Maxillary giant cell reparative granuloma

Abstract

"Giant cell reparative granuloma" was introduced into medical literature by Jaffe in 1953. Prior to that time most authors considered this lesion to be a variant of the benign giant cell tumor of the long bones, or a giant cell variant of osteitis fibrosa. Bernier and Cahn established the subdivision between the rare central giant cell reparative granuloma and the common peripheral epulis. In the past, considerable emphasis has been placed on the importance of differentiating the true giant cell tumor from the giant cell reparative granuloma of the jaw bones. Most authors now believe the true giant cell tumor does not appear in the jaw bones except in rare cases associated with Paget's disease of the skull. Developing from membranous, rather than cartilaginous, ossification might account for this. Both peripheral and central intraosseous lesions, parathyroid osteopathy and the pathologic tissue of cherubism show no appreciable histologic difference. These tumefactions are histologically a proliferative fibroblastic lesion with multinucleated giant cells. The histopathology of the giant cell tumor of the long bones is probably identical to the histopathology of the giant cell reparative granuloma of the jaw bones. The diagnosis of giant cell reparative granuloma must be made by physical examination, history, laboratory, X-ray parameters and clinical follow-up. Localized maxillary swelling is the most important clinical feature. The swelling is smooth and palpation can reveal a rubbery, elastic sensation where bone has been thinned. There are no specific radiographic signs. Conservative surgical management is indicated and adequate for giant cell reparative granulomas. Radiation is not indicated because of long term risks. Steroids have not been proven useful.

Giant Cell Reparative Granuloma Presenting as Cheek Swelling: Case Series of Four Patients

“…It was introduced into medical literature by Jaffe in 1953 and accounts for 1-7% of all benign lesions of the jaw and arises most often in the mandible and maxilla [3,5]. Cases have been reported in small bones of the hand & feet, sinuses, temporal bone, skull, spine, clavicle, tibia, humerus, ribs and femur.…”

Treatment of giant cell granuloma of the maxilla with intralesional injection of steroids

“…Localized swelling is the most important clinical manifestation, 3 although other symptoms such as localized pain, nasal obstruction, and epistaxis can occur. When it occurs in the head and neck, it usually affects the maxilla or the mandible.…”

“…When it occurs in the head and neck, it usually affects the maxilla or the mandible. 3 Radiographically, these lesions are seen as well-defined radiolucencies that may be multilocular or unilocular. 4 The typical finding on physical examination is a smooth-surfaced mass that is either firm or spongy in consistency.…”

“…1 It is a lesion characterized by proliferation of fibroblasts and multinucleated giant cells in a densely packed stroma. 3 Jafe 1 recommended curettage for these lesions, because they have the potential for extensive bone destruction. This difference in incidence is attributed to the difference in developmental patterns.…”

Granuloma reparativo de células gigantes dos seios etmoidal e maxilar

“…Posteriormente, o GRCG foi descrito, em vários artigos, nos seios paranasais 6,7 , ossos temporais 8 , órbita 9 e ossos tubulares de extremidades 10 . A distinção entre o GRCG e TCG tornou-se bem estabelecida e mais amplamente aceita.…”