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Aliu F, Shabani DB, Aliu I, Qeli ED, Kaçani G, Fiorillo L, Meto A. Evaluating Treatment Modalities for Reducing Recurrence in Central Giant Cell Granuloma: A Narrative Review. Dent J (Basel) 2024; 12:295. [PMID: 39329860 PMCID: PMC11431665 DOI: 10.3390/dj12090295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Revised: 09/13/2024] [Accepted: 09/14/2024] [Indexed: 09/28/2024] Open
Abstract
Treating central giant cell granuloma (CGCG) is challenging due to high recurrence rates and variable therapy responses. This study examines the efficacy of various treatments in reducing CGCG recurrence. A literature review explored outcomes of surgical excision, curettage, intralesional corticosteroid injection, and adjuvant therapy, considering factors like lesion location, size, and histological features. Aggressive surgical techniques such as en bloc resection were found to potentially lower recurrence rates compared to conservative approaches. However, treatment should be tailored to individual patient needs. Further research is needed to confirm these findings and improve treatment strategies. A concise literature review was conducted using PubMed, MEDLINE, and Google Scholar, focusing on papers published from 1986 to 2024. Search terms included "central giant cell granuloma", "recurrence", "treatment modalities", and "surgical excision". Studies reporting recurrence rates and treatment outcomes for CGCG were analyzed. Twenty-nine studies were reviewed, including six studies on surgical excision and curettage, eight studies on intralesional corticosteroid injections, six studies on calcitonin therapy, five studies on interferon-alpha therapy, and four studies on the therapy with denosumab. Analysis indicated that aggressive surgical treatments like en bloc resection were associated with lower recurrence rates compared to conservative methods. Predictors of recurrence included lesion size (>3 cm), location (mandible), and aggressive histopathological features. Aggressive surgical excision combined with nonsurgical methods may lower recurrence rates, while conservative techniques remain viable in some cases. Further prospective research is needed to validate these findings and enhance CGCG treatment options.
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Affiliation(s)
- Flamur Aliu
- Private Dental Clinic “I Dent”, 10000 Prishtina, Kosovo; (F.A.); (I.A.)
| | - Donika Bajrami Shabani
- Department of Dental Pathology and Endodontics, Faculty of Medicine, University of Prishtina, 10000 Prishtina, Kosovo
| | - Iliriana Aliu
- Private Dental Clinic “I Dent”, 10000 Prishtina, Kosovo; (F.A.); (I.A.)
| | - Etleva Droboniku Qeli
- Department of Dental Therapy, Faculty of Dental Medicine, University of Medicine, 1005 Tirana, Albania;
| | - Gerta Kaçani
- Department of Prosthetics, Faculty of Dental Medicine, University of Medicine, 1005 Tirana, Albania;
| | - Luca Fiorillo
- Department of Dentistry, Faculty of Dental Sciences, University of Aldent, 1007 Tirana, Albania;
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98100 Messina, Italy
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania “Luigi Vanvitelli”, 80121 Naples, Italy
- Department of Public Health Dentistry, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune 411018, Maharashtra, India
| | - Aida Meto
- Department of Dentistry, Faculty of Dental Sciences, University of Aldent, 1007 Tirana, Albania;
- Laboratory of Microbiology and Virology, Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy
- Department of Conservative Dentistry and Endodontics, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune 411018, Maharashtra, India
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Choi WJ, Lee P, Thomas PC, Rath TJ, Mogensen MA, Dalley RW, Wangaryattawanich P. Imaging approach for jaw and maxillofacial bone tumors with updates from the 2022 World Health Organization classification. World J Radiol 2024; 16:294-316. [PMID: 39239241 PMCID: PMC11372550 DOI: 10.4329/wjr.v16.i8.294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2024] [Revised: 08/22/2024] [Accepted: 08/27/2024] [Indexed: 08/28/2024] Open
Abstract
Jaw and maxillofacial bone lesions encompass a wide variety of both neoplastic and non-neoplastic pathologies. These lesions can arise from various tissues, including bone, cartilage, and soft tissue, each presenting distinct challenges in diagnosis and treatment. While some pathologies exhibit characteristic imaging features that aid in diagnosis, many others are nonspecific. This overlap often necessitates a multimodal imaging approach, combining techniques such as radiographs, computed tomography, and magnetic resonance imaging to achieve a diagnosis or narrow the diagnostic considerations. This article provides a comprehensive review of the imaging approach to jaw and maxillofacial bone tumors, including updates on the 2022 World Health Organization classification of these tumors. The relevant anatomy of the jaw and dental structures that is important for accurate imaging interpretation is discussed.
