Central Giant Cell Granuloma of The Maxilla: Case Report and Literature Review

Introduction: Central giant cell granuloma (CGCG) is a rare bony lesion in the Head and Neck region. It is a non-odontogenic tumor never seen in any other bone of the skeleton. It is an intraosseous lesion consisting of cellular fibrous tissue that contains multiple foci of hemorrhage, aggregations of multinucleated giant cells and occasionally trabeculae of woven bone. Case Report: We report a case of a 50-year-old female patient with swelling on the right side of face for 4 months. Intraoral examination shows a mass in right lower jaw in the region of 45 and 46 edentulous areas. The swelling had smooth surface, firm and tender on palpation. There was no expansion of lingual region. The radiological examination revealed a well-defined multiloculated expansile and lytic lesion in the right mandible, extending from the 44 to 47 with a resorption of teeth 44. The patient underwent incisional biopsy and the diagnosis of CGCG and brown tumor of hyperparathyroidism was proposed. According to the clinical radiological and biological findings, the diagnosis of CGCG was confirmed. The enucleation of the lesion with the extraction of 44 was done. Discussion: Central giant cell granuloma (CGCG) is a benign intraosseous lesion of the head and neck with potential for aggressive and locally destructive behaviour. Lesions of the maxilla tend to expand more than those of the mandible due to the thinner cortices and spongy tissue of this location. Surgical removal is the most common treatment; however, it may be disfiguring in aggressive cases, especially for lesions located in the maxilla. Alternative treatments, such as intralesional corticosteroid injections, have been performed with satisfactory results.

Multiple Odontogenic Keratocysts in a Non-syndromic Young Patient: An Unusual Case Report

Odontogenic keratocyst (OKC) is a benign intraosseous lesion with invasive and aggressive behavior. It comprises approximately 2-21.8% of all jaw cysts. Odontogenic keratocysts (OKCs) are believed to arise from remnants of the dental lamina most common site in the molar ramus area. OKCs have a specific histopathologic appearance and are found to be locally aggressive and have a high recurrence rate, thus requires close long-term follow-up. OKCs are one component of the Gorlin-Goltz syndrome and all patients with multiple OKCs should be evaluated for this syndrome. In this paper, we present a case of a 13-year old non-syndromic female patient with multiple OKCs located at symphysis and bilateral mandibular angle region who was treated surgically with no obvious post-operative complications during follow-up period.

Rapid growth of spinal epidural capillary hemangioma associated with isolated intraosseous lesion at the same level: A case report

A 47-year-old man presented with a spinal epidural capillary hemangioma manifesting as a 6-month history of worsening low back pain and lower limb pain. Computed tomography and magnetic resonance imaging (MRI) at a previous hospital showed intraosseous abnormal signals and an epidural lesion at the L3 level. One month later, MRI revealed rapid growth of the epidural lesion. Total resection of the epidural tumor and partial removal of the intraosseous tumor were performed. Macroscopically, the intraosseous lesion and epidural lesion seemed to be isolated from each other. Histopathological diagnosis was consistent with capillary hemangioma. Spinal epidural capillary hemangioma sometimes recurs via underlying arteriovenous anastomosis. Progressive clinical symptoms, as seen in our case, indicate the possibility of tumor growth even if the lesions are well demarcated, which suggests of benign tumor. Spinal epidural capillary hemangioma in addition to metastatic spinal tumors should be considered in the differential diagnosis of spinal epidural tumors associated with intraosseous lesions.

Central Giant Cell Granuloma: A Narrative Review of Radiological Features and Differential Diagnosis

The Central Giant Cell Granuloma is an uncommon lesion, accounting less than 7% of all benign jaw lesions. In 1953, Jaffe was the first to describe these lesions as a giant cell reparative granuloma of the jaw bones, and in 1971, thanks to Pindborg and Kramer, it was included in the current nomenclature. The aetiology of CGCG is unknown, there is also a peripheral type that some authors consider the most common in maxillary bones. WHO defines CGCG as an intraosseous lesion consisting of cellular fibrous tissue that contains multiple foci of hemorrhage, aggregations of multinucleated giant cells, and some trabeculae of woven bone. The radiographic appearance of CGCGs is not pathognomonic. CGCGs should be differentiated from other lesions of the jaws such as Brown’s tumour of hyperparathyroidism, fibrous dysplasia, aneurysmal bone cysts, giant cell tumours, fibro-osseous lesions, and other malignancies that arise in the jaw bones. Furthermore, it needs to be differentiated even from some genetic syndromes, such as Cherubism, type 1-neurofibromatosis and Noonan’s syndrome. The aim of this study is to focus on radiographic features of CGCG in order to achieve an appropriate tool for diagnosis.

Ectopic Cerebellar Tissue in the Occipital Bone: A Case Report

Ectopic cerebellar tissue has only been described in isolated case reports, with only two reported cases in adult patients. We report the case of a 63-year-old woman with progressive, medically refractory headaches. A scan showed an intraosseous lesion of the midline occipital bone. Surgical resection of the soft tissue lesion was undertaken. Her headaches ceased postoperatively. Histopathological analysis revealed cerebellar cortical tissue with a surrounding meningothelial cell layer, characteristic of cerebellar ectopia. This is the second reported case of an intraosseous location of this lesion, and only the third case described in an adult patient. Our findings illustrate a rare cause of headaches and support the therapeutic roles of surgical treatment for this extremely rare condition.

Central Giant Cell Granuloma

Central giant cell granuloma (central giant cell granuloma) is an uncommon benign bony lesion that occurs in the mandible and maxilla and accounts for approximately 7% of all benign tumours of the jaws [1]. The World Health Organization (WHO) has defined central giant cell granuloma as an intraosseous lesion consisting of cellular fibrous tissue that contains multiple foci of haemorrhage, aggregations of multinucleated giant cells and occasional trabeculae of woven bone [2]. Central giant cell granuloma occurs predominantly in children or young adults, with approximately 75%of cases presenting before 30 years of age although presentation can occur at any age [3]. Females are affected more frequently than males, with a ratio of 2:1

Fibrous Meningioma with Skull Invasion

In patients with meningiomas, the presence of skull invasion is known to be a predictor of aggressive clinical behavior, which may negatively influence patient outcomes. In the present report, we discuss a case of fibrous meningioma with skull invasion. A 42-year-old woman was referred to our department presenting with hyperostosis in the right parietal bone. T1-weighted magnetic resonance imaging with gadolinium enhancement revealed prominent enhancement of the intraosseous lesion and dura mater. Following the removal of the tumor body and bone lesion, we performed immunohistochemical staining for osteopontin (OPN), matrix metalloproteinase- 2 (MMP2), and integrin β-1 (CD29). The tumor body was immunoreactive for OPN and CD29, but not MMP2, whereas, the bone lesion was immunoreactive for all the three antigens. The present case suggests that OPN, MMP2, and CD29 play key regulatory roles in bone invasion.