Skip to main content

Advertisement

SpringerLink
Log in

Central giant cell granuloma: treatment with calcitonin, triamcinolone acetonide, and a cystic finding 3 years and 6 months after the primary treatment

  • Case Report
  • Published:
Oral and Maxillofacial Surgery Aims and scope Submit manuscript

Abstract

Background

Central giant cell granuloma is a benign condition of the jaws which may present an aggressive behavior.

Case report

A 9-year-old boy was complaining of swelling in the floor of the mouth. A solid swelling was observed in the area of the lower incisors. From the radiographic exam, we observed a radiolucent image in the mandibular bone with well-defined limits extending from the apical region of tooth 33 to the apical region of tooth 42.

Discussion

Due to the diagnosis and the age of the patient, we chose a conservative treatment, administering subcutaneous injections of calcitonin. During this treatment, no reduction to the lesion was observed. Therefore, we chose to treat the lesion with triamcinolone acetonide. Monthly follow-ups demonstrated good lesion reduction and the absence of any clinical symptoms during the first 2 years. After a 3-year follow-up, the patient returned, presenting mobility of the lower incisors. A significant increase in the size of the lesion was observed. After a biopsy, with the removal of tissue which had the appearance of a cyst capsule, microscopic analyses were found to be compatible with a secondarily infected cyst. Two months following this procedure, the patient did not present tooth mobility anymore and the oral mucosa presented a normal aspect. Following a radiographic exam, full lesion repair was observed. These conservative treatments should be the first option in cases of central giant cell granuloma and the patient must be observed for a long period of time, until no further clinical or radiographic signs of lesions are observed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. de Lange J, Rosenberg AJ, van den Akker RK, Koole R, Wirds JJ, van den Berg H (1999) Treatment of central giant cell granuloma of the jaw with calcitonin. Int J Oral Maxillofac Surg 28:372–376

    Article  PubMed  Google Scholar 

  2. Waldron CA (2002) Bone pathology. In: Neville BW, Damm DD, Allen CN, Bouquot JE (eds) Oral and maxillofacial pathology, 2nd edn. Saunders, Philadelphia, pp 544–547

    Google Scholar 

  3. Cohen MA, Hertzann Y (1988) Radiologic features, including those seen with computed tomography, of central giant cell granuloma of the jaws. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 65:255–261

    CAS  Google Scholar 

  4. Kaffe I, Ardekian L, Taicher S, Littner MM, Buchner A (1996) Radiologic features of central giant cell granuloma of the jaws. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 81:720–726

    Article  PubMed  CAS  Google Scholar 

  5. Whitaker SB, Waldron CA (1993) Central giant cell lesions of the jaws. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 75:199–208

    CAS  Google Scholar 

  6. Leon B, Eveson JW, Reichert P, Sidransky D (2005) Central giant cell lesion. In: Jundt G (ed) Pathology & genetics of head and neck tumours: odontogenic tumours. IARC Press, Lyon Motamedi, p 324

    Google Scholar 

  7. Kaban LB, Mulliken JB, Ezekowitz RA, Ebb D, Smith PS, Folkman J (1999) Antiangiogenic therapy of a recurrent giant cell tumor of the mandible with interferon alpha-2A. Pediatrics 103:1145–1149

    Article  PubMed  CAS  Google Scholar 

  8. Pogrel MA, Regezi JA, Harris SR, Goldring SR (1999) Calcitonin treatment for central giant cell granulomas of the mandible: report of two cases. J Oral Maxillofac Surg 57:848–853

    Article  PubMed  CAS  Google Scholar 

  9. Eisenbud L, Stern M, Rothberg M, Sachs S (1988) Central giant cell granuloma of the jaws: experiences in the management of thirty seven cases. J Oral Maxillofac Surg 46:376–384

    Article  PubMed  CAS  Google Scholar 

  10. Marx RE, Stern D (2003) Oral and maxillofacial pathology. A rationale for diagnosis and treatment. Quintessence, Chicago, pp 783–789

    Google Scholar 

  11. Terry BC, Jacoway JR (1994) Management of central giant cell lesions. An alternative to surgical therapy. Oral Maxillofac Surg Clin North Am 6:579–600

    Google Scholar 

  12. de Lange J, van den Akker HP (2005) Clinical and radiologic features of central giant cell lesions of the jaw. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 99:464–470

    Article  PubMed  Google Scholar 

  13. Kaban LB, Dodson TB (2003) Calcitonin therapy for central giant cell granuloma. J Oral Maxillofacial Surg 61:653–654

    Article  Google Scholar 

  14. Chuong R, Kaban LB, Kozakewich H, Perez-Atayde A (1986) Central giant cell granuloma lesions of the jaws: a clinicopathologic study. J Oral Maxillofac Surg 44:708–713