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Affiliation(s)
- Woongsoon John Choi
- Division of Neuroradiology, Department of Radiology, University of Washington School of Medicine, Seattle, WA 98195, United States
- Department of Radiology, M&S Radiology Associates, San Antonio, TX 78217, United States
| | - Peggy Lee
- Division of Oral Radiology, University of Washington School of Dentistry, Seattle, WA 98195, United States
| | - Penelope C Thomas
- Division of Neuroradiology, Department of Radiology, University of Washington School of Medicine, Seattle, WA 98195, United States
| | - Tanya J Rath
- Division of Neuroradiology, Department of Radiology, Mayo Clinic, Phoenix, AZ 85054, United States
| | - Monique A Mogensen
- Division of Neuroradiology, Department of Radiology, University of Washington School of Medicine, Seattle, WA 98195, United States
| | - Roberta W Dalley
- Division of Neuroradiology, Department of Radiology, University of Washington School of Medicine, Seattle, WA 98195, United States
| | - Pattana Wangaryattawanich
- Division of Neuroradiology, Department of Radiology, University of Washington School of Medicine, Seattle, WA 98195, United States
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Bhat A, Smart R, Egbert M, Susarla SM. Benign Non-Odontogenic Pathology in Children. Oral Maxillofac Surg Clin North Am 2024; 36:295-302. [PMID: 38402139 DOI: 10.1016/j.coms.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2024]
Abstract
This article provides a comprehensive overview of benign non-odontogenic pathologies. Bone-derived lesions like osteoma, osteoid osteoma, osteoblastoma, and osteochondroma are discussed in detail, emphasizing their radiographic features, locations, and treatment strategies. Cartilage-derived lesions such as chondroma, chondroblastoma, and chondromyxoid fibroma are also examined, noting their typical presentation and management approaches. The article then delves into fibroconnective tissue lesions. Mesenchymal and vascular lesions are detailed regarding their clinical and radiographic characteristics and treatment options. Lastly, nerve-derived lesions like schwannoma and neurofibroma are covered, providing insights into their association with diseases like neurofibromatosis and preferred management strategies.
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Affiliation(s)
- Aparna Bhat
- Department of Oral and Maxillofacial Surgery, University of Washington School of Dentistry, 1959 NE Pacific Street, B-307, Seattle, WA 98195, USA
| | - Ryan Smart
- Department of Surgery, University of North Dakota School of Medicine and Health Sciences, Private clinic 2585 23rd Avenue South, Fargo, ND 58103, USA.
| | - Mark Egbert
- Department of Oral and Maxillofacial Surgery, University of Washington School of Dentistry, 1959 NE Pacific Street, B-307, Seattle, WA 98195, USA; Division of Plastic Surgery, Department of Surgery, University of Washington School of Medicine, 1959 Northeast Pacific Street, B-307, Seattle, WA 98195, USA; Craniofacial Center, Seattle Children's Hospital, 4800 Sand Point Way Northeast, Seattle, WA 98015, USA
| | - Srinivas M Susarla
- Department of Oral and Maxillofacial Surgery, University of Washington School of Dentistry, 1959 NE Pacific Street, B-307, Seattle, WA 98195, USA; Division of Plastic Surgery, Department of Surgery, University of Washington School of Medicine, 1959 Northeast Pacific Street, B-307, Seattle, WA 98195, USA; Craniofacial Center, Seattle Children's Hospital, 4800 Sand Point Way Northeast, Seattle, WA 98015, USA
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Barut O, Mukdad M, Danielsson K, Legrell PE, Sjöström M. Giant cell granuloma and neurofibroma in the mandible of a patient with neurofibromatosis type 1: a long-term follow-up case report with radiological and surgical aspects and a review of the literature. BMC Oral Health 2024; 24:792. [PMID: 39004713 PMCID: PMC11247863 DOI: 10.1186/s12903-024-04543-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 06/28/2024] [Indexed: 07/16/2024] Open
Abstract
BACKGROUND Magnetic resonance imaging (MRI) of the brain is frequently performed on patients with neurofibromatosis type 1 (NF1), to detect and follow-up intracranial findings. In addition, NF1-related pathologies can appear in the jaws. This case study investigates if it is advantageous to assess the depicted parts of the jaws in the imaging of NF1 patients with intracranial findings, thereby detecting jaw pathologies in their initial stages. CASE PRESENTATION We report on the 3-year management with clinical and radiological follow-ups of a central giant cell granuloma and a neurofibroma in the mandible of a patient with NF1 who underwent examinations with brain MRIs. A review of the mandible in the patient's MRIs disclosed lesions with clear differences in progression rates. CONCLUSION NF1-related jaw pathologies may be detected in the early stages if the depicted parts of the jaws are included in the assessment of the imaging of NF1 patients with intracranial findings. This could impact the treatment of eventual pathologies before lesion progression and further damage to the vicinity.
