Central giant cell granuloma of the mandibular condyle: additional case and literature review

Lucas Marti-Flich,Romain Nicot,Matthias Schlund

doi:10.1051/mbcb/2021048

Abstract

Introduction: Central giant cell granuloma (CGCG) of the jaws is not a common lesion. Only five cases are reported in the mandibular condyle. Observation: A 25 year-old male presented with preauricular swelling and a premature occlusal contact on the molars. The lesion had radiological features of aggressiveness and a high metabolic uptake. Initial biopsy was misleading. The lesion was treated surgically by resection. Discussion: Histologically, CGCG are very similar to other giant cell lesions such as GCT (Giant cell Tumor) or BTH (brown tumor of hyperparathyroidism). The standard treatment is surgical either by curettage or resection. Only 6 cases have been described in the literature, including this one. The diagnosis is difficult, relying on a bundle of clinical, radiological and histological arguments. However, radical surgery should be performed to avoid the tumor recurrence. The genetic mutations associated with CGCG (notably TRPV4 and RAS pathway) may explain why this tumor is mostly found in the dental part of the jaws and only rarely in the mandibular condyle.

Highlights

Central giant cell granuloma (CGCG) of the jaws is not a common lesion with only 2270 cases reported in the literature in 2018 [1], the mandibular condyle is seldom affected with only 5 cases reported [2]
The initial description was made by Jaffe in 1953 [3]. It is a benign lesion of the giant cell lesion family, closely related to giant cell tumors (GCT) and brown tumors of hyperparathyroidism (BTH)
The lesion is characterized by multinucleated osteoclast-like giant cells intermingled with mononuclear spindle cells and hemorrhagic foci with hemosiderin deposition according to the World Health Organization [4]

Summary

Introduction

Central giant cell granuloma (CGCG) of the jaws is not a common lesion with only 2270 cases reported in the literature in 2018 [1], the mandibular condyle is seldom affected with only 5 cases reported [2]. A 25 year-old male student, with no medical history, was referred to our Department for a painless right preauricular swelling. Magnetic resonance imaging (MRI) revealed a multicystic lesion of the right mandibular condyle with local aggressive characteristics (large swelling, rapid rate of growth and bone cortical resorption) (Fig. 2). Positron Emission Tomography (PET) scanning showed a high metabolic feature of the lesion with a standardized uptake value (SUV) peak = 9.5 (Fig. 3). The patient is currently recurrence-free but still under surveillance

Discussion

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Findings

Ethical approval