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Extremely aggressive behavior of central giant cell granuloma after biopsy:a case report

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Abstract

Although central giant cell granulomas (CGCGs) appear to be benign, their radiographic findings are active. These tumors become severely invasive with the stimulus of surgery, resembling malignant tumors. Achieving the correct diagnosis is reportedly difficult because CGCGs are very similar to odontogenic jaw tumors. We herein describe an intriguing case of a 21-year-old male patient who was referred to our outpatient clinic with persistent swelling of the left buccal region. After making a provisional diagnosis of ameloblastoma from panoramic and computed tomography images, a biopsy was performed. Nine days after this operation, the intraoral lesion started to enlarge, causing facial disfigurement. Soon afterward, this lesion was examined by computed tomography, magnetic resonance imaging, and by both bone and tumor scintigraphy. Segmental resection of the mandible was conducted in the hospital, and the histopathological appearance was consistent with CGCG. Although CGCG tends to be indolent, the present case suggests that the stimulus of surgery can trigger clinically invasive behavior more characteristic of malignancy. CGCG exhibits variable features, but with the stimulus of surgery, its clinical behavior becomes extremely invasive, resembling a malignant tumor. The CGCG in the present case showed unusual development and intriguing radiographic and histopathological findings. It is important to be aware of the findings that can help to achieve a correct diagnosis.

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Acknowledgments

This study was supported by grants from the Sato Fund and the Nihon University School of Dentistry for 2012.

Conflict of interest

Masao Araki, Teruhiko Ishii, Naoyuki Matsumoto, Kunihito Matsumoto, Kazuya Honda, Satoshi Nishimura, and Takayoshi Tanaka declare that they have no conflict of interest.

Human rights statement and informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later version(s). Informed consent was obtained from all patients for being included in the study.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Radiology, Dental Research Center, Nihon University School of Dentistry, 1-8-13 Kanda-Surugadai, Chiyoda-ku, Tokyo, 101-8310, Japan

    Masao Araki, Kunihito Matsumoto & Kazuya Honda

  2. Department of Oral and Maxillofacial Surgery, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan

    Teruhiko Ishii, Satoshi Nishimura & Takayoshi Tanaka

  3. Department of Pathology, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan

    Naoyuki Matsumoto

  4. Division of Advanced Dental Treatment, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan

    Masao Araki, Kunihito Matsumoto & Kazuya Honda

  5. Division of Immunology and Pathobiology, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan

    Teruhiko Ishii, Naoyuki Matsumoto, Satoshi Nishimura & Takayoshi Tanaka

Authors
  1. Masao Araki
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  2. Teruhiko Ishii
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  3. Naoyuki Matsumoto
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  4. Kunihito Matsumoto
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  5. Kazuya Honda
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  6. Satoshi Nishimura
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  7. Takayoshi Tanaka
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Correspondence to Masao Araki.

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Araki, M., Ishii, T., Matsumoto, N. et al. Extremely aggressive behavior of central giant cell granuloma after biopsy:a case report. Oral Radiol 31, 115–122 (2015). https://doi.org/10.1007/s11282-014-0177-1

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  • DOI: https://doi.org/10.1007/s11282-014-0177-1

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