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Affiliation(s)
- Oya Barut
- Oral and Maxillofacial Radiology, Umeå University Hospital, Umeå, Sweden.
- Oral and Maxillofacial Radiology, Department of Odontology, Umeå University, Umeå, Sweden.
| | - Marcel Mukdad
- Oral and Maxillofacial Surgery, Umeå University Hospital, Umeå, Sweden
| | - Karin Danielsson
- Orofacial Medicine, Department of Odontology, Umeå University, Umeå, Sweden
| | - Per Erik Legrell
- Oral and Maxillofacial Radiology, Umeå University Hospital, Umeå, Sweden
| | - Mats Sjöström
- Oral and Maxillofacial Surgery, Department of Odontology, Umeå University, Umeå, Sweden
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Tabatabaei S, Paknahad M, Garmabi J, Ghorbani F. Central giant cell granuloma in the posterior region of mandible mimicking a fibro-osseous lesion and hemangioma: a case report. J Med Case Rep 2024; 18:255. [PMID: 38769587 PMCID: PMC11106875 DOI: 10.1186/s13256-024-04571-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 04/03/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND A central giant cell granuloma (CGCG) is a benign, proliferative, intraosseous, and non-odontogenic lesion occurring primarily in children and young adults. On the histological level, it is characterized by numerous multinucleated giant cells scattered randomly throughout a sea of spindle-shaped mesenchymal stromal cells which are dispersed throughout the fibrovascular connective tissue stroma containing areas of haemorrhage. When it comes to radiographic features, CGCG can have an array of variations, ranging from well-defined expansile lesions to ill-defined and destructive lesions, with or without expansion. CASE PRESENTATION This case report reviews an 11-year-old Caucasian patient with a chief complaint of slow-growing swelling involving the right posterior mandibular region. The cone beam computed tomography (CBCT) revealed an ill-defined mixed lesion mimicking both fibro-osseous lesion and hemangioma. However, microscopic examination revealed multinucleated giant cells in a fibrous stroma suggestive of central giant cell granuloma. CONCLUSION Our intent in reporting this case is to highlight the importance of thorough clinical, radiographical and histopathological examination for accurate diagnosis and therapeutic interventions as well as to emphasize the importance of taking different possibilities into consideration when examining bony swellings in the head and neck region.
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Affiliation(s)
- Salma Tabatabaei
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Paknahad
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Javad Garmabi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Farhad Ghorbani
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Ghasrodasht Street, Shiraz, 7144833586, Iran.
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Shirzadeh A, Amirpour Haradasht S, Dehabadi F. Successful Combined Treatment Approach for Central Giant Cell Granuloma: A Case Study of Surgery Following Intralesional Steroid Injection. World J Plast Surg 2024; 13:82-86. [PMID: 39193244 PMCID: PMC11346697 DOI: 10.61186/wjps.13.2.82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 05/09/2024] [Indexed: 08/29/2024] Open
Abstract
The occurrence of Central Giant Cell Granuloma (CGCG) represents a rare yet clinically significant entity within the realm of maxillofacial pathology. This article presents a compelling case of CGCG in a 17-year-old female, shedding light on the diagnostic and therapeutic challenges encountered in managing this condition. Given the relative infrequency of CGCG in this demographic, the case not only contributes to the clinical understanding of CGCG but also underscores the importance of tailored, patient-specific management strategies. Through this presentation, we aim to elucidate the intricacies of CGCG manifestation, diagnosis, and treatment while highlighting the nuanced considerations essential in addressing this pathology in adolescent patients.
