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Liu Y, Housley Smith M, Patel PB, Bilodeau EA. Pediatric Gnathic Bony and Mesenchymal Tumors. Pediatr Dev Pathol 2023; 26:621-641. [PMID: 37232383 DOI: 10.1177/10935266231170744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Evaluation of bone pathology within the head and neck region, particularly the gnathic bonesis is complex, demonstrating unique pathologic processes. In part, this variation is due to odontogenesis and the embryological cells that may be involved, which can contribute to disease development and histologic variability. As with any boney pathosis, the key is to have clinical correlation, particularly with radiographic imaging prior to establishing a definitive diagnosis. This review will cover those entities that have a predilection for the pediatric population, and while it is not all inclusive, it should serve as a foundation for the pathologist who is evaluating bony lesions involving the craniofacial skeleton.
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Affiliation(s)
- Yingci Liu
- Rutgers School of Dental Medicine, Newark, NJ, USA
| | | | - Paras B Patel
- Center for Oral Pathology, Dallas, TX, USA
- Oral and Maxillofacial Pathology ProPath, Dallas, TX, USA
| | - Elizabeth Ann Bilodeau
- Oral & Maxillofacial Pathology, Director, UDHS Oral Pathology Laboratory, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA, USA
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Hosur MB, Puranik RS, Vanaki SS, Puranik SR, Ingaleshwar PS. Clinicopathological profile of central giant cell granulomas: An institutional experience and study of immunohistochemistry expression of p63 in central giant cell granuloma. J Oral Maxillofac Pathol 2018; 22:173-179. [PMID: 30158768 PMCID: PMC6097366 DOI: 10.4103/jomfp.jomfp_260_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background: The central giant cell granuloma(CGCG) of bone constitutes about 10% of benign jawbone lesions. It affects females more often than males, mandible than maxilla. Biological behavior of CGCG ranges from a slow growing asymptomatic swelling to an aggressive process. True giant cell tumor (GCT) should be distinguished from CGCG. The histological distinction between these lesions depends on quite subtle differences. Expression of p63 has been demonstrated in GCT of bone conversely, has not been detected in CGCG. Therefore this short study attempts to study the expression of p63 in CGCG in conjunction with clinicopathological profile of the cases reported in the institute. Aims and objectives: To review all the cases of CGCGs of the jaws reported in the institute from 1998 to 2015 and study their clinicopathological profile. To study the immunohistochemical (IHC) expression of p63 in CGCG cases
Methods and materials: The retrospective study reviewed records for clinically and histopathologically diagnosed cases of CGCG from the archives of department of Oral pathology. Data was recorded and analyzed. These cases were subjected for IHC analysis for expression of p63, also RANK, RANKL in selected cases to study the nature of giant cells. Results and Conclusion: This paper is an institutional experience of clinicopathological profile of diagnosed cases of CGCG. Clinicopathological findings were in concurrent with previous literature. Total number of cases was ten. Six occurred in females and four in males. Most of them occurred in the second decade, more commonly involving mandible. Three cases showed recurrence. Histologically most showed classical features. Expression of p63 showed negativity in all the cases in accordance with the previous studies. RANK and RANKL showed strong and diffuse immunoexpression in both mononuclear and giant cells. Thus study supports the finding that p63 expression can be used to differentiate between CGCG and GCT. However, more number of studies with larger sample size are required to confirm reliability of using p63 as a distinguishing marker between GCT and CGCG.
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Affiliation(s)
- Mahadevi B Hosur
- Department of Oral Pathology, PMNM Dental College and Hospital, Bagalkot, Karnataka, India
| | - Rudrayya S Puranik
- Department of Oral Pathology, PMNM Dental College and Hospital, Bagalkot, Karnataka, India
| | - Shreenivas S Vanaki
- Department of Oral Pathology, PMNM Dental College and Hospital, Bagalkot, Karnataka, India
| | - Surekha R Puranik
- Department of Oral Medicine, PMNM Dental College and Hospital, Bagalkot, Karnataka, India
| | - Pramod S Ingaleshwar
- Department of Oral Pathology, PMNM Dental College and Hospital, Bagalkot, Karnataka, India
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Buraczewski T, Potluri A, Costello BJ, Bilodeau EA. Multilocular radiolucency of the anterior mandible. J Am Dent Assoc 2017; 148:840-845. [PMID: 29080606 DOI: 10.1016/j.adaj.2017.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 08/04/2017] [Accepted: 08/14/2017] [Indexed: 10/18/2022]
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Zargaran M, Moghimbeigi A, Afsharmoghadam N, Nasr Isfahani M, Hashemi A. A Comparative Study of Cathepsin D Expression in Peripheral and Central Giant Cell Granuloma of the Jaws by Immunohistochemistry Technique. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2016; 17:98-104. [PMID: 27284554 PMCID: PMC4885679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
STATEMENT OF THE PROBLEM Peripheral and central giant cell granuloma are two common benign lesions of the oral cavity. In spite of histopathological similarities, they have different clinical behaviors. Cathepsin D is a lysosomal enzyme which has different functions on the basis of protein and applied peptide cleavage. PURPOSE This research aimed to evaluate and compare the expression level of Cathepsin D in these two lesions to find the reasons for the differences in clinical and biologic characteristics. MATERIALS AND METHOD The expression of Cathepsin D was investigated by using the immunohistochemistry method in 20 samples of peripheral giant cell granuloma and 20 samples of central giant cell granuloma. The percentage of stained giant cells (labeling index), the intensity of staining of giant cells, and staining-intensity-distribution in both groups were calculated and compared. RESULTS The labeling indices of Cathepsin D in peripheral giant cell granuloma and central giant cell granuloma were 95.9±4.03 and 95.6±2.34, respectively. There was no significant difference in the percentages of stained giant cells between the two groups (p= 0.586). The intensity of staining of giant cells in central giant cell granuloma was stronger than that of peripheral giant cell granuloma (p> 0.001). Staining- intensity- distribution of giant cells in central giant cell granuloma was significantly greater than that of the peripheral type of lesion (p= 0.001). CONCLUSION The higher expression level of Cathepsin D in central giant cell granuloma compared to peripheral type of lesion can explain more aggressive behavior of central giant cell granuloma.
