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. 2024 Apr;23(2):316-319.
doi: 10.1007/s12663-023-02004-4. Epub 2023 Nov 24.

Central Giant Cell Granuloma: Negotiating the Diagnostic and Management Dilemmas

Smriti Puri  1 , Rohit Nayyar  1 , Harit Kumar Chaturvedi  2 , Atul Thatai  3 , Shweta Agarwal  4 , Akshat Malik  1
Affiliations

Central Giant Cell Granuloma: Negotiating the Diagnostic and Management Dilemmas

Smriti Puri et al. J Maxillofac Oral Surg. 2024 Apr.

Abstract

Introduction: Giant cell lesions of orofacial region although rare in presentation, have diagnostic and treatment challenges due to overlapping clinical, radiological, and histopathological signs.

Background: We happened to come across a case, which presented to us with an aggressive jaw lesion of nonodontogenic origin, mimicking a malignancy and putting us in a conundrum with regard to work up and treatment. The sequential work up not only helped us reach a definitive diagnosis but also led us the draw algorithms for diagnosis of Giant cell lesions and management of Central giant cell granuloma.

Conclusion: Meticulous planning along with molecular studies helps in better delineating one giant cell lesion from other.

Keywords: Brown tumour; Central giant cell granuloma; Giant cell lesions; Giant cell tumour; Oral cavity.

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Figures

Fig. 1
Fig. 1
a Clinical presentation of the lesion. b Frontal view of 3D-CT (Face) showing large expansile osteolytic lesion of mandible, with very thin sliver of bone remaining at the inferior border. c Haematoxylin–Eosin stained microscopic Sections 40X magnification showing giant cells with 50–60 nuclei with visible nucleoli (marked arrow). d Sanger sequencing of the Histone H3 mutation at G34 in the H3F3A gene was performed and was found to be negative
Fig. 2
Fig. 2
a Algorithm for diagnosis of giant cell lesions and treatment of giant cell granuloma. HPE: Histopathologic evaluation, GCT: giant cell tumour, CGCG: central giant cell granuloma, PTH: parathormone, ALP: alkaline phosphatase, HPT: hyperparathyroidism, IHC: immunohistochemistry. b Algorithm for treatment of Central Giant Cell Granuloma
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