Giant Cell Granuloma Research Articles

Characterization of Gingival Epulis Lesions: A Histological and Morphological Approach

Objective: To conduct a clinical and histopathological study of Epulis at Bhittai medical and Dental College, Mirpurkhas. Methodology: A descriptive cross-sectional study was carried out at the Bhittai medical and Dental College Mirpurkhas. Patients clinically diagnosed with gingival outgrowth, across all age groups and both genders, were included. A provisional diagnosis of epulis was made based on clinical examination. After taking a careful history, relevant clinical features were recorded, and a biopsy procedure was performed using infiltration near the lesion or regional nerve block techniques. The data was documented using a pre-designed proforma and analyzed using SPSS version 22.0. Results: Out of 50 subjects, 30 (60%) were female and 20 (40%) were male. Most cases involved the maxillary gingiva (anterior or posterior) (62%). The majority of lesions measured between 2cm and 3cm (76%). Lesions typically exhibited a soft consistency (70%), with fewer cases being firm (8%) or hard (22%). Histologically, peripheral giant cell granuloma (PG) was most prevalent (50%), followed by fibrous epulis (42%), peripheral ossifying fibroma (4%), and peripheral giant cell granuloma with features of central giant cell granuloma (PGCG) (4%). No cases of congenital epulis or pregnancy tumor were reported. Histological evaluation revealed no significant gender differences (p-value 0.86). Conclusion: Clinically, most epulis lesions presented as painless, soft, coral pink masses, typically measuring approximately 2-3 cm in diameter and exhibiting a sessile form and observed more commonly in females, with a predominant occurrence in the maxillary region. Histopathological examination revealed that the most frequent types were fibrous epulis and peripheral giant cell granuloma.

Central giant cell granuloma of mandible: a case report

Central Giant Cell Granuloma(CGCG) and giant cell tumour of jawbone are grouped underneath same umbrella but with distinct clinical behavior. CGCG is a rare benign lesion of the jaws distinguish by the presence of multinucleated giant cells within a fibrous stroma. The pathogenicity of CGCG still remains an enigma, which demands the differentiation from other look-alike lesions in order to have proper diagnosis and treatment planning. In this article, a case of CGCG in a 30-year-old female patient who presented with complaints of gradually increasing swelling and discomfort in the mandible is described.

New Insights Into the Spectrum of RASopathies: Clinical and Genetic Data in a Cohort of 121 Spanish Patients.

Noonan syndrome and related disorders are a group of well-known genetic conditions caused by dysregulation of the Ras/mitogen-activated protein kinase (RAS/MAPK) pathway. Because of the overlap of clinical and molecular features, they are now called RASopathies. In this study, we retrospectively analyzed the clinical data of 121 patients with a molecularly confirmed diagnosis of RASopathy, describing frequencies for clinical features in all organ systems as well as molecular data. The most common clinical diagnosis was Noonan Syndrome and the most frequently affected gene was PTPN11 followed by SOS1, RAF1, LZTR1, and RIT1. All patients had distinctive craniofacial features indicative of the RASopathy spectrum but we report some atypical features regarding craniofacial shape, such as craniosynostosis and microcephaly. We also describe uncommon clinical characteristics such as aortic dilation, multivalvular heart disease, abnormalities of the posterior fossa, and uterine congenital anomalies in female patients. Furthermore, the presence of multiple giant cell granulomas was observed specifically in patients with SOS1 variants. This comprehensive evaluation allows broadening the phenotypic spectrum of our population and their correlation with the genotype, which are essential to improve the recognition and the follow up of RASopathies as a multisystemic disease.

