OC5Diagnosis of secondary syphilis due to oral lesions

Central giant cell granuloma (CGCG) is a benign lesion of unknown etiology that especially affects the jaws, usually appears in patients younger than 30 years and is more common in females than in males. Lesions generally occur in the anterior portion of the jaws and mandibular lesions frequently cross the midline. The conventional treatment of CGCG is surgical removal. According to clinical and radiological features, the extent of tissue removal ranges from simple curettage to an en bloc resection. We present an 8-year-old male patient, lack of any systemic disease or syndrome, complaining from painless swelling of the left posterior part of the mandible. In intraoral examination, a firm, expansive swelling with overlying intact mucosa, extending from mandibular primary canine to the distal portion of the left permanent first molar, was detected. A panoramic radiograph exhibited an ill-defined radiolucent lesion of 1.5 x 2 cm, extending from left permanent first molar to angulus mandibula and a well-defined, unilocular radiolucent lesion of 1 x 2 cm, extending from angulus to ramus mandibula on the asymptomatic right side. After the assessment of MRI, surgical removal was planned with the otorhinolaryngology department and lesions were totally removed under general anesthesia in two consecutive operation. Histopathologic examination revealed typical giant cell granuloma containing numerous multinucleated giant cells embedded in a fibrous stroma. In presenting this case we aimed to share occurrence of bilateral central giant cell granulomas of the mandible in the absence of hyperparathyroidism and associated syndromes, which is very rare in the literature.     

OC1Bilateral central giant cell granuloma of the mandible: a case report

Central giant cell granuloma (CGCG) is a benign lesion of unknown etiology that especially affects the jaws, usually appears in patients younger than 30 years and is more common in females than in males. Lesions generally occur in the anterior portion of the jaws and mandibular lesions frequently cross the midline. The conventional treatment of CGCG is surgical removal. According to clinical and radiological features, the extent of tissue removal ranges from simple curettage to an en bloc resection. We present an 8‐year‐old male patient, lack of any systemic disease or syndrome, complaining from painless swelling of the left posterior part of the mandible. In intraoral examination, a firm, expansive swelling with overlying intact mucosa, extending from mandibular primary canine to the distal portion of the left permanent first molar, was detected. A panoramic radiograph exhibited an ill‐defined radiolucent lesion of 1.5 x 2 cm, extending from left permanent first molar to angulus mandibula and a well‐defined, unilocular radiolucent lesion of 1 x 2 cm, extending from angulus to ramus mandibula on the asymptomatic right side. After the assessment of MRI, surgical removal was planned with the otorhinolaryngology department and lesions were totally removed under general anesthesia in two consecutive operation. Histopathologic examination revealed typical giant cell granuloma containing numerous multinucleated giant cells embedded in a fibrous stroma. In presenting this case we aimed to share occurrence of bilateral central giant cell granulomas of the mandible in the absence of hyperparathyroidism and associated syndromes, which is very rare in the literature.     

Central giant cell granuloma of the anterior maxilla

Central giant cell granuloma (CGCG) formerly called giant cell reparative granuloma is a non-neoplastic proliferative lesion of unknown etiology. It occurs most commonly in the mandible. The case reported here resembled a wide variety of conditions that led to a misdiagnosis both on clinical and radiographic examination but was histopathologically diagnosed as CGCG. We describe a case of central giant cell granuloma arising from the anterior maxilla to highlight to the general dental practitioner the importance of histopathology in the diagnosis of this enigmatic lesion.     

Central giant cell granuloma of the mandible in a 7-year-old boy: a case report.

Central giant cell granuloma is a relatively uncommon benign bony lesion of a variably aggressive nature. This paper presents the case of a 7-year-old boy with central giant cell granuloma in the anterior mandible. In children with mixed dentition, a pathologic lesion could be the underlying cause of regular tooth mobility and exfoliation of primary teeth and can easily be overlooked, especially in cases that are not accompanied by an obvious bony expansion. The clinician needs to be aware of possible oral pathology when tooth mobility and displacement are present, and central giant cell granuloma should be considered in the differential diagnosis for children with maligned and mobile teeth.     

Videoendoscopic assisted curettage of central giant cell granuloma of the maxilla in pediatric age

Giant cell granuloma is an uncommon bony benign lesion that generally involves the mandible and maxilla. It may be locally aggressive and result in extensive tissue destruction in advanced cases. Surgery is the traditional and still the most accepted treatment for giant cell granuloma. We report a pediatric case of central giant cell granuloma of the maxilla treated with videoendoscopic assisted surgical excision.     

Regression of central giant cell granuloma by a combination of imatinib and interferon: a case report

Central giant cell granuloma is a benign lesion of the jaws which is sometimes aggressive locally. The most common treatment is curettage,which has a high recurrence rate, particularly in more aggressive lesions. Other treatments such as interferon (IFN) and calcitonin have been described. We report a patient with Stickler syndrome and an aggressive central giant cell granuloma in the mandible. Initial treatment with calcitonin was not successful. A combination of IFN and imatinib, given for 9 months, initiated regression of the lesion that continued after treatment had ceased.     

