A central giant cell granuloma influenced by pregnancy.

Abstract

A case of a 17-year-old patient with exacerbation of a central giant cell granuloma of the mandible during pregnancy is reported. The possible relationship of the giant cell lesion to a pre-existing fibrous dysplasia is considered although there was lack of histological evidence.A 17-year-old healthy female patient was referred by her dentist for evaluation of a lesion in the area of a missing mandibular left third molar. The only relevant dental history was the removal of the third molars 3 years earlier. The panoramic film taken at that time revealed cyst-like radiolucencies around the apical region of the second molar and continuous with a mixed radiolucent-radiopaque lesion that extended to occupy the anterior half of the ascending ramus. There was slight expansion and the internal aspect had a granular bone pattern consistent with a fibro-osseous lesion. A biopsy resulted in a histopathological diagnosis of an aneurysmal bone cyst. One month later the lesion in the body of the mandible was completely curetted. The patient returned 8 months later complaining of a hard bone-like swelling on the buccal aspect of the alveolar process adjacent to the left mandibular second molar. A panoramic radiograph revealed non-uniform repair of the previous surgical procedure (Figure 1). The patient was monitored with another panoramic film in 6 months (Figure 2). At that time the films were submitted for a radiological opinion. Of note was the finding that although there were changes in the body of the mandible secondary to the surgery, the granular bone pattern of the portion of the lesion in the ramus had not changed. The radiological opinion was that the appearance was most consistent with fibrous dysplasia.After another 6 months the patient returned complaining of pain and a considerable swelling of rapid onset. At that time she was in the fourth month of her pregnancy. A panoramic film taken at that time

Central giant cell granulomas: a systematic review of the radiographic characteristics with the addition of 20 new cases.

“…5 In the present study, no gender predilection was found. A small female predominance was present, albeit not statistically signi®cant.…”

Central giant cell granuloma of posterior mandible: Report of a case

“…Pregnancy may alter the progression of CGCG but is very unlikely to initiate a new lesion. [8] The present lesion was seen in a young female patient.…”

Bone Lesions

“…There is a distinct gender predilection, with 65% of cases affecting females. [424][425][426] The rapid growth results from stimulation of a preexisting lesion rather than initiation of a new one. The anterior part of the mandible is a favorable site, and lesions commonly cross the midline.…”