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Affiliation(s)
- Alireza Shirzadeh
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sadra Amirpour Haradasht
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Farnaz Dehabadi
- Assistant Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, Zahedan University of Medical Sciences, Zahedan, Iran
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7
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Kitagawa N, Fukino K, Matsushita Y, Ibaragi S, Tubbs RS, Iwanaga J. The notch of the mandible: what do different fields call it? Anat Cell Biol 2023; 56:308-312. [PMID: 37106571 PMCID: PMC10520864 DOI: 10.5115/acb.23.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/03/2023] [Accepted: 03/07/2023] [Indexed: 04/29/2023] Open
Abstract
The bony notch on the inferior border of the mandible, anterior to the attachment of the masseter muscle, where the facial vessels commonly pass, has been called different names in the literature, e.g., premasseteric notch, antegonial notch, and notch for the facial vessels. Interestingly, various disciplines have leaned toward different names for this notch. Therefore, to aid in consistent communication among professionals, the present study aimed to analyze usage of these varied terms and make recommendations for the best terminology. Based on the adjacent anatomical structures used to name this notch, three groups were analyzed in this study, a group using masseter in the term, a group using gonion in the term, and a group using facial vessels in the term. A literature search found that the group using gonion in the term was found most in the literature. The orthodontics field used gonion in the term the most (29.0%: 31/107) followed by the oral and maxillofacial surgery field (14.0%: 15/107), the plastic surgery field (4.7%: 5/107), and the anatomy field (3.7%: 4/107). The dental field used gonion in this term the most (43.9%: 47/107) and the medical field used facial vessels in the term the most (33.3%: 6/18). Based on these results, the use of gonial terms for this notch seems to be preferred.
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Affiliation(s)
- Norio Kitagawa
- Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Keiko Fukino
- Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuki Matsushita
- Department of Cell Biology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Soichiro Ibaragi
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - R. Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Anatomical Sciences, St. George’s University, St. George’s, Grenada, West Indies
- Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA
- Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA
- Dental and Oral Medical Center, Kurume University School of Medicine, Fukuoka, Japan
| | - Joe Iwanaga
- Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA
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Pandey ND, Bagul SB, Talmohite RR, Choudhary AK. Rare hybrid tumor of odontogenic fibromyxoma and central giant cell granuloma in maxilla: First reported case. Indian J Dent Res 2023; 34:332-334. [PMID: 38197359 DOI: 10.4103/ijdr.ijdr_349_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024] Open
Abstract
Fibromyxoma is a locally aggressive rare benign tumor of mesenchymal origin with or without odontogenic epithelium. The etiology of this tumor remains unknown and it is responsible for approximately 3-8% of all cysts and tumors. Another locally destructive benign lesion is central giant cell granuloma (CGCG) which contains osteoclast-like multinucleated giant cells. CGCG accounts for about 7% of all benign jaw tumors, which usually affects younger females. A hybrid lesion with histologic features of both central fibromyxoma and CGCG has not been reported in the literature so far. In the present article, we report the first case of a hybrid tumor comprising odontogenic fibromyxoma with CGCG in a female along with a brief review of its clinical presentation, radiographic features, histological features, and management.