Prosthetically Driven Approach to Post-Ablative Maxilla Rehabilitation with an Implant-Supported Overdenture: A Case Report

This clinical report details the prosthetic rehabilitation of a patient following maxillary ablation to remove a peripheral giant cell granuloma. After a hemimaxillectomy, the defect was reconstructed with a fasciocutaneous radial free flap. Implant placement was digitally planned using the dual scanning technique, and implants were inserted with the aid of an acrylic surgical guide. After implant osseointegration, a removable implant-supported overdenture with an electroplated secondary structure retained on a titanium bar was fabricated. At the 3-year follow-up, peri-implant tissues remained healthy, showing only mild gingival hyperplasia around the bar, while no prosthesis retention loss or significant technical complications were observed. In conclusion, the reconstruction of the moderate maxillary defect using a soft-tissue flap provided satisfactory functional and esthetic outcomes, significantly enhancing patient satisfaction. However, the limited bone availability necessitated precise implant planning to ensure adequate biomechanical support for the overdenture.

Central odontogenic fibroma: retrospective study of six cases with variable histopathologic features using 2022 WHO classification

BackgroundCentral odontogenic fibroma (COF) is a rare benign odontogenic tumor with a wide range of histopathologic features. We evaluated COF diagnosed in our institute with 16 years’ experience using 2022 WHO classification.MethodsOur archives were reviewed and cases diagnosed as COF were selected. Clinical, radiographic and microscopic features were tabulated and analyzed.ResultsOf 13,736 specimens, six cases (0.04%) of COF were discovered. Patients ranged in age from 14 to 44 years. There were two males and four females. Maxilla and mandible were affected equally. Five cases showed radiolucent appearance (4 unilocular, 1 multilocular) and one case showed a mixed radiolucent-radiopaque pattern. Histopathologically, three cases were conventional type (2 epithelium-rich, 1 epithelium-poor). Two cases were the hybrid COF with central giant cell granuloma (CGCG) and one of which was also associated with secondary aneurysmal bone cyst (ABC). The last case with a mixed radiolucent-radiopaque pattern was the ossifying subtype.ConclusionOur results demonstrated that COF is a rare odontogenic tumor and exhibits diverse radiographic and microscopic appearances. The triphasic tumor consisting of the COF, CGCG and ABC, is reported here for the first time, while the ossifying subtype is considered the tenth case reported in the English-language literature. Oral and maxillofacial pathologists and other healthcare personnel must be aware of this rare odontogenic tumor and its variants to achieve the definite diagnosis.Clinical trial numberNot applicable.

Deep Fungal Infections of Skin and Role of Histopathology in Diagnosis

Abstract Introduction: Deep mycoses acquired by penetrating trauma to the skin can have varied and sometimes atypical morphological presentations resulting in diagnostic dilemmas and delay in treatment onset. Histopathology can be a useful tool in not only diagnosing but also differentiating various deep mycoses. Aims and Objectives: To observe various morphological presentations and histopathological features of deep fungal infections. Materials and Methods: A retrospective multi-centric study was conducted from 2010 to 2020 at 16 centres. The cases with diagnoses of various deep mycoses were included in the study. The patients presenting with cutaneous manifestations were included in the study. Their demographic details, history, presenting signs and symptoms, morphological presentations, histopathological features and treatment details were collected from the case sheets. Results: A total of 124 cases were found from the case records. The most common type was chromoblastomycosis (42) followed by mycetoma (28) and rhinosporidiosis (17). The mean age was 43.76 ± 5.44 years. The average duration of symptoms before presentation was between 2 months to 10 years (average 2.5 ± 1.33 years). Male to female ratio was 1:0.7. Prior history of trauma was recorded in 36% of cases. Chromoblastomycosis cases presented with verrucous to atrophic plaques with black dots on the surface and histopathology findings included pesudoepitheliomatous hyperplasia, epithelioid cell granulomas, copper penny bodies within granulomas and abscesses. Rhinosporidiosis cases had polypoid grape-like lesions in the nose and eyes most commonly with histopathology findings of abundant thick-walled sporangia in dermis packed with thousands of spores. Eumycetoma patients had pigmented, indurated swelling with multiple sinuses discharging black granules and histopathology showed dermal abscesses and foreign body granulomatous reaction with PAS-positive hyphae. Histoplasmosis patients presented with few to multiple nodulo-pustular lesions on skin and palatal ulcers while small basophilic bodies packed in the cytoplasm of histiocytes were noted in histopathology. Phaeohyphomycosis cases presented as deep-seated cystic lesions and biopsy revealed deepithelialized cysts in the dermis or hypodermis with lumen showing necro inflammatory debris and fungal hyphae. Sporotrichosis cases had erythematous, tender nodules and papules either as single lesions or as multiple lesions arranged in a linear fashion and histopathology showed pseudoepitheliomatous hyperplasia of epidermis, loose to well-defined epithelioid cell granulomas and microabscesses. Spores were found in two cases. Cryptococcosis patient had multiple umbilicated lesions resembling giant molluscum contagiosum loose epithelioid cell granulomas and medium-sized spores lying in both intra and extracellularly on histopathology. Penicilliosis patients had nodulo-pustular lesions and histopathology showed an admixture of histiocytes, epithelioid cells, plasma cells, lymphocytes and polymorphs in the dermis with the presence of yeast-like spores in the cytoplasm of histiocytes and epithelioid cells. Entomophthoromycosis cases presented with asymptomatic subcutaneous firm swelling with loss of skin pinchability. Conclusion: Though clinical findings of deep fungal infections are characteristic similar morphology and atypical presentations can be sometimes confusing. Histopathology is useful for confirming the diagnosis.