    Article  PubMed  CAS  Google Scholar 

  15. Chambers TJ, Fuller K, McSheeny PMJ (1985) The effects of calcium regulating hormones on bone resorption by isolated human osteoclastoma cells. J Pathol 45:297–305

    Article  Google Scholar 

  16. Harris M (1993) Central giant cell granulomas of the jaws regress with calcitonin therapy. Br J Oral Maxillofac Surg 31:89–94

    Article  PubMed  CAS  Google Scholar 

  17. Pogrel MA (2003) Calcitonin therapy for central giant cell granuloma. J Oral Maxillofac Surg 61:649–653

    Article  PubMed  CAS  Google Scholar 

  18. Borges HOI, Machado RA, Vidor MM, Beltrão RG, Heitz C, Filho MS (2008) Calcitonin: a non-invasive giant cells therapy. Int J of Pediatr Otolaryngol 72:959–963

    Article  Google Scholar 

  19. Kermer C, Millesi W, Watzke IM (1994) Local injection of corticosteroids for central giant cell granuloma. A case report Int J Oral Maxillofac Surg 23:366–368

    Article  CAS  Google Scholar 

  20. Carlos R, Sedano HO (2002) Intralesional corticosteroids as an alternative treatment for central giant cell granuloma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 93:161–166

    Article  PubMed  Google Scholar 

  21. Kurtz M, Mesa M, Alberto P (2001) Treatment of a central giant cell lesion of the mandible with intralesional glucocorticosteroids. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 91:636–637

    Article  PubMed  CAS  Google Scholar 

  22. Nogueira RLM, Teixeira RC, Cavalcante RB, Ribeiro RA, Rabenhosrt SHB (2010) Intralesional injection of triamcinolone hexacetonide as an alternative treatment for central giant cell granuloma in 21 cases. Int J of Oral Maxillofacial Surg 39:1204–1210

    Article  CAS  Google Scholar 

  23. Berti AS et al (2009) Spontaneous resolution of a central giant-cell granuloma after incisional biopsy: a case report. J Oral Maxillofac Surg 67:1543–1547

    Article  PubMed  Google Scholar 

  24. Rajeevan NS, Soumithran CS (1998) Intralesional corticosteroid injection for central giant cell granuloma. A case report. Int J Oral Maxillofac Surg 1998(27):303–304

    Article  Google Scholar 

  25. Yoon JH, Kim SG, Lee S, Kim J (2004) Simultaneous occurrence of an odontogenic keratocyst and giant cell granuloma-like lesion in the mandible. Int J Oral Maxillofac Surg 33:615–617

    Article  PubMed  CAS  Google Scholar 

  26. Lombardi T, Bischof M, Nedir R, Vergain D, Galgano C, Samson J, Küffer R (2006) Periapical central giant cell granuloma misdiagnosed as odontogenic cyst. Int Endod J 39:510–515

    Article  PubMed  CAS  Google Scholar 

  27. Dahlkemper P, Wolcott JF, Pringle GA, Hicks ML (2000) Periapical central giant cell granuloma: a potential endodontic misdiagnosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 90:739–745

    Article  PubMed  CAS  Google Scholar 

  28. Odell EW, Lombardi T, Barret AW, Morgan PR, Speight PM (1997) Hybrid central giant cell granuloma and central odontogenic fibroma-like lesions of the jaws. Histopathology 30:165–171

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Stomatology, Bauru School of Dentistry, University of São Paulo (FOB-USP), Al. Dr. Octávio Pinheiro Brisola, 9-75, Bauru, SP, Brazil, 17012-901

    Marcelo Bonifácio da Silva Sampieri, Renato Yassutaka Faria Yaedú, Paulo Sérgio Silva Santos, Eduardo Sanches Gonçales, Eduardo Santa’Ana, Alberto Consolaro & Lyzete Berriel Cardoso

  2. Department of Stomatology, Discipline of Oral Surgery, Al. Dr. Octávio Pinheiro Brisola, 9-75, Bauru, SP, Brazil, 17012-901

    Marcelo Bonifácio da Silva Sampieri

Authors
  1. Marcelo Bonifácio da Silva Sampieri
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Renato Yassutaka Faria Yaedú
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Paulo Sérgio Silva Santos
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Eduardo Sanches Gonçales
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Eduardo Santa’Ana
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Alberto Consolaro
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Lyzete Berriel Cardoso
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marcelo Bonifácio da Silva Sampieri.

Rights and permissions

Reprints and permissions

About this article

Cite this article

da Silva Sampieri, M.B., Yaedú, R.Y.F., Santos, P.S.S. et al. Central giant cell granuloma: treatment with calcitonin, triamcinolone acetonide, and a cystic finding 3 years and 6 months after the primary treatment. Oral Maxillofac Surg 17, 229–234 (2013). https://doi.org/10.1007/s10006-012-0370-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10006-012-0370-5

Keywords

Search

Navigation