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Affiliation(s)
- Massoumeh Zargaran
- Dental Research Center, Dept. of Oral and Maxillofacial Pathology, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Abbas Moghimbeigi
- Modeling of Noncommunicable Disease Research Center, Dept. of Biostatistics and Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Noushin Afsharmoghadam
- Dept. of Pathology, AL Zahra Medical Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Mohsen Nasr Isfahani
- Pathology Technologist, Dept. of Pathology, AL Zahra Medical Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Atefeh Hashemi
- Dept. of Oral and Maxillofacial Pathology, Dental School, Arak University of Medical Sciences, Arak, Iran.
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Sandhya T, Avinash T, Snehal D, Neha T, Uma M. Multifocal Central Giant Cell Granuloma - A Case Report. IRANIAN JOURNAL OF PATHOLOGY 2016; 11:276-280. [PMID: 27799978 PMCID: PMC5079462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Accepted: 10/10/2016] [Indexed: 06/06/2023]
Abstract
Central giant cell granuloma is a benign, aggressive neoplasm composed of multinucleated giant cells that almost exclusively occurs in the jaws though extra- gnathic incidence is rare. Multifocal CGCGs of the jaws are very rare and suggestive of systemic diseases such as hyperparathyroidism, an inherited syndrome such as Noonan- like multiple giant cell lesion syndrome or other disorders.Very few cases of multifocal CGCGs in the jaws without any concomitant systemic disease have been reported. This paper describes an unusual case reported to the Oral Surgery Department of Dr. D.Y.Patil Dental College & Hospital, Nerul, Navi-Mumbai in 2014 in a 45-year-old male with multifocal central giant cell granuloma involving maxilla and mandible. The serum alkaline phosphatase, calcium and phosphorus levels were within the normal limits. After complete clinical examination hyperparathyroidism and clinical characteristic of any syndromes such as Noonan-like syndrome and neurofibromatosis were ruled out. Thus this paper reports a non-syndromic multifocal central giant cell granuloma.
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Affiliation(s)
- Tamgadge Sandhya
- Dept. of Oral & Maxillofacial Pathology and Microbiology, Dr D Y Patil Dental College & Hospital, Sector 7, Nerul, Navi Mumbai, Maharashtra, India
| | - Tamgadge Avinash
- Dept. of Oral & Maxillofacial Pathology and Microbiology, Dr D Y Patil Dental College & Hospital, Sector 7, Nerul, Navi Mumbai, Maharashtra, India
| | - Dhauskar Snehal
- Dept. of Oral & Maxillofacial Pathology and Microbiology, Dr D Y Patil Dental College & Hospital, Sector 7, Nerul, Navi Mumbai, Maharashtra, India
| | - Tiwari Neha
- Dept. of Oral & Maxillofacial Pathology and Microbiology, Dr D Y Patil Dental College & Hospital, Sector 7, Nerul, Navi Mumbai, Maharashtra, India
| | - Mudaliar Uma
- Dept. of Oral & Maxillofacial Pathology and Microbiology, Dr D Y Patil Dental College & Hospital, Sector 7, Nerul, Navi Mumbai, Maharashtra, India
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Munde A, Modi P, Karle R, Wankhede P, Shoeb S. Nonsyndromic Synchronous Multifocal Central Giant Cell Granulomas of the Maxillofacial Region: Report of a Case. JOURNAL OF DENTISTRY (TEHRAN, IRAN) 2015; 12:157-62. [PMID: 26056526 PMCID: PMC4434130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Accepted: 12/12/2014] [Indexed: 11/25/2022]
Abstract
Central giant cell granuloma (CGCG) is a benign proliferation of fibroblasts and multinucleated giant cells that almost exclusively occurs in the jaws. It commonly occurs in young adults showing a female predilection in the anterior mandible. Multifocal CGCGs in maxillofacial region are very rare and suggestive of systemic diseases such as hyperparathyroidism, an inherited syndrome such as Noonan-like multiple giant cell lesion syndrome or other disorders. Only 10 cases of multifocal CGCGs in the maxillofacial region without any concomitant systemic disease have been reported in the English literature. Here, we report an unusual case of 36 year-old female presented with non-syndromic synchronous, multifocal CGCGs in the left posterior mandible and left posterior maxilla without any concomitant systemic disease. Relevant literature is reviewed and the incidence, clinical features, radiological features, differential diagnosis and management of CGCGs are discussed.
