Giant Cell Reparative Granuloma Research Articles

Giant Cell Granuloma of the Temporal Bone in a Mixed Martial Arts Fighter

Background and Importance Giant cell granuloma (GCG) is a rare, benign, non-neoplastic lesion of the head and neck. More common in the jaw bones, there have been few reports of the lesion arising in the temporal bone. Initially referred to as a “giant cell reparative granuloma,” due to the previously accepted notion of its nature in attempting to repair areas of injury, the term “giant cell granuloma” is now more frequently used as this lesion has been found in patients without a history of trauma. In addition, several cases with a destructive nature, in contrast to a reparative one, have been observed.Clinical Presentation We report a case of GCG presenting as a head and neck tumor with dural attachments and extension into the middle cranial fossa in a mixed martial arts fighter.Conclusion Giant cell granulomas are typically treated surgically and have a good prognosis; however, care must be taken when they present in unusual locations. This case supports the theory of trauma and inflammation as risk factors for GCG.

Giant cell reparative granuloma of parotid region – A case report

Giant cell reparative granuloma is a benign neoplastic lesion primarily affecting mandible and maxilla. Giant cell reparative granuloma of parotid region has never been reported in the literature. We report a case of giant cell reparative granuloma of parotid region infiltrating the whole of whole parotid gland, probably arising from the zygomatic bone. Total conservative parotidectomy was done to completely excise the lesion. Histological examination revealed multinucleate giant cells with areas of fibrosis and hemosiderin deposits surrounded by normal parotid gland tissue.

Analysis of giant cell tumour of bone cells for Noonan syndrome/Cherubism‐related mutations

Giant cell tumour of bone (GCTB) is an osteolytic tumour which contains numerous osteoclast-like giant cells and a proliferation of mononuclear stromal cells (MSC). Giant cell-rich osteolytic lesions can also develop in the jaw bones in Noonan syndrome, a cherubism-like developmental abnormality that is transmitted in an autosomal dominant fashion, often because of mutation in the PTPN11 or BRAF genes. We screened GCTBs for mutations in PTPN11 and BRAF to determine whether GCTBs develop through alterations of genes involved in Noonan syndrome. MSC were isolated from 10 GCTBs. Chromosome banding analysis of these cells revealed telomeric associations (tas) in 7 of the 10 cases. Thus, the cultured cells expressed a cytogenetic abnormality typically found in short-term cultures from GCTBs. Sequencing of DNA extracted from the seven GCTB-derived MSC cultures displaying tas did not identify any mutation in PTPN11 or in exons 9-15 of BRAF. Our findings indicate that the molecular pathways involved in GCTB development are different from those causing Noonan syndrome. The method for isolating and culturing GCTB stromal cells described in this study generated a population of MSC that contained tas, indicating that it is useful for obtaining stromal cells from GCTB and other giant cell-rich lesions, such as giant cell reparative granuloma, for genetic and other studies.

Prosthodontic Treatment and Medical Considerations for a Patient with Turner Syndrome: A Clinical Report

This clinical report describes a multidisciplinary approach in the rehabilitation of a 23-year-old Caucasian woman affected with Turner's syndrome and subsequently diagnosed with T4 Giant cell reparative granuloma of the right maxillary sinus. The surgical treatment included a maxillectomy and infratemporal fossa dissection followed by a free fibula palatal reconstruction, fibula bone graft of the orbital floor, dental implant placement, and prosthodontic rehabilitation. Prosthodontic planning and treatment considerations in an adult patient with Turner Syndrome are discussed.

Giant cell bone lesions in the craniofacial region: a diagnostic and therapeutic challenge

Giant cell tumors of bone (GCTs) are common in the long bones, but rare in the craniofacial region, with only 1% of cases occurring in the latter. Clinical, radiological, and anatomical diagnosis of this locally aggressive disease, which occurs in response to trauma or neoplastic transformation, poses a major challenge in clinical practice. The present study describes a series of 4 cases and highlights the main features of the differential diagnosis and treatment of these lesions: GCT, giant cell reparative granuloma (GCRG), and the brown tumor of hyperparathyroidism. GCT presents as a benign neoplasm, most typically affecting the knees, and rarely in the temporal and sphenoid bones. It is radiologically indistinguishable from GCRG due to its lytic, poorly defined appearance. The distinction can only be made microscopically, as the presence of multinucleated giant cells scattered throughout the stroma and the absence of a history of trauma favor a diagnosis of GCT. The brown tumor of hyperparathyroidism occurs with rapid, localized osteoclast activity secondary to the effects of increased parathyroid hormone (PTH) levels; parathyroid examination is indispensable. The diagnosis and treatment of these lesions poses a major challenge due to their similar clinical presentation and radiological appearance. Accurate diagnosis is essential for definition of appropriate management, as complete resection is the goal in GCT and GCRG to avoid recurrence, whereas the brown tumor often yields to treatment of the underlying hyperparathyroidism.

