Towards better understanding of giant cell granulomas of the oral cavity

Abstract

Giant cell granulomas are enigmatic lesions of the oral cavity characterised by a peculiar combined proliferation of mononuclear and multinucleated giant cells in a mesenchymal stromal background. Central and peripheral giant cell granulomas may have similar pathogenesis and histology but differ in their location and biological behaviour. It is important to differentiate them from other giant cell lesions that can occur in the oral cavity, such as giant cell tumour of the bone, aneurysmal bone cyst, brown tumour of hyperparathyroidism, and giant cell lesions of Ramon syndrome, Noonan syndrome, neurofibromatosis and Jaffe-Campanacci syndrome. A recent insight into their molecular genetics and pathogenesis, with identification of KRAS, FGFR1 and TRPV4 mutations, allows for better diagnostic differentiation and opens the door to the use of pathway inhibitors in the treatment of recurrent or dysmorphic lesions. In this review, we provide an updated summary of the clinical and pathological features of oral cavity giant cell granulomas that help with their precise diagnosis and management.

Spontaneous Regression of Brown Tumor in a Patient Treated With Peritoneal Dialysis

“…BT is a non-neoplastic osteolytic reactive lesion that reflects abnormal bone resorption caused by HPT [1].…”

“…Brown tumor (BT) is a non-neoplastic lesion that reflects abnormal bone resorption caused by hyperparathyroidism (HPT) [1]. It can be either monostotic or polyostotic and affects any bone in the body, most commonly facial bones, clavicle, ribs, pelvis, and femur [2].…”

Lesão periférica de células gigantes intrabucal

“…Os granulomas de células gigantes são lesões caracterizadas pela combinação da proliferação de células gigantes mono e multinucleadas em um fundo estromal mesenquimal. As lesões periféricas e centrais podem ter histologia semelhantes, mas diferem em sua patogênese, localização e comportamento biológico (Ahmed & Naidu, 2021;Jindal et al, 2019).…”

“…Embora, a lesão possa causar reabsorção óssea e ter recorrência, é considerada menos agressiva que a lesão central de células gigantes e por alguns autores é considerada uma variante do mesmo processo. É uma lesão reacional, surgindo em função de trauma ou irritação localizada na gengiva ao redor dos dentes ou implantes dentários (Abofoul et al, 2022;Ahmed & Naidu, 2021;Ahmed & Haggag, 2022;Baesso et al, 2019;Chapple et al, 2018;Chrcanovic, Gomes, & Gomez, 2019;Sánchez-Torres et al, 2021).…”

“…Clinicamente, a LPCG apresenta-se como uma lesão nodular intrabucal, variando sua coloração de vermelho-escura a roxo-azulada, podendo apresentar áreas de ulceração, sendo mais comum na mandíbula do que na maxila (Abofoul et al, 2022;Ahmed & Naidu, 2021;Ahmed & Haggag, 2022;Katsikeris, Kakarantza-Angelopoulou, & Angelopoulos, 1988;Shadman, Ebrahimi, Jafari, & Eslami, 2009). Pela semelhança clínica, o diagnóstico diferencial deve ser feito especialmente entre o granuloma piogênico e o fibroma ossificante periférico (Lester, Cordell, Rosebush, Palaiologou, & Maney, 2014).…”