Synchronous central giant cell lesions of the jaws: Report of a case and review of the literature

Clinico-Pathologic Conference AAOMP/IAOP 2008: Case 3

“…Cases of CGCG with several recurrences and concomitant ipsilateral/contra-lateral multiple lesions in the absence of a systemic condition have been reported [9][10][11], however, they were not as complex and non-responsive as the present case. In order to emphasize the exceptional biologic behavior of our case, we chose to use the terms ''atypical'' and ''aggressive'' for the submitted diagnosis.…”

“…Alternatively, it could be proposed that this is a case of occult hyperparathyroidism that would eventually develop into an overt state [14,15]; or else, there is the possibility that this case might represent an abnormally amplified responsiveness of the local osteoclasts involved in tooth eruption, to normal levels of PTH. The progression of the lesion along the mandible to a posterior location compared to the point of origin in the midline and the expansion of the lesion to the ipsilateral jawbone, may be explained in terms of tumor spill and hematogeneous spread, respectively [9,14].…”

Multifocal Central Giant Cell Granuloma of the Jaws: Case Report and Review of Literature

“…Eight cases occurred in patients under the age of 30 years, 5,10,[26][27][28][29][30] and seven of them occurred in patients above the age of 30 years (Table 1). 5,[31][32][33][34][35][36] The age of the present case was 62 years.…”

“…According to their opinion, metachronous lesions are more likely to demonstrate a recurrence because of inadequate initial treatment, whereas synchronous lesions are more likely to demonstrate true multifocality. 35 However, when we examined previously reported metachronous cases, secondary lesions were seen in a different location from the primary lesion located in the jaw (Table 1). 5,32,33,36 Therefore, the recurrence of a treated lesion is expected to occur in the primary focus.…”

A Case of Recurrent Multifocal Central Giant Cell Granulomas

“…In previous reviews of the literature, different cases have been included as multifocal CGCG [34, 35]. Previous cases of multiple giant cell lesions may represent:

Unusual reports of cherubism [36, 37]

Association with a syndrome or genetic condition [14, 15, 38]

A single lesion of a jaw separated by normal bone

Association with elevated PTHrP [39]

True giant cell tumors originating in the maxillofacial region,

Multifocality resulting from hematogenous spread due to inadequate treatment

…”