab. Pediatric blood & cancer, 68(3), e28778.

Mohan, R. P., Verma, S., Agarwal, N., & Singh, U. (2013). Central giant cell granuloma: a case report. BMJ case reports, 2013, bcr2013009903.

Gupta, M., Gupta, M., Singh, S., & Kaur, R. (2013). Central giant cell granuloma of the maxilla. BMJ case reports, 2013, bcr2013009102.

Chrcanovic, B. R., Gomes, C. C., & Gomez, R. S. (2018). Central giant cell lesion of the jaws: An updated analysis of 2270 cases reported in the literature. Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology, 47(8), 731–739.

Melo-Muniz, V., Nunes, F. D., Cangussu, M., Cury, P. R., Xavier, F., de Azevedo, R. A., Leitão, Á., de Faro Valverde, L., Carneiro Júnior, B., & Dos Santos, J. N. (2020). Central giant cell granuloma: A clinicopathological and immunohistochemical study of macrophages, blood vessels, lymphatic vessels and regulatory proteins. Annals of diagnostic pathology, 46, 151526.

Barbosa, C. D. S. (2019). Reconstrução óssea com enxerto autógeno de crista ilíaca em fratura cominutiva de mandíbula PAF: relato de caso.

Pirgousis P; Brown D; L Fernandes. Digital Measurementes of 120 mandibular Angles to determine the ideal Fibula Wedge Osteotomy To Re-Create. The Mandibular Angle For Microvascular Reconstruction.Jornal Maxillofac Surg 71:2169-2175,2013.

Vayvada H, Mola F, Menderes A, et al.Surgical management of ameloblastoma in the mandible: Segmental mandibulectomy and immediate reconstruction with free fibula or deep circumflex iliac artery flap (evaluation of the long-term esthetic and functional results). J Oral MaxillofacSurg, 2006; 64:1532.

Published

01/08/2021

How to Cite

LIMA JÚNIOR, M. O. de .; FRANÇA, A. J. B. de .; SOARES, C. F. .; NEVES, R. F. S. N. .; LIMA, H. A. de .; GENU, P. R. .; SANTOS , A. J. F. dos .; SILVA , T. C. G. da .; VASCONCELLOS, R. J. de H. . Surgical and reconstructive treatment of central giant cell lesion in the mandible: Case report. Research, Society and Development, [S. l.], v. 10, n. 9, p. e51610918350, 2021. DOI: 10.33448/rsd-v10i9.18350. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/18350. Acesso em: 20 sep. 2021.

Issue

Section

Health Sciences