Imaging Science in Dentistry

Korean Academy of Oral and Maxillofacial Radiology (대한영상치의학회)
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Cone-beam computed tomographic imaging of central giant cell granuloma: A comprehensive review

  • Tahmasbi-Arashlow, Mehrnaz (Department of Diagnostic Sciences, Texas A&M University College of Dentistry) ;
  • Patel, Paras B. (Department of Diagnostic Sciences, Texas A&M University College of Dentistry) ;
  • Nair, Madhu K. (Department of Diagnostic Sciences, Texas A&M University College of Dentistry) ;
  • Liang, Hui (Department of Diagnostic Sciences, Texas A&M University College of Dentistry) ;
  • Cheng, Yi-Shing Lisa (Department of Diagnostic Sciences, Texas A&M University College of Dentistry)
  • Received : 2022.01.30
  • Accepted : 2022.03.18
  • Published : 2022.06.30
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Abstract

Purpose: The aim of this study was to characterize the cone-beam computed tomographic (CBCT) imaging features of central giant cell granuloma (CGCG) of the jawbone. Materials and Methods: This study retrospectively reviewed 26 CBCT studies of histologically proven cases of CGCG during a period of 20 years, from 1999 to 2019. Patients' demographic data were recorded, and radiographic features were assessed (location, border, cortication, appearance of the internal structure, locularity, septation, expansion, cortical perforation, effects on surrounding tissue, whether the lesion crossed the midline, and lesion volume). Results: In this study, CGCGs were seen almost twice as often in the mandible than in the maxilla, and 64.7% of mandibular lesions involved the anterior region. Only 26.9% of lesions crossed the midline, a feature that was considered characteristic of CGCG. Furthermore, 65.4% of lesions were unilocular and 34.6% were multilocular. The correlation between a lesion's size and its locularity was statistically significant, and larger lesions showed a multilocular appearance. The mean volume of multilocular lesions was greater than that of unilocular lesions. Conclusion: CGCGs showed variable radiographic features on CBCT, and this imaging modality is highly effective at demonstrating the radiographic spectrum and lesional extent of CGCGs in the jawbone.

Keywords

Acknowledgement

The abstract of this study was presented as an oral presentation at the ICDMFR 2021 meeting.

