Multicentric giant cell tumour of the mandible: a clinical rarity

Abstract

Giant cell tumours of bone (GCT) are benign, locally aggressive tumours affecting the epiphyseal regions of long bones in young adults. These nonodontogenic tumours rarely present in the oral cavity, either peripherally in soft tissues (gingiva) or centrally (in bone). GCT account for <7% of all benign jaw lesions and may present as aggressive or non-aggressive clinical forms. Histologically, these lesions are usually composed of mononuclear stromal cells and characteristic multinucleated giant cells that exhibit osteoclastic activity. Multicentricity of GCT of bone is an extreme rarity accounting for <1% of these tumours. The biological behaviour and the clinical presentation (e.g. localisation, age, and gender distribution) of multicentric GCT are different from solitary lesions. As other primary bone lesions may also have a polyostotic presentation, the precise diagnosis relies on correlation of clinical and radiographic findings with confirmation of the diagnosis by histopathologic examination. We encountered one such interesting case in a 12-year-old boy, who presented with pedunculated fibrous growth arising from the gingiva in the left mandibular posterior region along with extensive osteolytic lesions of ramus of mandible bilaterally. The workup and management of the case is hereby presented along with relevant review of literature. Clinical relevanceMulticentric osteolytic lesions with similar presentation may have varied aetiology and management. The case presented here had a unique presentation and posed a diagnostic dilemma. Precise differential diagnosis with accurate workup may aid the clinician to arrive at a correct definitive diagnosis in such cases, thus enabling prompt management of the case.