Central Giant Cell Granuloma Treated with Intralesional Corticosteroid Injections and Bisphosphonates: A Long-Term Follow-Up Case Study

Abstract

Central giant cell granuloma (CGCG) is a benign intraosseous lesion of the head and neck with potential for aggressive and locally destructive behaviour. Lesions of the maxilla tend to expand more than those of the mandible due to the thinner cortices and spongy tissue of this location. Surgical removal is the most common treatment; however, it may be disfiguring in aggressive cases, especially for lesions located in the maxilla. Alternative treatments, such as intralesional corticosteroid injections, have been performed with satisfactory results. We report a case of a 12-year-old female patient with a CGCG of the left maxilla that was treated with 40 doses of intralesional triamcinolone acetonide infiltrations combined with alendronate sodium and calcium carbonate. Clinical and imaging follow-up over 12 years demonstrates improvement in the patient's condition.

Central giant cell granuloma of the maxilla: Long‐term follow‐up of a patient treated with an adjuvant corticosteroid

“…Otherwise, this approach is of concern to other authors, as it may represent a risk of osteonecrosis. 16 Nonetheless, neither adverse effects of the drugs were observed, nor did we observe any clinical evidence of recurrence during the 11-year follow-up.…”

“…Pharmacological agents have been a promising alternative therapeutic strategy replacing surgical treatment, in particular when CGCG affects the maxilla. 10,16 Adherents to these alternative treatment regimens claim that pharmacological agents have the potential to decrease recurrence rates and, at the same time, minimize surgical morbidity or even preclude the need of surgical intervention. 12,16,17,34 Therefore, we are in line with the concept of Schreuder and colleagues, 5 who stated that, particularly in the case of a growing young individual, the short-term risks of pharmacological treatment may surpass the long-term sequels of surgical intervention.…”

“…15 In particular, few reports of long-term follow-up of aggressive CGCG in pediatric patients, who had undergone pharmacological treatment with or without surgery, have been published in the literature. 5,16 Herein, we documented the case of a 15-year-old girl who had suffered from aggressive CGCG in the maxilla. This case sheds light on the treatment with a systemic and intralesional corticosteroid associated with a calcitonin nasal spray.…”

Granuloma Central de Células Gigantes dos maxilares: Relato de caso/ Granuloma Central Giant Cells of the Maxilla: Case Report

“…Sua estratégia de execução dependerá do comportamento clínico da lesão, variando de acordo com o objetivo central da cirurgia e experiência do cirurgião. 6 Dentre as técnicas mais invasivas, a curetagem cirúrgica é a mais utilizada tradicionalmente, seguida pela ressecção em bloco com margem de segurança,geralmente empregada em lesões de caráter agressivo e recorrente. 4,6 Mediante as informações apresentadas, o dado trabalho tem por objetivo relatar um caso de GCCG em corpo de mandíbula, acometendo um paciente do gênero masculino, cujo plano de tratamento baseou-se na ressecção cirúrgica, precedida por uma fixação rígida com placa 2.4 em base de mandíbula e enxerto ósseo sintético injetável para corrigir defeito ósseo.…”

Correction to: Central Giant Cell Granuloma Treated with Intralesional Corticosteroid Injections and Bisphosphonates: A Long‑Term Follow‑Up Case Study

“…After the publication of this article [1] it was brought to the authors' attention that the appropriate consent statement was not included in the manuscript. The correct statement is given below:…”