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Affiliation(s)
- Anita Munde
- Professor, Department of Oral Medicine Radiology,Pravara Institute of Medical Sciences, Loni, Maharashtra, India, Corresponding author: A. Munde, Department of Oral Medicine Radiology,Pravara Institute of Medical Sciences, Loni, Maharashtra, India,
| | - Priyanka Modi
- Post Graduate Student, Department of Oral Medicine and Radiology, Rural Dental College, Pravara Institute of Medical Sciences, Loni, Maharashtra, India
| | - Ravindra Karle
- Professor, Department of Pathology,Rural Medical College,Pravara Institute of MedicalSciences, Loni, Maharashtra, India
| | - Pranali Wankhede
- Assistant Professor, Department of Oral Medicine and Radiology,Rural Dental College,Pravara Institute of Medical Sciences, Loni, Maharashtra, India
| | - Safia Shoeb
- Professor, Department of Oral Medicine and Radiology, Rural Dental College,Pravara Institute of Medical Sciences, Loni, Maharashtra, India
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Ravi SB, Prashanthi C, Karun V, Melkundi M, Nyamati S, Annapoorna HB. Collision lesion of mandible--coexistence of keratocystic odontogenic tumor with central giant cell granuloma: a rare case report. J Contemp Dent Pract 2013; 14:355-9. [PMID: 23811673 DOI: 10.5005/jp-journals-10024-1327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM AND BACKGROUND An odontogenic keratocyst (OKC) or keratocystic odontogenic tumor (KCOT) and giant cell granuloma (GCG) in the jaws are common lesions which have been studied extensively in detail over the years. However, a lesion showing features of both is exceptionally rare and is reported only twice in the literature till date. CASE DESCRIPTION A rare case of OKC in mandible showing foci of GCG like areas is reported in a 29 years old male patient. CONCLUSION It seems to be a collision lesion, though the possibility of KCOT showing a reactive response to form giant cells or it being a rare variant cannot be totally ruled out. CLINICAL SIGNIFICANCE This entity requires aggressive treatment since biological behavior of this unique lesion is difficult to predict unless more of such lesions are reported and followed up in future.
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Affiliation(s)
- Spoorthi B Ravi
- Department of Oral Pathology, MS Ramaiah Dental College and Hospital, Bengaluru, Karnataka, India.
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Borges BBP, Fornazieri MA, Bezerra APCDA, Martins LAL, Pinna FDR, Voegels RL. Giant cell bone lesions in the craniofacial region: a diagnostic and therapeutic challenge. Int Forum Allergy Rhinol 2012; 2:501-6. [PMID: 22566483 DOI: 10.1002/alr.21050] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2011] [Revised: 03/01/2012] [Accepted: 03/31/2012] [Indexed: 11/12/2022]
Abstract
BACKGROUND Giant cell tumors of bone (GCTs) are common in the long bones, but rare in the craniofacial region, with only 1% of cases occurring in the latter. Clinical, radiological, and anatomical diagnosis of this locally aggressive disease, which occurs in response to trauma or neoplastic transformation, poses a major challenge in clinical practice. METHODS The present study describes a series of 4 cases and highlights the main features of the differential diagnosis and treatment of these lesions: GCT, giant cell reparative granuloma (GCRG), and the brown tumor of hyperparathyroidism. RESULTS GCT presents as a benign neoplasm, most typically affecting the knees, and rarely in the temporal and sphenoid bones. It is radiologically indistinguishable from GCRG due to its lytic, poorly defined appearance. The distinction can only be made microscopically, as the presence of multinucleated giant cells scattered throughout the stroma and the absence of a history of trauma favor a diagnosis of GCT. The brown tumor of hyperparathyroidism occurs with rapid, localized osteoclast activity secondary to the effects of increased parathyroid hormone (PTH) levels; parathyroid examination is indispensable. CONCLUSION The diagnosis and treatment of these lesions poses a major challenge due to their similar clinical presentation and radiological appearance. Accurate diagnosis is essential for definition of appropriate management, as complete resection is the goal in GCT and GCRG to avoid recurrence, whereas the brown tumor often yields to treatment of the underlying hyperparathyroidism.
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