Diagnosis and management of central giant cell granulomas of the jaws: a European and multicenter study

Abstract

Introduction: Central giant cell granulomas (CGCGs) are benign but locally aggressive rare neoplasms that affect the bony skeleton, particularly the maxillofacial region. The purpose of this European multicenter study was to describe and assess the characteristics, diagnosis, management, and recurrence of CGCGs at different European oral and maxillofacial surgery centers.

Methods: The data from all the treated CGCGs from the involved oral and maxillofacial surgical units across Europe between January 1st^, 2014 and December 31st^, 2023 were recorded.

Results: A total of 76 patients, including 37 males and 39 females diagnosed with CGCG met the inclusion criteria and were included. The mean age of the study population at diagnosis was 41.8 years. Fifty-three lesions were found in the mandible, with the most frequently involved subsite being the mandibular parasymphysis. Overall, 75.0 % of included CGCGs were unilocular. The most frequent treatment option was surgery alone. A total of 12 recurrences (15.8 %) were observed with a mean follow up of 41 months.

Discussion: Further genetic and molecular studies regarding the pathways underlying CGCGs are needed, in order to predict their natural history and to direct non-surgical therapies. In the meantime, surgeons should balance the risks of higher recurrence rates associated with lower surgical morbidity, performing an individualized treatment plan, taking into consideration the clinical and radiological features together with the patients' age and comorbidities. A radiographic follow-up of patients with treated CGCGs could advised for the first 5 years.

Keywords: Central giant cell granuloma; Diagnosis; Epidemiology; Recurrence; Surgery.