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Affiliation(s)
- Narayan Dutt Pandey
- Department of Oral and Maxillofacial Surgery, Sinhgad Dental College and Hospital, Pune, Maharashtra, India
| | - Sushilkumar Balasaheb Bagul
- Department of Oral and Maxillofacial Surgery, S.M.B.T. Dental College and Hospital, Sangamner, Maharashtra, India
| | - Rajeev Ramesh Talmohite
- Department of Oral Medicine and Radiology, Sinhgad Dental College and Hospital, Pune, Maharashtra, India
| | - Amit Kumar Choudhary
- Department of Critical Care Medicine, Manipal Hospital, Bengaluru, Karnataka, India
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9
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Arumugam SD, Kanniyappan B, Giri U, Muthanandam S. Aggressive giant cell lesion of mandible-confusing to common: true neoplasm versus reactive lesion. BMJ Case Rep 2023; 16:e253499. [PMID: 37142281 PMCID: PMC10163411 DOI: 10.1136/bcr-2022-253499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
Destructive lesions in the craniofacial region especially in the jawbones, if associated with giant cells, include a spectrum of lesions that pose difficulty in diagnosis. The nature of such a lesion in the jawbones is questionable about whether it is a reactive/benign lesion or aggressive/non-aggressive. Clinical, radiological and histopathological correlation may be a reliable indicator to differentiate between the qualities of the lesion, which directly accounts for effective and individual planning of the treatment. Here we present a case of a woman in her late 20s with an unusual destructive lesion of the mandible.
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Affiliation(s)
- Santha Devy Arumugam
- Oral & Maxillofacial Pathology and Oral Microbiology, Sri Balaji Vidyapeeth University, Pondicherry, India
| | - Bharathraj Kanniyappan
- Oral & Maxillofacial Surgery, Sri Balaji Vidyapeeth University, Pondicherry, Puducherry, India
| | - Umamaheswari Giri
- Oral & Maxillofacial Pathology and Oral Microbiology, Sri Balaji Vidyapeeth University, Pondicherry, India
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10
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Pakfetrat A, Zamani T, Anbiaee N, Mirhashemi M, Vazavandi E. Osteosarcoma of the mandible: A case with a clinical appearance similar to benign lesions. Clin Case Rep 2023; 11:e7198. [PMID: 37064745 PMCID: PMC10098420 DOI: 10.1002/ccr3.7198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/26/2023] [Accepted: 03/29/2023] [Indexed: 04/18/2023] Open
Abstract
A 34-year-old woman with complaints of mandibular swelling that started 4 months earlier was referred to the Oral Diseases Department. Based on the clinical and radiographic appearance, the primary diagnosis was an intraosseous reactive lesion. However, the result of histopathology indicated osteosarcoma.
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Affiliation(s)
- Atessa Pakfetrat
- Oral and Maxillofacial Diseases Research Center Mashhad University of Medical Sciences Mashhad Iran
- Professor of oral and maxillofacial medicine, Oral and Maxillofacial Diseases Research Center Mashhad University of Medical Sciences Mashhad Iran
| | - Toktam Zamani
- Assistant of oral and maxillofacial Medicine Mashhad University of Medical Sciences Mashhad Iran
| | - Najmeh Anbiaee
- Oral and Maxillofacial Diseases Research Center Mashhad University of Medical Sciences Mashhad Iran
- Assistant professor of oral and maxillofacial radiology, Oral & Maxillofacial radiology Department Mashhad University of Medical Sciences Mashhad Iran
| | - Majid Mirhashemi
- Oral and Maxillofacial Diseases Research Center Mashhad University of Medical Sciences Mashhad Iran
- Associate professor of oral and maxillofacial pathology, Oral & Maxillofacial pathology Department Mashhad University of Medical Sciences Mashhad Iran
| | - Elahe Vazavandi
- Associate professor of oral and maxillofacial Medicine, Oral & Maxillofacial medicine Department Kerman University of Medical Sciences Kerman Iran
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11
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Nath P, Nath T. Central Giant Cell Granuloma of the Jaw: A Case Report and Review of the Literature. J Maxillofac Oral Surg 2022. [DOI: 10.1007/s12663-022-01769-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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12
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Mortazavi H, Baharvand M, Safi Y. Scalloped border as a possible diagnostic aid for differentiating jaw lesions: A pictorial essay. Imaging Sci Dent 2022; 52:309-317. [PMID: 36238702 PMCID: PMC9530295 DOI: 10.5624/isd.20220033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/05/2022] [Accepted: 05/18/2022] [Indexed: 11/21/2022] Open
Abstract
Purpose The aim of this study was to introduce a category of jaw lesions comprising cysts and tumors associated with scalloped borders. Materials and Methods General search engines and specialized databases including Google Scholar, PubMed, PubMed Central, and Scopus, as well as an authoritative textbook, were used to find relevant studies by using keywords such as “jaw lesion,” “jaw disease,” “scalloping,” “scalloped border,” “scalloped margin,” “irregular border,” and “irregular margin.” Out of 289 articles, 252 records were removed because they were duplicates, did not have a relevant title, or did not mention the frequency of findings described using the term “scalloped border.” Finally, 37 closely related articles were chosen. Results According to the relevant literature, scalloped borders are found most frequently in ameloblastoma, followed by simple bone cyst, central giant cell granuloma, odontogenic keratocyst, and glandular odontogenic cyst. Conclusion The lesions most frequently reported to have scalloped borders are ameloblastoma, central giant cell granuloma, odontogenic keratocyst, simple bone cyst, and glandular odontogenic cyst.