Quiste óseo aneurismático mandibular de tipo sólido

Solid aneurysmal bone cyst is a rare benign bone lesion for which no consensus exists regarding its origin. It has nonspecific clinical, radiological and histological features so ultrastructural studies are essential for diagnosis and classification. The differential diagnosis is extensive and includes a variety of bone lesions, such as giant cell reparative granuloma, and even malignant tumors like osteosarcoma. The treatment of choice is conservative surgery. Recurrence is due mainly to incomplete resection.

Peripheral Giant Cell Granuloma

ABSTRACT The peripheral giant cell granuloma (PGCG), also known as osteoclastoma, giant cell reparative granuloma, giant cell epulis or giant cell hyperplasia, is a relatively frequent reactive benign exophytic lesion of the oral cavity originating from the periosteum or periodontal membrane following local irritation or chronic trauma. PGCG manifests as a red-purple nodule consisting of multinucleated giant cells in a background of mononuclear stromal cells and extravasated red blood cells located in the region of the gums or edentulous alveolar margins, fundamentally in the lower jaw. The lesion can develop at any age, though it is more common between the fifth and sixth decades of life, and shows a slight female predilection. PGCG is a soft tissue lesion that very rarely affects the underlying bone, though the latter may suffer superficial erosion. Here, we present a case of PGCG who presented with the chief complaint of nasal blockade with a palatal mass. How to cite this article Chopra H, Puri S, Chopra N. Peripheral Giant Cell Granuloma. Clin Rhinol Int J 2012;5(1):46-48.

Central Giant Cell Granuloma of Maxilla: A Case Report

Central giant cell granuloma formerly called as giant cell reparative granuloma is a non neoplastic proliferative lesion of unknown etiology. It occurs most commonly in mandible, but can also occur in maxilla. The case described here involved maxilla which was treated with surgical excision.

A novel t(6;13)(q15;q34) translocation in a giant cell reparative granuloma (solid aneurysmal bone cyst)

Aneurysmal bone cyst is a rapidly growing and locally aggressive lesion that commonly affects children and young adults. Initially regarded as a reactive process, primary aneurysmal bone cyst is now widely accepted as a neoplasm owing to recent findings of recurrent clonal chromosomal alterations, mostly t(16;17)(q22;p13). However, other infrequent chromosomal rearrangements have also been reported. Giant cell reparative granuloma, previously regarded as a nonneoplastic process and histologically indistinguishable from the solid variant of aneurysmal bone cyst, is frequently seen in the gnathic bones and the short tubular bones of the hands and feet. Here we present such a case of giant cell reparative granuloma (solid aneurysmal bone cyst) in the finger of a 63-year-old white man. Cytogenetic analysis revealed a novel alteration involving a reciprocal translocation between 6q and 13q, with a karyotype of 46,XY,t(6;13)(q15;q34),del(20)(q13.1).

Giant cell reparative granuloma of temporal bone: Case report of a 62-year-old male

Giant cell reparative granuloma (GCRG) is an uncommon non-neoplastic reactive tumor which occurs almost exclusively within the mandible and maxilla. GCRG of the temporal bone is a rare condition. It has been found to affect predominantly adolescents and adults (age: 10-25 years). We report a case of a 62-year-old male with GCRG of left temporal bone who presented to us with progressive left temporal swelling for 3 months. It was associated with hearing loss. There was no history of trauma. A non-contrast computed tomography scan brain showed a locally destructive lesion involving squamous temporal bone closely related to the left temporal lobe and infratemporal fossa. Magnetic resonance imaging brain with contrast showed a hypointense lesion on T1 and with peripheral contrast enhancement after gadolinium injection. Patient underwent left temporal craniotomy with atticotomy, mastoidectomy, duraplasty, and opening of middle ear and temporomandibular joint. A bone graft was then taken from right iliac crest and used to repair the resulting defect. Final histopathology report confirmed GCRG. We discuss radiological and histopathological features of lesion in this case report.

Giant cell reparative granuloma of the sphenoid: Case report and review of the literature

Background:Giant cell reparative granulomas (GCRGs) are rare lesions in the cranial bones. We present a case of this rare lesion emanating from the clivus and replacing the sphenoid sinus, a highly unusual location for this entity.Case Description:The case and clinical course of a 29-year-old female who presented with a large sphenoid mass are described here. The patient presented with symptoms of severe headache and diplopia; imaging demonstrated a large sphenoid mass which was completely resected via an endoscopic endonasal approach. It was based on the clivus and was shown to be a GCRG.Conclusion:GCRGs are benign granulomatous lesions which should be considered in the differential in the setting of a sphenoid mass.

