Combination therapies for the treatment of recurrent central giant cell lesion in the maxilla: a case report

Abstract

BackgroundCentral giant cell lesion is a non-neoplastic proliferation, usually asymptomatic, of unknown etiology. The purpose of this case report is to report the diagnosis and the treatment of a recurrent central giant cell lesion in the maxilla.Case presentationA 31-year-old Brazilian woman presented to our Surgery Service for evaluation of a cystic lesion in her teeth 13 and 15, although she had previously received endodontic treatment for her teeth 13 and 15 without regression of the lesion. On clinical examination, an increase and painless swelling was observed in her right jaw. An excisional biopsy of the lesion was performed under general anesthesia; the material was sent for pathological examination and a diagnosis compatible with central giant cell lesion was made. She presented again, 10 months after the removal of the lesion, with a recurrent lesion that surrounded her incisors, canine, and right premolar. We suggested that she underwent treatment with intralesional corticosteroids injection. The lesion was significantly reduced and the remainder of the lesion was enucleated. She is monitored at 3-month intervals; at 6 months postoperatively there has been no recurrence.ConclusionsCentral giant cell lesion can have a high degree of invasiveness, which increases the importance of early diagnosis. Combination therapies can provide a favorable prognosis. Periodic monitoring is recommended, thus avoiding the chance of a relapse.

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

“…Alternative treatment with intralesional corticosteroid injections has been performed with satisfactory results. These are used as definitive or presurgical treatments, aimed at reducing morbidity [6][7][8].…”

Central Giant Cell Granuloma of The Maxilla: Case Report and Literature Review

“…Its appearance is usually consistent with a unilocular or multilocular radiolucency, well or poorly defined, plus a varied expansion and destruction of the cortical plate. This pattern is not pathognomonic radiographically and can be confused with many other injuries in the maxilla and mandible [8]. In this case, the lesion was involving multiloculated radiolucent and well-defined area, with a resorption of teeth 44 and the destruction of the external cortical plate.…”

“…The approach is calcitonin enhances and inhibits osteoclast activity. However, due to their great discomfort and relatively long treatment time, this treatment is not well accepted by all patients [14]. Bisphosphonate could be used for CGCG and fibrous dysplasia treatments in children.…”

“…They can be considered a first treatment option. Intralesional injection is preferred than systemic injection, because in first one it is possible to achives a high drug concentration in tissue [14].…”

Inyección intralesional de corticoesteroides como tratamiento conservador del granuloma central de células gigantes: revisión de la literatura

“…Así mismo, a excepción de tres artículos 13,26,32 , en todos los casos se utilizó un anestésico como marcaina, bupivacaina o lidocaína en proporción 1:1 con la tiramcinolona. En la mayoría de los casos, las inyecciones se aplicaron una vez a la semana por 6 semanas, mientras que otros artículos presentaron una variación en la frecuencia y duración de las aplicaciones [11][12][13]15,[17][18][19][20]22,24,26,[29][30][31]35 .…”