Peripheral giant cell granuloma

Peripheral giant cell granuloma is a benign reactive lesion of gingiva. It manifests as a firm, soft, bright nodule or as a sessile or pedunculate mass. This article reports the management of peripheral giant cell granuloma in a 12-year-old boy by surgical excision.     

Central giant cell granuloma of the palate; unusual localisation in a five year old child

The central giant cell granuloma of the maxillo-mandibular region is a relatively uncommon lesion (3.5%-0.1%). Essentially, it occurs in the second decade of life and it is mainly located in the mandibular region. The female/male ratio is 3:1. The authors present an unusual localisation of central giant cell granuloma in a five year old child's maxillary bone. After a surgical curettage of the lesion, an eighteen months follow-up examination did not show any recurrence.     

Central giant cell granuloma

Central giant cell granuloma, a fibro-osseous lesion, is more commonly found in the mandible and mainly in children and young adults. The lesion, which has a greater incidence in females, may be uni or multilocular. On the basis of clinical, radiological and histologic features, central giant cell granulomas can be classified as "non-aggressive" or "aggressive". Management involves surgical removal and in most cases the dentition can be maintained. Three cases of central giant cell granuloma are reported and they illustrate clinical features of the lesion, how differential diagnosis can be assisted by ORAD (a special software program), treatment, and the importance of recall examinations.     

Benign cementoblastoma involving multiple maxillary teeth: report of a case with a review of the literature

A rare case of benign cementoblastoma involving multiple deciduous and permanent teeth is presented with a review of the literature. A 12-year-old boy was admitted for a swelling in the right maxillary premolar-molar region. A radiologic examination revealed a well-defined, round, radiopaque mass extending from the right maxillary first premolar to the second permanent molar. The tumor was removed with all associated teeth. A histologic examination of the surgical specimen revealed a well-circumscribed tumor composed of cementum-like tissue surrounded by a fibrous capsule. The tumor was attached to the roots of the second deciduous molar, first premolar, and the first and second permanent molars and embedded in the crown and root of the right maxillary second premolar, suggesting that the lesion had arisen from the second deciduous molar. There has been no recurrence of the lesion more than 18 months after the surgical procedure.     

Reparative giant cell granuloma in a pediatric patient

Reparative giant cell granulomas are benign, infrequent tumors, of non-odontogenic origin, that develop at central or peripheral level. Peripherally located lesions are frequently denominated "giant cell epulis", and never correspond to true neoplasia, but rather to inflammatory reactions secondary to another lesion (hemorrhage, etc.). It should be taken into account, that in general, head and neck tumors of infancy usually demonstrate an atypical biological behaviour. Furthermore, the anatomicopathologic diagnosis is often compromised in this type of lesion. We present the case of a 6-year-old boy, who, three weeks after suffering a slight facial trauma, developed a painless, exophytic swelling of approximately 4 cm, with bleeding on palpation, in the ipsilateral hemimaxilla. The lesion demonstrated rapid, progressive and continuous growth. The facial CT and incisional biopsy confirmed the suspected diagnosis of reparative giant cell granuloma. The patient was surgically treated, carrying out a left marginal maxillectomy associated with the extirpation of the soft-tissue lesion. The resultant defect was reconstructed with a Bichat fat-pad providing the patient with optimal esthetic and functional results. The definitive anatomicopathologic report of the surgical piece is compatible with reparative giant cell granuloma.     

Neurofibromatosis type 1 associated with bilateral central giant cell granuloma of the mandible

Neurofibromatosis type 1, or von Recklinghausen disease, is one of the most common hereditary neurocutaneous disorders in humans. Clinically, Neurofibromatosis type 1 is characterized by café-au-lait spots, freckling, skin neurofibroma, plexiform neurofibroma, bony defects, Lisch nodules and tumors of the central nervous system. Central giant cell granuloma is a benign central lesion of bone, primarily involving the jaws, of variably aggressive nature characterized by aggregates of multinucleated giant cells in a background of cellular vascular fibrous connective tissue and spindle-shaped mononuclear stromal cells. The association between neurofibromatosis and central giant cell granuloma has been reported in the literature. A case of mandibular bilateral central giant cell granuloma in a patient with Neurofibromatosis type 1 was conservatively but successfully treated by adequate surgical curettage of mandibular bone lesions.     

Central giant cell granuloma and fibrous dysplasia occurring in the same jaw

Fibrous dysplasia (FD) is a developmental tumor like condition that is characterized by replacement of normal bone by an excessive proliferation of cellular fibrous connective tissue intermixed with irregular bony trabeculae. Central giant cell granuloma (CGCG) is described as a benign lesion affecting the mandible and maxilla that consists of a massive fibrohistiocytic proliferation with numerous heavily hemosiderin-laden multinucleate-giant cells. A 20 year old woman present at the Department of Oral Medicine, Dentistry School, Tehran University of Medical Sciences with a slowly growing non painful swelling of the right mandible for one year. Our differential diagnosis was osteoma, osteoid osteoma and Fd. The histological feature reveal Central giant cell granuloma fibrous dysplasia. Central giant cell granuloma and fibrous dysplasia occurring in the same jaw is rarely reported in the literatures.     