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Affiliation(s)
- Hamed Mortazavi
- Department of Oral and Maxillofacial Medicine, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Baharvand
- Department of Oral and Maxillofacial Medicine, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yaser Safi
- Department of Oral and Maxillofacial Radiology, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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13
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Deodati A, Fintini D, Levtchenko E, Rossi M, Ubertini G, Segers H, Battafarano G, Cappa M, Del Fattore A. Mechanisms of acute hypercalcemia in pediatric patients following the interruption of Denosumab. J Endocrinol Invest 2022; 45:159-166. [PMID: 34216372 DOI: 10.1007/s40618-021-01630-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 06/29/2021] [Indexed: 12/25/2022]
Abstract
PURPOSE Denosumab is a fully human monoclonal anti-RANK-L antibody that is clinically used to counteract the bone loss induced by exacerbated osteoclast activity. Indeed, its binding to RANK-L prevents the interaction RANK-L/receptor RANK that is essential for osteoclastogenesis and bone resorbing activity. Although there are many medications available to treat bone loss diseases, including bisphosphonates, Denosumab is highly effective since it reduces the bone erosion. The use in pediatric patients is safe. However, some concerns are related to the interruption of the treatment. Indeed, in this study, we reported hypercalcemia in two pediatric patients and alterations of circulating osteoclast precursors. METHODS Peripheral Blood Mononuclear Cells (PBMC) were isolated from two pediatric patients with hypercalcemia after Denosumab interruption and from 10 controls. Cytofluorimetric analysis and in vitro osteoclastogenesis experiments were performed. RESULTS Increase of CD16-CD14+CD11b+ cells was revealed in PBMC from patients reflecting the enhanced in vitro osteoclastogenesis. CONCLUSION Our data suggest that precautions must be taken when Denosumab therapy is interrupted and gradual decrease of dose and/or timing of treatment should be performed. To prevent the onset of hypercalcemia that could be in the discontinuation phase, cytofluorimetric analysis of PBMC should be performed to evaluate osteoclast precursors.
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Affiliation(s)
- A Deodati
- Endocrinology Unit, University Pediatric Clinical Department, Bambino Gesù Children's Hospital, IRCCS, 00146, Rome, Italy
| | - D Fintini
- Endocrinology Unit, University Pediatric Clinical Department, Bambino Gesù Children's Hospital, IRCCS, 00146, Rome, Italy
| | - E Levtchenko
- Department of Pediatrics, University Hospitals Leuven, 3000, Leuven, Belgium
| | - M Rossi
- Bone Physiopathology Research Unit, Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, IRCCS, Viale San Paolo 15, 00146, Rome, Italy
| | - G Ubertini
- Endocrinology Unit, University Pediatric Clinical Department, Bambino Gesù Children's Hospital, IRCCS, 00146, Rome, Italy
| | - H Segers
- Department of Pediatrics, University Hospitals Leuven, 3000, Leuven, Belgium
| | - G Battafarano
- Bone Physiopathology Research Unit, Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, IRCCS, Viale San Paolo 15, 00146, Rome, Italy
| | - M Cappa
- Endocrinology Unit, University Pediatric Clinical Department, Bambino Gesù Children's Hospital, IRCCS, 00146, Rome, Italy
| | - A Del Fattore
- Bone Physiopathology Research Unit, Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, IRCCS, Viale San Paolo 15, 00146, Rome, Italy.
