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. 2023 Feb 25;9(3):e14087.
doi: 10.1016/j.heliyon.2023.e14087. eCollection 2023 Mar.

Oral giant cell tumor or giant cell granuloma: How to know?

E Hoarau  1   2 , P Quilhot  3   4 , V Baaroun  5   1 , G Lescaille  5   1 , F Campana  6 , R Lan #  7 , J Rochefort #  5   1
Affiliations

Oral giant cell tumor or giant cell granuloma: How to know?

E Hoarau et al. Heliyon. .

Abstract

Introduction: The distinction between giant cell tumors and giant cell granulomas is challenging, as both entities have overlapping diagnostic criteria, especially in oral locations. The two entities have similar clinical and radiological presentations, but they differ in their prognoses.

Objective: The main objective of this study was to list the clinical, radiological, histological, and prognostic features of maxillomandibular giant cell tumors and giant cell granulomas cases n order to assess their value as a diagnostic referral factor that may allow the distinction between maxillo-mandibular giant cell granuloma and giant cell tumor.

Study design: Data of maxillomandibular giant cell granulomas and giant cell tumors were assessed through a scoping review and a pre-existing systematic review of literature. We have also realized a bicentric retrospective study.

Results: Various criteria facilitate the differential diagnosis like age, size, locularity and presence of necrosis zone but not the gender. The most discriminating factors was symptomatology (reported in 72% of GCTs while only 15% of GCGs) and the distribution pattern of giant cells in the stroma (homogeneously dispersed in 80% of GCTs versus grouped in clusters in 86.7% of GCGs). Recurrences were most described for giant cell tumors than giant cell granulomas. Malignant transformation and pulmonary metastasis were exclusively reported for giant cell tumors.

Conclusion: As clinical and radiological elements are not sufficient to distinguish between these two entities, immunohistochemistry and molecular genetics can be represent diagnostic biomarkers to distinguish giant cell granulomas and giant cell tumors in oral cavity. We have attempted to define the main criteria for the differentiation of giant cell tumor and giant cell granuloma and propose a decision tree for the management of single maxillomandibular giant cell lesions.

Keywords: Giant cell granuloma; Giant cell lesion; Giant cell tumor of bone; Giant cells.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Flow chart of the scoping review and article selection on maxillomandibular Giant Cell Tumors (GCTs).
Fig. 2
Fig. 2
Histologic aspects of Giant Cell Granuloma (GCGs) staining with haematoxylin and eosin. (A), low magnification; (B), high magnification. Proliferation of spindle-shaped stromal cells associated with multinucleated giant cells (1). Hemorrhagic background with siderophages (2).
Fig. 3
Fig. 3
Proposal of a decision chart for the diagnosis of single giant cell lesion of maxillo-mandibular location.
See this image and copyright information in PMC

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