References

  1. Jaffe HL. Giant-cell reparative granuloma, traumatic bone cyst, and fibrous(fibro-osseous) dysplasia of the jawbones. Oral Surg Oral Med Oral Pathol 1953; 6: 159-75. https://doi.org/10.1016/0030-4220(53)90151-0
  2. Baskaran P, Gopal M, Rastogi V, Misra SR. Aggressive central giant cell granuloma of the mandible, a diagnostic dilemma. J Oral Maxillofac Radiol 2015; 3: 88-91. https://doi.org/10.4103/2321-3841.170614
  3. Jaju PP, Jaju SP. Clinical utility of dental cone-beam computed tomography: current perspectives. Clin Cosmet Investig Dent 2014; 6: 29-43. https://doi.org/10.2147/CCIDE.S41621
  4. Gohel A, Villa A, Sakai O. Benign jaw lesions. Dent Clin North Am 2016; 60: 125-41. https://doi.org/10.1016/j.cden.2015.08.005
  5. Venkatesh E, Elluru SV. Cone beam computed tomography: basics and applications in dentistry. J Istanb Univ Fac Dent 2017; 51 (3 Suppl 1): S102-21.
  6. De Lange J, Van den Akker HP. Clinical and radiological features of central giant-cell lesions of the jaw. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005; 99: 464-70. https://doi.org/10.1016/j.tripleo.2004.11.015
  7. Abdelqader S, Roche N, Manfredi L, Papon JF, Maman L, Ferre F. Giant-cell granuloma: 2 case reports. J Oral Med Oral Surg 2018; 24: 182-6. https://doi.org/10.1051/mbcb/2018007
  8. Jeyaraj P. Management of central giant cell granulomas of the jaws: an unusual case report with critical appraisal of existing literature. Ann Maxillofac Surg 2019; 9: 37-47. https://doi.org/10.4103/ams.ams_232_18
  9. Hosur MB, Puranik RS, Vanaki SS, Puranik SR, Ingaleshwar PS. Clinicopathological profile of central giant cell granulomas: an institutional experience and study of immunohistochemistry expression of p63 in central giant cell granuloma. J Oral Maxillofac Pathol 2018; 22: 173-9. https://doi.org/10.4103/jomfp.jomfp_260_17
  10. Barnes L, Eveson JW, Reichart P, Sidransky D. Odontogenic Tumours. In: WHO classification of tumors: pathology and genetics of head and neck tumours. Lyon: IARC; 2005. p. 53-4.
  11. Andersen L, Fejerskov O, Philipsen HP. Oral giant cell granulomas: A clinical and histological study of 129 new cases. Acta Pathol Microbiol Scand A 1973; 81: 606-16.
  12. Eisenbud L, Stern M, Rothberg M, Sachs SA. Central giant cell granuloma of the jaws: experiences in the management of thirtyseven cases. J Oral Maxillofac Surg 1988; 46: 376-84. https://doi.org/10.1016/0278-2391(88)90221-2
  13. Ficarra G, Kaban LB, Hansen LS. Central giant cell lesions of the mandible and maxilla: a clinicopathologic and cytometric study. Oral Surg Oral Med Oral Pathol 1987; 64: 44-9. https://doi.org/10.1016/0030-4220(87)90115-0
  14. Horner K. Central giant cell granuloma of the jaws: a clinicoradiological study. Clin Radiol 1989; 40: 622-6. https://doi.org/10.1016/S0009-9260(89)80325-3
  15. Waldron CA, Shafer WG. The central giant cell reparative granuloma of the jaws. An analysis of 38 cases. Am J Clin Pathol 1966; 45: 437-47. https://doi.org/10.1093/ajcp/45.4.437
  16. Whitaker SB, Waldron CA. Central giant cell lesions of the jaws. Oral Surg Oral Med Oral Pathol 1993; 75: 199-208. https://doi.org/10.1016/0030-4220(93)90094-K
  17. Stavropoulos F, Katz J. Central giant cell granulomas: a systematic review of the radiographic characteristics with the addition of 20 new cases. Dentomaxillofac Radiol 2003; 31: 213-7. https://doi.org/10.1038/sj.dmfr.4600700
  18. De Lange J, van den Akker HP, Klip H. Incidence and diseasefree survival after surgical therapy of central giant-cell granulomas of the jaw in The Netherlands: 1990-1995. Head Neck 2004; 26: 792-5. https://doi.org/10.1002/hed.20069
  19. Auclair PL, Cuenin P, Kratochvil FJ, Slater LJ, Ellis GL. A clinical and histomorphologic comparison of the central giant cell granuloma and the giant cell tumor. Oral Surg Oral Med Oral Pathol 1988; 66: 197-208. https://doi.org/10.1016/0030-4220(88)90094-1
  20. Triantafillidou K, Venetis G, Karakinaris G, Iordanidis F. Central giant cell granuloma of the jaws: a clinical study of 17 cases and a review of the literature. Ann Otol Rhinol Laryngol 2011; 120: 167-74. https://doi.org/10.1177/000348941112000305
  21. Kaffe I, Ardekian L, Taicher S, Littner MM, Buchner A. Radiologic features of central giant cell granuloma of the jaws. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996; 81: 720-6. https://doi.org/10.1016/S1079-2104(96)80079-5
