Fine Needle Aspiration Cytology and Intralesional Steroid Injection in a Central Giant Cell Granuloma Affecting the Gingiva: A New Clinical Approach

Abstract

Central giant cell granuloma (CGCG) is a benign jaw lesion predominantly found in the mandible of young female patients with a variable clinical behavior. Although surgical management is regarded as the main treatment modality for this lesion, the use of intralesional injections of steroids has been recently advocated for its treatment. In addition to this conservative management, the use of fine needle aspiration cytology (FNAC) for diagnosing CGCGs has been proven a safe and efficient approach, especially useful in cases with lesions located in esthetic regions. Herein, it is described a case of CGCG extending to the overlying gingiva of a 15-year-old male patient diagnosed by FNAC and subsequently treated with intralesional injections of a solution of triamcinolone acetonide and ethanolamine oleate that led to an important clinical remission, allowing a more conservative surgical procedure for preservation of gingival esthetics. Therefore, both procedures can be considered as management options for CGCG of the jaws.

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

“…CGCL accounts for approximately 7% of all benign lesions in the maxilla. These lesions occur more frequently in the mandible than in the maxilla with more involvement in the right side [4, 2, 5, 9, 10]. CGCL is more common in females, with a ratio 2:1 [7].…”

“…CGCL is more common in females, with a ratio 2:1 [7]. This lesion can occur at all ages, but most cases were diagnosed between the second and third decade of life [1, 9, 11]. …”

Treatment of an aggressive central giant cell lesion

“…For large or recurrent lesions, therapy with intralesional injections of corticosteroids can also be used. [7,8] This paper presents the case of a patient with CGCL addressing its diagnosis, treatment and rehabilitation.…”

Avaliação da punção aspirativa por agulha fina (PAAF) em cavidade oral e região de cabeça e pescoço em diferentes técnicas de coloração

“…Em cavidade oral, a PAAF ainda é pouco utilizada, sendo seus trabalhos relatos de casos em lesões intra ósseas (August et al, 1999;Gupta et al, 2009;Fonseca et al, 2013), tumores odontogênicos (Stone et al, 1998;Blocklage et al, 1997;Choudhury et al, 2000;Saran et al, 2000;Kumar et al, 2002;Tsamis et al, 2002;Vargas et al, 2007;Dereci et al, 2011;Kaliamoorthy et al, 2013), lesões de glândulas salivares menores (Netto et al, 2008) e outras regiões orais (Barnard et al, 1993;Domanski;Akerman, 1998;Shah et al, 1999;Ashraf et al, 2010;Cozzolino et al, 2014) .…”

“…As colorações mais utilizadas em PAAF na cavidade oral, são as mesmas de outras regiões, as colorações tipo Romanowsky para lâminas secas ao ar e as colorações de Papanicolau e Hematoxilina-Eosina, para as lâminas fixadas em álcool (Barnard et al, 1993;Castelli et al, 1993;Domanski;Akerman, 1998;August et al, 1999;Stone et al, 1998;Blocklage et al, 1997;Shah et al, 1999;Choudhury et al, 2000;Saran et al, 2000;Kumar et al, 2002;Tsamis et al, 2002;Vargas et al, 2007;Ashraf et al, 2010;Netto et al, 2008;Saleh et al, 2008;Gupta et al, 2009;Dereci et al, 2011;Santos et al, 2011;Fonseca et al, 2013;Kaliamoorthy et al, 2013;Cozzolino et al, 2014). O procedimento foi realizado de acordo com a técnica descrita por Zadjicek (Kline, 1988;Fulciniti et al, 1997;Santos et al, 2011)…”