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14
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Shum BJ, Kim MS, Kondra K, Hammoudeh JA, Strom C, Ryabets-Lienhard A. A Unique Case of Aggressive Central Giant Cell Granuloma in a 10-Year-Old Boy With 16p13.11 Microdeletion Syndrome. J Investig Med High Impact Case Rep 2022; 10:23247096221123146. [PMID: 36154495 PMCID: PMC9513564 DOI: 10.1177/23247096221123146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Central giant cell granuloma (CGCG) is a rare disease characterized by
sporadic, benign, intraosseous mandibular lesions of unknown etiology.
Histologically, these lesions are indistinguishable from brown tumors
of hyperparathyroidism and cherubism, and occasionally have been
associated with different syndromes raising a question for genetic
etiology. The CGCG has varied presentation ranging from nonaggressive
and indolent to aggressive, destructive, and recurrent, often posing
diagnostic and therapeutic challenges. Herein, we present the first
case of a 10-year-old boy with CGCG and 16p13.11 microdeletion
syndrome, highlight the diagnostic challenges inherent to this
heterogeneous disorder, and discuss the genetics and treatment
approaches of these complex lesions.
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Affiliation(s)
- Betty J. Shum
- Center for Endocrinology, Diabetes, and Metabolism, Children’s Hospital Los Angeles, CA, USA
| | - Mimi S. Kim
- Center for Endocrinology, Diabetes, and Metabolism, Children’s Hospital Los Angeles, CA, USA
- The Saban Research Institute at Children’s Hospital Los Angeles, CA, USA
- University of Southern California, Los Angeles, USA
| | - Katelyn Kondra
- Division of Plastic and Maxillofacial Surgery, Children’s Hospital Los Angeles, CA, USA
| | - Jeffrey A. Hammoudeh
- Division of Plastic and Maxillofacial Surgery, Children’s Hospital Los Angeles, CA, USA
| | - Charles Strom
- Department of Medical Genetics, Children’s Hospital Los Angeles, CA, USA
| | - Anna Ryabets-Lienhard
- Center for Endocrinology, Diabetes, and Metabolism, Children’s Hospital Los Angeles, CA, USA
- The Saban Research Institute at Children’s Hospital Los Angeles, CA, USA
- University of Southern California, Los Angeles, USA
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15
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Tahmasbi-Arashlow M, Patel PB, Nair MK, Liang H, Cheng YSL. Cone-beam computed tomographic imaging of central giant cell granuloma: A comprehensive review. Imaging Sci Dent 2022; 52:123-131. [PMID: 35799967 PMCID: PMC9226240 DOI: 10.5624/isd.20220130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/08/2022] [Accepted: 03/18/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose The aim of this study was to characterize the cone-beam computed tomographic (CBCT) imaging features of central giant cell granuloma (CGCG) of the jawbone. Materials and Methods This study retrospectively reviewed 26 CBCT studies of histologically proven cases of CGCG during a period of 20 years, from 1999 to 2019. Patients’ demographic data were recorded, and radiographic features were assessed (location, border, cortication, appearance of the internal structure, locularity, septation, expansion, cortical perforation, effects on surrounding tissue, whether the lesion crossed the midline, and lesion volume). Results In this study, CGCGs were seen almost twice as often in the mandible than in the maxilla, and 64.7% of mandibular lesions involved the anterior region. Only 26.9% of lesions crossed the midline, a feature that was considered characteristic of CGCG. Furthermore, 65.4% of lesions were unilocular and 34.6% were multilocular. The correlation between a lesion’s size and its locularity was statistically significant, and larger lesions showed a multilocular appearance. The mean volume of multilocular lesions was greater than that of unilocular lesions. Conclusion CGCGs showed variable radiographic features on CBCT, and this imaging modality is highly effective at demonstrating the radiographic spectrum and lesional extent of CGCGs in the jawbone.