Versatility of patient specific implants in reconstruction of maxillofacial defect: a case report of central giant cell granuloma

Reconstructing maxillofacial defects is challenging due to its complex anatomy and cosmetic and functional effects on patients. From a functional and esthetic view, it is imperative for surgeons to accurately restore the defect in a way that will ensure patient satisfaction and well-being. Here, a case of large lytic lesion of anterior mandible, causing extensive bony resorption, in a young female patient is reported. Incisional biopsy was performed and the histopathological features were suggestive of Central giant cell granuloma (CGCG). Surgical treatment by en-bloc resection of the lesion was done. Several reconstruction options are available in the literature are available for the residual bony defect including iliac crest graft, costochondral graft, submental island flaps and more. However, the advent of additive manufacturing, 3–dimensional (3D) printing, and the recent advances in those technologies has positively influenced the biomedical field, leading to the utilization of patient-specific implants (PSIs) in the surgical repair of maxillofacial defects. This report highlights the advantages of using Patient Specific Implant and describes our experience with it.

ALTERNATIVAS NÃO INVASIVAS NO MANEJO DO GRANULOMA CENTRAL DE CÉLULAS GIGANTES DOS MAXILARES: UMA REVISÃO NARRATIVA DA LITERATURA

Introduction: The Central Giant Cell Granuloma of the jaws is described as an uncommon intraosseous lesion that can exhibit different clinical and imaging characteristics. It can present in an aggressive or non-aggressive manner. When aggressive, the lesion is typically expansive, painful, and associated with bone tissue destruction. The standard treatment is surgical removal, but the choice of the ideal therapeutic approach depends on factors such as the patient’s age, lesion behavior, and its extent. Objective: To explore the main conservative treatment options for the management of Central Giant Cell Granuloma of the jaws. Methods: This is a narrative literature review based on research in databases such as PubMed and Google Scholar, conducted between July and August 2024, using DeCS/MeSH descriptors in English, “calcitonin” OR “interferon” OR “denosumab” AND “central granuloma of giant cells in jaws” AND “central giant-cell lesion” OR “corticosteroids injections” AND “intralesional triamcinolone.” Literature Review: The drug class used for the treatment of Central Giant Cell Granuloma is corticosteroids, which show high rates of therapeutic success, followed by calcitonin, denosumab, and interferon. However, despite promising results, additional clinical trials are necessary to establish the true efficacy of these treatments. Conclusion: All non-invasive treatment modalities have been shown to be effective in reducing or achieving complete regression of Central Giant Cell Granuloma of the jaws, either alone or in combination. However, there are limitations, such as the risk of adverse effects and the limited number of published studies to date.

