The diagnosis and treatment of central giant cell granuloma

Radiological features of central giant cell granuloma: comparative study of 7 cases and literature review

OBJECTIVE

To review and analyze the clinical and imaging features of central giant cell granuloma patients and to review the relevant literatures for the diagnosis and clinical manifestation of central giant cell granuloma.

METHODS

Seven cases of central giant cell granuloma were retrospectively selected for the study, all of which were confirmed by pathology and had relevant imaging investigations. All seven cases had undergone CT scan, three cases had undergone MRI scan. Detailed clinical features were compared along with the imaging findings and analysis was done on the basis of their presentation and imaging features.

RESULTS

The clinical features, radiologic features were varied according to the site of the lesion. CT features include unevenly dense expansile mass causing bone destruction and cortical thinning. While MRI features with low to iso-intensity in T₁- and T₂ weighted images. There may be presence of cystic degeneration, hemorrhage or hemosiderin deposits or osteoid formation, which can cause T1 and T2 signal changes. On contrast study, the lesion doesn't enhance but periphery may enhance mildly.

CONCLUSION

Unevenly dense expansile mass with bone destruction and cortical thinning with low to iso-intensity in T₁ weighted and T₂ weighted images and mildly enhance peripherally, Central giant cell granuloma should be considered.

Rehabilitation of a maxillary defect secondary to recurrent giant cell granuloma

This is a presentation of the treatment history of a young woman with a benign lesion resulting in a large maxillary defect. This patient's complex treatment resulted in a full spectrum of rehabilitation modalities. Her story shows alternative treatment options with the ultimate goal of restoring form, function, and quality of life to a patient with an extensive maxillary defect.

Intracranial reparative giant cell granuloma secondary to cholesteatoma in a 15-year-old girl

A 15-year-old girl presented with pain in the right ear and acute onset of total peripheral facial nerve palsy. Imaging studies revealed an intracranial mass of the right temporal bone causing temporal lobe displacement. A first biopsy led to the diagnosis of intracranial giant cell reparative granuloma (GCRG), a rare benign tumor of the bone or soft tissue that can show expansive growth. The etiology of GCRG is unclear. Facial nerve palsy responded to treatment with diclofenac and physiotherapy, however, the intracranial lesion progressed at follow-up. Total surgical excision revealed a cholesteatoma central to the GCRG originating from the right middle ear and mastoid. Cholesteatoma should be considered as a trigger for intracranial GCRG growth, especially if adjacent to the temporal bone.

An endosseous, implant-retained obturator for the rehabilitation of a recurrent central giant cell granuloma: a clinical report

The prosthodontic rehabilitation of a patient with a recurrent maxillary CGCG has been described. The patient's immense defect originally was rehabilitated with a scapular microvascular free flap, endosseous dental implants, and an ISP that became obsolete by virtue of the resection of recurrent disease and the subsequent need for velopharyngeal obturation. The patient was provided with a surgical obturator at the time of the resection of the recurrent CGCG. The surgical obturator thereafter was modified into an interim obturator to provide velopharyngeal competence while the soft tissues around the palatal defect healed. Finally, the construction of a bar-retained definitive obturator markedly improved the patient's speech, mastication, and deglutition.

Central giant cell granuloma: a troublesome lesion

This case reports a central giant cell granuloma, an uncommon but potentially troublesome idiopathic benign lesion. Its radiographic similarity to a routine inflammatory periradicular lesion led to not only delay in diagnosis, but also further delay in successful treatment.