  22. Upadhyaya JD, Cohen DM, Islam MN, Bhattacharyya I. Hybrid central odontogenic fibroma with giant cell granuloma like lesion: a report of three additional cases and review of the literature. Head Neck Pathol 2018; 12: 166-74. https://doi.org/10.1007/s12105-017-0845-7
  23. Miloro M, Quinn PD. Synchronous central giant cell lesions of the jaws: report of a case and review of the literature. J Oral Maxillofac Surg 1995; 53: 1350-5. https://doi.org/10.1016/0278-2391(95)90600-2
  24. Cleven AH, Hocker S, Briaire-de Bruijn I, Szuhai K, CletonJansen AM, Bovee JV. Mutation analysis of H3F3A and H3F3B as a diagnostic tool for giant cell tumor of bone and chondroblastoma. Am J Surg Pathol 2015; 39: 1576-83. https://doi.org/10.1097/PAS.0000000000000512
  25. Gomes CC, Diniz MG, Amaral FR, Antonini Guimaraes BV, Gomez RS. The highly prevalent H3F3A mutation in giant cell tumours of bone is not shared by sporadic central giant cell lesion of the jaws. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118: 583-5. https://doi.org/10.1016/j.oooo.2014.07.011
  26. Wood NK, Goaz PW. Differential diagnosis of oral lesions. 4th ed. St. Louis: Mosby-Year Book; 1991. p. 393-5.
  27. Bodner L, Bar-Ziv J. Radiographic features of central giant cell granuloma of the jaws in children. Pediatr Radiol 1996; 26: 148-51. https://doi.org/10.1007/BF01372096
  28. Abdelkarim AZ, Abu El Sadat SM, Chmieliauskaite M, Syed AZ. Radiographic diagnosis of a central giant cell granuloma using advanced imaging: cone beam computed tomography. Cureus 2018; 10: e2735.
  29. Whitaker SB, Bouquot JE. Estrogen and progesterone receptor status of central giant cell lesions of the jaws. Oral Surg Oral Med Oral Pathol 1994; 77: 641-4. https://doi.org/10.1016/0030-4220(94)90327-1
  30. Ide F, Horie N, Shimoyama T, Sakashita H, Kusama K. So-called hybrid odontogenic tumors: do they really exist? Oral Med Pathol 2001; 6: 13-21. https://doi.org/10.3353/omp.6.13
  31. Rai A, Ahmad SA, Saleem M, Faisal M. Hybrid central giant cell granuloma and central ossifying fibroma: case report and literature review. J Oral Maxillofac Surg Med Pathol 2019; 31; 258-63. https://doi.org/10.1016/j.ajoms.2019.02.007
  32. Mosqueda Taylor A, Bermudez Flores V, Diaz Franco MA. Combined central odontogenic fibroma and giant cell granuloma-like lesion of the mandible: report of a case and review of the literature. J Oral Maxillofac Surg 1999; 57: 1258-62. https://doi.org/10.1016/S0278-2391(99)90500-1
  33. Fasolis M, Zavattero E, Garzino-Demo P, Ramieri G, Berrone S. Surgical management of synchronous central giant cell granuloma and ossifying fibroma of the mandible. J Craniofac Surg 2013; 24: e627-30. https://doi.org/10.1097/SCS.0b013e3182a2ddc4
  34. Bologna Molina R, Pacheco Ruiz L, Mosqueda Taylor A, Huesca Ramirez HG, Ponce Lonato JA, Gonzalez-Gonzalez R. Central odontogenic fibroma combined with central giant cell lesion of the mandible. Immunohistochemical profile. J Clin Exp Dent 2011; 3: e348-51.
  35. Neville BW, Damm DD, Allen CM, Chi AC. Oral and maxillofacial pathology. 4th ed. St. Louis: Elsevier; 2016.
  36. Moller B, Claviez A, Moritz JD, Leuschner I, Wiltfang J. Extensive aneurysmal bone cyst of the mandible. J Craniofac Surg 2011; 22: 841-4. https://doi.org/10.1097/SCS.0b013e31820f3703
  37. Yu H, Cui JL, Cui SJ, Sun YC, Cui FZ. Differentiating benign from malignant bone tumors using fluid-fluid level features on magnetic resonance imaging. Korean J Radiol 2014; 15: 757-63. https://doi.org/10.3348/kjr.2014.15.6.757
  38. Wood N, Goaz P. Differential diagnosis of oral and maxillofacial lesions. 5th ed. St. Louis: Mosby; p. 337-40.
  39. Wang K, Guo W, You M, Liu L, Tang B, Zheng G. Characteristic features of the odontogenic myxoma on cone beam computed tomography. Dentomaxillofac Radiol 2017; 46: 20160232. https://doi.org/10.1259/dmfr.20160232
  40. de Lange J, van den Akker HP, van den Berg H. Central giant cell granuloma of the jaw: a review of the literature with emphasis on therapy options. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 104: 603-15. https://doi.org/10.1016/j.tripleo.2007.04.003
  41. Naidu A, Malmquist MP, Denham CA, Schow SR. Management of central giant cell granuloma with subcutaneous denosumab therapy. J Oral Maxillofac Surg 2014; 72: 2469-84. https://doi.org/10.1016/j.joms.2014.06.456