Central Giant Cell Granuloma Associated with the Maxillary Sinus

Central Giant Cell Granuloma Associated with the Maxillary Sinus

Peripheral Giant Cell Granuloma: Case Series and Treatment Approaches

Peripheral Giant Cell Granuloma: Case Series and Treatment Approaches

Aggressive central giant cell granuloma in a pediatric patient

Aggressive central giant cell granuloma in a pediatric patient

Evaluating Treatment Modalities for Reducing Recurrence in Central Giant Cell Granuloma: A Narrative Review.

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.

Traumatic Fibroma : A Case Report

Fibroma is a benign fibrous tissue growth that develops as reactive hyperplasia to trauma or local irritation. It is usually characterized by slow growing, painless, firm, nodular mass merging with the colour of surrounding tissue. It is mainly seen in the region of buccal mucosa, along the plane of occlusion of maxillary and mandibular teeth, tongue, gingiva and hard palate. On clinical examination it resembles pyogenic granuloma, peripheral giant cell granuloma.

Differences in characteristics of Central Giant Cell Granuloma with Ameloblastoma, Odontogenic Myxoma and Aneurysmal Bone Cyst through radiographic approach

Objectives: This study aims to determine the differences in the characteristics of Central Giant Cell Granuloma with Ameloblastoma, Odontogenic Myxoma, and Aneurysmal Bone Cyst through a radiographic approach so as to expand understanding of the characteristics of Central Giant Cell Granuloma with benign lesions of the oral cavity that have similar characteristics. Review: The data used in this study are research journals published on PubMed and Google Scholar search engines. Selecting keywords namely Radiology, Central Gaint Cell Granuloma, Differential Diagnosis by formulating research questions to provide an operational framework using the PICO framework (P: Patient, Population, or Problem; I: Intervention or Exposure; C: Comparison; Outcome). Data collection procedures were carried out through journal identification, then data reduction was carried out, namely selecting journals that were in accordance with the research concept, so that inclusion and exclusion criteria were determined and tested for eligibility and completeness of journals. Conclusion: In this literature review, it was found that Central Giant Cell Granuloma can be diagnosed in comparison with Ameloblastoma, Odontogenic Myxoma, and Aneurysmal Bone Cyst. A total of 41.6% compared with Ameloblastoma, so Ameloblastoma has a higher percentage. 19.4% compared with Odontogenic Myxoma and 38.8% compared with Aneurysmal Bone Cyst.

Peripheral giant cell granuloma in a child with ectrodactyly-ectodermal dysplasia-cleft lip/palate syndrome: a case report

BackgroundEctrodactyly-ectodermal dysplasia-cleft lip/palate (EEC) syndrome mainly affects ectodermal and mesodermal tissues. It is usually manifested as split hands and feet, ectodermal dysplasia, and orofacial clefting, along with other signs and symptoms. A multidisciplinary approach to treatment is required, in which dentists play an important role in identifying and treating various oral conditions that may be genetically linked to or may be the result of EEC syndrome.Case presentationThe present case describes the oral condition of a young child suffering from EEC syndrome and presenting with peripheral giant cell granuloma (PGCG) in the mandibular anterior region. After obtaining a thorough medical and family history and a clinical examination, the lesion was surgically excised under local anesthesia. The patient was followed up at periodic intervals for the next twenty four months, during which no recurrence of the lesion was observed.ConclusionThis report highlights the role of a dentist in the management of the oral conditions of patients suffering from EEC syndrome.

A Surgical management of Mandibular Central Giant Cell Granuloma: A case report

A Surgical management of Mandibular Central Giant Cell Granuloma: A case report

Insights into peripheral giant cell granuloma: A case study analysis

Insights into peripheral giant cell granuloma: A case study analysis

Central Giant Cell Granuloma of the Mandible and Maxilla: A Clinicopathological Study of 21 Cases.