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Affiliation(s)
| | - Paras B. Patel
- Department of Diagnostic Sciences, Texas A&M University College of Dentistry, United States
| | - Madhu K. Nair
- Department of Diagnostic Sciences, Texas A&M University College of Dentistry, United States
| | - Hui Liang
- Department of Diagnostic Sciences, Texas A&M University College of Dentistry, United States
| | - Yi-Shing Lisa Cheng
- Department of Diagnostic Sciences, Texas A&M University College of Dentistry, United States
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16
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Kahlon GK, Tilak K, Kondamudi N. Worsening Lower Jaw Swelling and Pain in a Teenager: Differential Diagnosis and Management. Cureus 2021; 13:e18296. [PMID: 34722071 PMCID: PMC8547371 DOI: 10.7759/cureus.18296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2021] [Indexed: 11/05/2022] Open
Abstract
Giant cell granuloma is a rare, benign non-neoplastic, aggressive tumor that originates mainly from the maxilla and mandible. It affects all age groups and is more commonly seen in children. We describe a 17-year-old female that presented to the Pediatrics Emergency room with a history of right lower jaw pain. Examination revealed a bone-like buccal vestibular swelling on the lower right tooth, a bone-like lingual swelling, and a pink gingival overgrowth lesion. The biopsy of the lesion revealed a central giant cell granuloma. Tissue biopsy with histopathological examination is diagnostic and surgical excision is the gold standard of treatment.
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Affiliation(s)
| | - Kedar Tilak
- Pediatrics, The Brooklyn Hospital Center, New York, USA
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17
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Role of Carnoy's solution as treatment adjunct in jaw lesions other than odontogenic keratocyst: a systematic review. Br J Oral Maxillofac Surg 2021; 59:729-741. [PMID: 34272109 DOI: 10.1016/j.bjoms.2020.12.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 12/31/2020] [Indexed: 11/24/2022]
Abstract
Carnoy's solution (CS) is routinely used as adjuvant therapy in the management of odontogenic keratocyst (OKC) and a few other benign lesions. The purpose of this study was to explore the evidence of its application and efficacy in benign lesions other than OKC. We have systematically reviewed published articles to identify the evidence of CS in benign jaw lesions other than OKC following the PRISMA guidelines. The search was conducted in PubMed, Google Scholar, Semantic Scholar, and Cochrane Library database, to find relevant articles from 1980 to March 2020. Finally, 39 studies were analysed in this review. It included studies where CS was used as an adjunct for the benign lesion of the jaw and followed for a minimum of 6 months. Thirty-nine studies with 11 different types of lesion were reported where CS was used as an adjuvant and application time was restricted to 3-5minutes. Recurrence were reported only in ameloblastoma cases [unicystic=10.98% (10/91), mixed=18.18% (26/143)]. Meta-analysis was not possible as all studies were non-controlled in nature. Based on the available data, there was no strong evidence for the use of CS as an adjuvant in the benign lesion of the jaw. Prospective and randomised control studies are recommended for the best stratification for the use of CS.
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18
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Khavanin N, White MJ, Walsh JM, Steinberg JP. Mandibular Reconstruction Following Central Giant Cell Granuloma Resection in Primary Dentition: A Case for the Use of a Costochondral Graft. Cleft Palate Craniofac J 2020; 58:260-268. [PMID: 32757776 DOI: 10.1177/1055665620946985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Central giant cell granuloma is a benign, intraosseous lesion that may affect the pediatric craniofacial skeleton, particularly the mandible. When surgery is indicated, the role of the craniofacial surgeon is to ameliorate the sequelae of ablative surgery by restoring facial symmetry, ensuring appropriate postoperative occlusion, and allowing for adequate interincisal opening, all in the setting of a growing craniofacial skeleton. Herein, we report the case of a 3-year-old female presenting for reconstruction after resection of the right hemimandible proximal to the unerupted first permanent molar. We highlight the various reconstructive challenges associated with mandibular reconstruction during primary dentition and make a case for the use of a costochondral graft, with a successful outcome demonstrated at 2 years of follow-up.
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Affiliation(s)
- Nima Khavanin
- Department of Plastic and Reconstructive Surgery, 1500The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Marissa J White
- Department of Pathology, 1500The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jonathan M Walsh
- Department of Otolaryngology-Head and Neck Surgery, 1500The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jordan P Steinberg
- Department of Plastic and Reconstructive Surgery, 1500The Johns Hopkins University School of Medicine, Baltimore, MD, USA
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