Giant Cell Lesion or Langerhans' Cell Histiocytosis of the Mandible? A Case Report

Langerhans' cell histiocytosis (LCH), formerly known as histiocytosis X, is characterized by cell proliferation. The leading clinical symptom of LCH within mandibular and maxillary bones is pain and it may resemble periodontal diseases, apical cysts, ameloblastoma, central giant cell granuloma, vascular malformation, osteomyelitys, bone metastasis and malignancies. In this paper we present the case of a mandibular histiocytosis misdiagnosed as a reparative giant cell granuloma at the first and as an aggressive giant cell tumor at the second biopsy. Definitive diagnosis was made only after examination of surgical specimens following hemimandibulectomy.

Giant cell reparative granuloma of the maxillary sinus: A case report

Giant cell reparative granulomaは全身に発生する非腫瘍性の線維性巨細胞病変である。特に上顎，下顎骨の発生が多い。病理学的に類似した疾患が多く，疫学や好発部位など疾患の特徴を認識していないと診断が難しい。文献的考察を加え1症例を報告した。症例は41歳の男性で右の頬部腫脹を主訴とし来院。画像では右上顎洞から頬部，眼窩内へ突出する腫瘤を認め，悪性腫瘍を疑わせたが下鼻道からの生検によりGiant cell reparative granulomaと診断。外科的切除，術後に局所ステロイド注入を行い良好な経過をたどった。

Orbital Manifestations of Noonan Syndrome

Noonan syndrome describes a rare multisystem condition that manifests with Turner syndrome phenotype combined with numerous systemic and facial characteristics. The most common systemic findings include cardiac defects, short stature, chest deformity, hearing loss, and bleeding diatheses. Patients with Noonan syndrome are also at a greater risk of developing various types of malignancies. Facial characteristics of Noonan syndrome consist of broad forehead, low-set ears, short and webbed neck, and low hairline. External ocular findings include hypertelorism, ptosis, epicanthal folds, antimongoloid slant, downward-sloping palpebral fissures, and malar flattening. In this case series and review of the literature, the authors present 2 cases of Noonan syndrome that embody the diverse spectrum of orbital manifestations associated with this rare disorder. The first case demonstrates more profound orbital pathology, including bilateral orbital giant cell reparative granulomas, proptosis, hypertelorism, shallow orbits, upper eyelid ptosis, and lower eyelid retraction. The second case displays classic Turner-syndrome-like facial characteristics including a broad forehead with low hairline, low-set ears, and short and webbed neck. Orbital findings were subtle and consisted of bilateral lower eyelid retraction and shallow orbits. In conclusion, Noonan syndrome is a rare congenital disorder with a wide spectrum of clinical findings. Various intraorbital and extraorbital tumors may occur in patients with Noonan syndrome, with giant cell reparative granuloma being the most commonly encountered. In patients with orbital tumors and eyelid retraction, the authors describe successful treatment through decompression, tumor extraction, and lower eyelid retractor release. Patients who present with ocular irritation and exposure due to less severe lower eyelid malposition may be successfully treated with lower eyelid retraction repair combined with lateral internal tarsoconjunctival tarsorrhaphy.

One and a Half Barrel Vascularized Free Fibular Flap for the Reconstruction of Segmental Mandibular Defect

Ulkur, Ersin MD; Karagoz, Huseyin MD; Kocyigit, Ismail D. DDS, PhD; Oksuz, Sinan MD; Acikel, Cengiz MD; Urhan, Muammer MD

A clinicopathological study of giant cell tumor of small bones

Background and purpose. Giant cell tumor (GCT) of the small bones (small-bone GCT) is usually rare and considered somewhat different from conventional GCT. The purpose of this study was to investigate and report the clinicopathological features of 11 cases with small-bone GCT.Materials and methods. Patient information was obtained with the help of questionnaires. X-rays and paraffin blocks obtained from several institutions were clinically, radiographically, and histologically evaluated.Results. Small-bone GCT was observed in younger patients compared to conventional GCT; 5 of the 11 (45%) patients were below 20 years of age, whereas the corresponding figure for all GCT patients is 16% in Japan. Excessive cortical bone expansion is a special feature. There were two cases of recurrence and one case of lung metastasis; the primary lesion was in the hand for all three cases. In contrast, no primary lesion of the foot recurred or metastasized. Varying degrees of positive p63 immunostaining were observed in all examined cases (n = 9) of small-bone GCT but were negative in case of giant cell reparative granuloma (GCRG) and solid variant of aneurysmal bone cyst (ABC). One case that demonstrated high-intensity positive staining had two episodes of recurrence.Conclusion. Small-bone GCT tends to develop in younger patients than does conventional GCT. Primary GCTs of the hand may be biologically more aggressive than those of the feet. The p63 immunostaining may be useful not only for differential diagnosis but also for prognostication of small-bone GCT.