Background Central giant cell granuloma (CGCG) presents as a locally invasive, intraosseous lesion characterized by the accumulation of multinucleated giant cells amidst a matrix of hemorrhage and reactive fibrous tissue that infiltrates bone trabeculae. This idiopathic non-neoplastic proliferative lesion primarily affects the mandible, typically presenting as either unilocular or multilocular radiolucencies on X-rays. Although trauma or intraosseous hemorrhages are potential triggers, the precise histogenesis and etiology remain unclear. CGCG predominantly occurs in children and young adults, with a slight female predilection. Methods and materials A retrospective analysis of 21 cases of CGCG diagnosed at the Oral Pathology/Pathology department of Temple University Hospital between 2015 and 2022 was conducted. Each case was evaluated based on various parameters, including age, gender, presenting symptoms, radiographic findings, clinical differential diagnosis, and histological confirmation. The primary radiographic technique employed for diagnosis was X-ray imaging of the mandible and maxilla. The histological examination involved cutting paraffin-embedded tissue into 5-micrometer-thick sections, which were then stained using routine hematoxylin and eosin (H&E) stain. Notably, no specialized histochemical or immunohistochemical stains were utilized in the evaluation process. Results In our study, we reviewed 21 cases; 9 were male, 11 were female, and one had no available gender data.The age range was 15-76 years, with a mean of 50 years. The mandible was the most commonly affected location (17 cases; 81%)while the maxilla was less commonly involved (4 cases; 19%). Many CGCG lesions were asymptomatic (13 cases; 62%); eight cases (38%) were symptomatic, with painand fullness of the affected dental region being the main manifestations. In a few cases, conditions such as brown tumor (severe hyperparathyroidism) and odontogenic neoplasms, such as ameloblastoma, were suspected clinically and radiographically. The diagnosis of CGCG with associated acute and chronic inflammation was confirmed in all the cases. Histological evaluation of routinely stained slides was the main diagnostic tool utilized. No special stains or molecular studies were required to establish the final diagnosis. Conclusions Our investigation has determined that CGCG exhibits a non-neoplastic nature, displaying a spectrum of behaviors ranging from non-aggressive to aggressive tendencies. While CGCG is predominantly observed in the mandible, rare instances of involvement in the maxilla have also been documented. Importantly, no confirmed association with neoplastic lesions was identified during our analysis. The clinical course of CGCG tends to be indolent, with some cases presenting in association with impacted teeth. It's noteworthy that CGCG can present features mimicking neoplastic conditions, such as ameloblastoma, or localized lesions linked to systemic disorderssuch as hyperparathyroidism (brown tumor).

Prevalence of Histopathologic Types of Gingival Lesions in the Iranian Population: A 22-Year Retrospective Study.

Gingiva is one of the supporting tissues around the teeth that can be affected by various neoplastic or nonneoplastic lesions. Previous studies have examined several types of gingival lesions, but the lack of a standardized classification system has hindered meaningful comparisons. Additionally, many studies focused primarily on reactive lesions. Our study aims to contribute to the understanding of gingival lesions by investigating their prevalence across age groups, genders, sites, and by their clinical presentation. This research could lead to improved diagnostic accuracy and treatment strategies. This retrospective study explores the prevalence of gingival lesions based on biopsies during a 22-year span. The patient's demographic details, including age, gender, and lesion's clinical presentation were systematically collected. These lesions were categorized into six groups. Descriptive statistics, χ2 test of independence, and one-way ANOVA were used for data analysis. Among the 7668 biopsied lesions, 684 (8.9%) lesions were located in the gingiva, with a greater occurrence in women (63.5%). Soft tissue tumors represented the most prevalent group in the gingival lesions (72.1%), and peripheral giant cell granuloma (PGCG) was the most frequent lesion (21.2%), followed by, pyogenic granuloma (19.3%), peripheral ossifying fibroma (17.8%) and focal fibrous hyperplasia (7.6%); all of which predominantly affected women, with mean ages falling in the fourth decade of life. Squamous cell carcinoma was recognized as the most common malignancy. In this study, PGCG was found to be the most common lesion in the gingiva in Iranian population. Further analysis using a unanimous categorization is required to confirm these results.

Central giant cell granuloma in the posterior region of mandible mimicking a fibro-osseous lesion and hemangioma: a case report

BackgroundA 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 presentationThis 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.ConclusionOur 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.