A comparative immunohistochemical evaluation of CD68 and TRAP protein expression in central and peripheral giant cell granulomas of the jaws

J Oral Pathol Med (2011) 40 : 334–337 Background: Giant cell granulomas of the jaws are lesions that arise either peripherally in periodontal ligament and mucoperiosteum or centrally in the bone. The aim of this study was to evaluate expression of CD68 and tartrate‐resistant acid phosphatase (TRAP) proteins in multinucleated giant cells and mononuclear cells. Methods: Formalin‐fixed and paraffin‐embedded tissue section of 20 specimens of central giant cell granuloma and 20 cases of peripheral giant cell granuloma were immunohistochemically analyzed for CD68 and TRAP proteins expression rate using Biotin‐Streptavidin method. Result: In central giant cell granuloma, more than 99% of multinucleated giant cells were positive for TRAP antibody and about 90% were positive for CD68. In mononuclear cells of this lesion, 14% of cases were positive with TRAP antibody and 8% with CD68. In peripheral giant cell granuloma, TRAP antibody was positive in 99% of giant cells and in 13% of mononuclear cells. A proportion of 97% of giant cells and 6% of mononuclear cells reacted positively with CD68. Conclusion: Immunohistochemical evidence of this study shows that giant cells and a group of mononuclear cells of stroma in both peripheral and central giant cell granuloma express TRAP antibody severely that is specific for osteoclast. Also, these cells are positive reactive to CD68, which is the macrophage marker and therefore it can be mentioned that giant cells are osteoclast, although their origins are macrophagic/monocytic or their precursors, and maybe mononuclear cells in stroma have a role in formation of giant cells.     

Peripheral giant cell granuloma: a potentially aggressive lesion in children

A slowly enlarging gingival mass with a reddish-purple surface is observed in a school-age boy. The lesion was first noted 3 months ago during a routine oral examination but recently it has increased in size and interferes with eating. A periapical radiograph demonstrated focal loss of the alveolar crestal bone in the mandibular incisor region. The diagnosis of peripheral giant cell granuloma, a benign reactive gingival lesion, is confirmed by histopathologic examination. Early detection and excision of this hyperplastic nodule is important to minimize potential dentoalveolar complications.     

Recurrent central giant cell granuloma in the mandible: surgical treatment and dental implant restoration

Central giant cell granuloma is an uncommon benign intraosseus lesion of jaws. Traditional treatment has been local curettage, although aggressive sub-types have a high tendency to recur. This patient report describes a recurrent central giant cell granuloma involving the body of the mandible in a 48-year-old-woman. Initial treatment of lesion consisted of curettage and peripheral ostectomy. When recurrence was detected one year later, an en bloc resection and defect regeneration with a composite bone graft of autogenous bone, xenograft, and autologous platelet-rich plasma was carried out. Adequate new bone formation was observed during follow-up of 24 months. Two dental implants were placed, and implant-supported prosthesis was constructed, providing a satisfactory dental restoration.     

Idiopathic synchronous central giant cell granulomas involving both the maxilla and mandible: a case report

The central giant cell granuloma is a well-defined lesion of the jaws and reports of multiple lesions are very uncommon. The authors report the case of a patient with idiopathic synchronous multiple central giant cell granulomas involving both the maxilla and the mandible. Surgical curettage of the lesions was performed. At the end of the 24 months follow-up, no recurrence was detected.     

Peripheral giant cell granuloma: a case report

The peripheral giant cell granuloma is a reactive lesion of the soft tissue of the oral cavity. Clinical appearance ranges from normal tissue coloration to dark red or purplish. These are elevated lesions generally 5-15 mm in diameter. Etiology is considered to be chronic irritation. To decrease the risk of clinical recurrence, treatment is complete excision to include the underlying periosteum. Histologic features of the peripheral giant cell granuloma include multinucleated giant cells with a stroma that may contain osteoblasts, myofibroblasts, macrophages, and Langerhans cells. A case report is presented.     

Peripheral giant cell granuloma in anterior maxilla: case report in a child

A case of giant cell granuloma in a 7-year-old boy was reported. The lesion was probably caused by trauma and was interfering with the normal eruption of the permanent maxillary left lateral incisor. Differential diagnosis and treatment of this lesion are discussed.     

Giant cell tumor of the mandible

A case of giant cell tumor of the mandible is presented, with treatment and follow-up for two and a half years. Although the lesion had characteristics of giant cell granuloma described by Jaffe, its aggressive clinical behavior influenced the diagnosis and treatment. Prosthetic rehabilitation was accomplished with a mandibular staple bone plate placed through a bone graft.