Central giant-cell granuloma: Difference between revisions

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'''Central giant-cell granuloma''' (CGCG) is a benign [[oral]] condition that involves the [[jaw]] or [[mandible]]. It is characterized by the presence of numerous [[multinucleated giant cells]] within a background of mononuclear stromal cells and extravasated red blood cells.
{{Short description|A benign intraosseous lesion of the jaw}}


==Etiology==
'''Central giant-cell granuloma''' (CGCG) is a benign intraosseous lesion that occurs predominantly in the [[jaw]]s. It is characterized by the presence of [[multinucleated giant cells]] within a background of spindle-shaped [[stromal cells]]. CGCG is considered a non-neoplastic lesion, although it can exhibit aggressive behavior in some cases.


The exact cause of CGCG is unknown. However, it is believed to be a reactive process rather than a true [[neoplasm]]. Some researchers suggest that it may be related to trauma or irritation, but this theory is not universally accepted.  
==Clinical Presentation==
CGCG typically presents as a painless swelling in the jaw, most commonly affecting the [[mandible]] more than the [[maxilla]]. It is often discovered incidentally on [[radiographic imaging]] or when it causes noticeable facial asymmetry. The lesion can cause [[tooth displacement]] and [[root resorption]] in adjacent teeth.


==Clinical Features==
==Radiographic Features==
On radiographs, CGCG appears as a unilocular or multilocular radiolucency. The borders of the lesion can be well-defined or ill-defined, depending on the aggressiveness of the lesion. [[Panoramic radiography]] and [[cone beam computed tomography]] (CBCT) are commonly used to assess the extent of the lesion.


CGCG typically presents as a painless swelling or enlargement of the jaw. It may cause displacement of teeth, root resorption, and occasionally pain or paresthesia. The lesion is often discovered during routine dental radiographs, where it appears as a radiolucent area.  
==Histopathology==
[[File:Central_giant_cell_granuloma_-_very_high_mag.jpg|Central giant-cell granuloma|thumb|right]]
Histologically, CGCG is characterized by the presence of numerous multinucleated giant cells scattered within a fibrous stroma. The stroma contains spindle-shaped fibroblasts and [[capillaries]]. The giant cells are similar to those seen in other giant cell lesions, such as [[giant cell tumor of bone]].


==Diagnosis==
==Pathogenesis==
 
The exact pathogenesis of CGCG is not fully understood. It is thought to arise from a reactive process, possibly in response to local trauma or inflammation. Some studies suggest a possible genetic component, with mutations in the [[SH3BP2]] gene being implicated in some cases.
Diagnosis of CGCG is based on clinical, radiographic, and histopathological findings. Radiographically, the lesion appears as a well-defined or ill-defined radiolucent area, often with a multilocular appearance. Histologically, the lesion is characterized by the presence of numerous multinucleated giant cells in a background of mononuclear stromal cells and extravasated red blood cells.  


==Treatment==
==Treatment==
 
The treatment of CGCG depends on the size and behavior of the lesion. Small, non-aggressive lesions may be managed with curettage alone. More aggressive lesions may require en bloc resection. Adjunctive therapies, such as [[corticosteroid]] injections, [[calcitonin]], or [[interferon]] therapy, have been used to reduce the size of the lesion before surgical intervention.
Treatment options for CGCG include surgical curettage, resection, and intralesional steroid injections. The choice of treatment depends on the size and location of the lesion, as well as the patient's age and general health.  


==Prognosis==
==Prognosis==
The prognosis for CGCG is generally good, with a low recurrence rate following complete surgical removal. However, aggressive lesions have a higher risk of recurrence and may require more extensive surgical management.


The prognosis for CGCG is generally good, with a low recurrence rate after treatment. However, larger lesions and those treated with curettage alone may have a higher recurrence rate.
==Related Pages==
 
* [[Giant cell tumor of bone]]
==See Also==
* [[Jaw tumors]]
* [[Giant cell]]
* [[Fibro-osseous lesions]]
* [[Granuloma]]
* [[Jaw tumors and cysts]]
 
==References==
<references />


{{Oral pathology}}
[[Category:Oral pathology]]
[[Category:Oral pathology]]
[[Category:Benign neoplasms]]
[[Category:Jaw disorders]]
[[Category:Jaw disorders]]
[[Category:Benign neoplasms]]
{{Oral pathology}}
{{Jaw disorders}}
{{Benign neoplasms}}
{{Medicine-stub}}
<gallery>
Central_giant_cell_granuloma_-_very_high_mag.jpg|Central giant-cell granuloma - very high magnification
</gallery>
<gallery>
File:Central giant cell granuloma - very high mag.jpg|Central giant-cell granuloma
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Revision as of 18:44, 23 March 2025

A benign intraosseous lesion of the jaw


Central giant-cell granuloma (CGCG) is a benign intraosseous lesion that occurs predominantly in the jaws. It is characterized by the presence of multinucleated giant cells within a background of spindle-shaped stromal cells. CGCG is considered a non-neoplastic lesion, although it can exhibit aggressive behavior in some cases.

Clinical Presentation

CGCG typically presents as a painless swelling in the jaw, most commonly affecting the mandible more than the maxilla. It is often discovered incidentally on radiographic imaging or when it causes noticeable facial asymmetry. The lesion can cause tooth displacement and root resorption in adjacent teeth.

Radiographic Features

On radiographs, CGCG appears as a unilocular or multilocular radiolucency. The borders of the lesion can be well-defined or ill-defined, depending on the aggressiveness of the lesion. Panoramic radiography and cone beam computed tomography (CBCT) are commonly used to assess the extent of the lesion.

Histopathology

Central giant-cell granuloma

Histologically, CGCG is characterized by the presence of numerous multinucleated giant cells scattered within a fibrous stroma. The stroma contains spindle-shaped fibroblasts and capillaries. The giant cells are similar to those seen in other giant cell lesions, such as giant cell tumor of bone.

Pathogenesis

The exact pathogenesis of CGCG is not fully understood. It is thought to arise from a reactive process, possibly in response to local trauma or inflammation. Some studies suggest a possible genetic component, with mutations in the SH3BP2 gene being implicated in some cases.

Treatment

The treatment of CGCG depends on the size and behavior of the lesion. Small, non-aggressive lesions may be managed with curettage alone. More aggressive lesions may require en bloc resection. Adjunctive therapies, such as corticosteroid injections, calcitonin, or interferon therapy, have been used to reduce the size of the lesion before surgical intervention.

Prognosis

The prognosis for CGCG is generally good, with a low recurrence rate following complete surgical removal. However, aggressive lesions have a higher risk of recurrence and may require more extensive surgical management.

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