Congenital Giant Cell Granuloma of the Temporal Bone

G iant cell reparative granuloma (GCRG), which is an uncommon, benign, granulomatous lesion of bone, was first described by Jaffe in 1953. It is most commonly found in the mandible but has been reported to occur in many other sites, including the axial skeleton, orbit, sinuses, and cranial vault. Approximately 35 cases of GCRG originating in the temporal bone have been reported. The lesion has been described in patients ranging in age from 2 months to 72 years. The youngest documented patient to date presented with a small palpable mass at the age of 2 months. To our knowledge, there are no previous reports of a congenital lesion. Our patient presented with a 4 4-cm mass at the age of 5 days, suggesting that the lesion had developed in utero.

Giant Cell Reparative Granuloma of the Proximal Phalanx: A Case Report and Literature Review

The present article is a case report of a 16-year-old boy who presented with a benign bony tumour, which on histological analysis suggested giant cell reparative granuloma (GCRG), but was not corroborate by blood tests. The implications of this type of tumour and the correct diagnostic requirements were investigated. The correct identification of GCRG from other giant cell-containing tumours is important because the treatment modalities for these tumours significantly differ from one another. In most cases, histological findings are sufficient to identify the tumours. In most GCRG cases, curettage is usually a curative treatment option. However, due to high recurrence rates of GCRGs, close follow-up of these patients is warranted. Also, due to osteoclastic activity of the giant cells in GCRGs, the use of drugs such as calcitonin or bisphosphonates, which inhibit osteoclast differentiation and activation, may have an important influence on future treatments or in reducing the recurrence rate of these tumours.

P63 Expression in Giant Cell–Containing Lesions of Bone and Soft Tissue

Previous studies have demonstrated p63 overexpression in giant cell tumors of bone and advocate its use as a potential diagnostic marker. Although routine histology is often all that is required to diagnose giant cell tumor of bone, immunohistochemistry could prove useful to distinguish it from other benign and malignant giant cell-containing lesions of bone and soft tissue on needle biopsies and unusual clinical settings. To assess p63 expression in giant cell-containing lesions of bone and soft tissue. p63 immunohistochemistry was performed in 23 giant cell tumors of bone, 8 primary aneurysmal bone cysts, 12 chondroblastomas, 4 giant cell reparative granulomas, 4 osteosarcomas, 15 tenosynovial giant cell tumors, 6 nonossifying fibromas, and 4 pigmented villonodular synovitides. p63 overexpression was identified in 20 of 23 giant cell tumors of bone (86.9%), 5 of 8 primary aneurysmal bone cysts (62.5%), 10 of 12 chondroblastomas (83.3%), 4 of 4 giant cell reparative granulomas (100%), 2 of 4 osteosarcomas (50%), 1 of 15 tenosynovial giant cell tumors (6.6%), 1 of 6 nonossifying fibromas (16.6%), and 1 of 4 pigmented villonodular synovitides (25%). The sensitivity, specificity, positive predictive value, and negative predictive value of p63 immunohistochemistry for the diagnosis of giant cell tumor of bone were 86.95%, 53.36%, 45.45%, and 91.17%, respectively. This study shows that although p63 is expressed by most giant cell tumors of bone, its lack of specificity limits its use as an immunohistochemical marker in the differential diagnosis of giant cell-containing lesions of bone and soft tissue.

Giant Cell-Rich Osteosarcoma or Giant Cell Reparative Granuloma of the Mandible?

Giant cell-rich osteosarcoma (GCRO) is a rare subtype of osteosarcoma, and no literature has reported occurrence in the mandible region up to now. In this article, we report a case of GCRO originating from the mandible in a 67-year-old woman who presented a history of painless mass located in the left side of the mandible after teeth extraction. The curettage biopsy histologic diagnosis is giant cell reparative granuloma before mandibulectomy surgery, but panoramic radiograph revealed an osteolytic lesion. The tumor was completely resected with segmental mandibulectomy and soft tissue with postoperative histologic diagnosis of GCRO. The free fibula osteomyocutaneous flap was performed to reconstruct the defect of the mandible and gingival mucosa. The patient received postoperative radiotherapy and chemotherapy. The 1-year follow-up situation is fine.