Pharmacological and surgical therapy for the central giant cell granuloma: A long-term retrospective cohort study

J Craniomaxillofac Surg. 2017 Feb;45(2):232-243. doi: 10.1016/j.jcms.2016.11.011. Epub 2016 Dec 9.

Abstract

Purpose: This is a retrospective cohort study of patients with a central giant cell granuloma (CGCG) treated at a single center to assess and compare the different surgical and non-surgical approaches.

Material and methods: A cohort with a single histologically proven non-syndrome-related CGCG was selected and reviewed. Patients were allocated to group I (surgery), group II (pharmacotherapy), and group III (pharmacotherapy and surgery). The primary outcome was long-term radiologic response using computed tomography. Secondary outcomes were intermediate radiologic responses and occurrence and severity of side effects.

Results: Thirty-three subjects were included in the study. The surgical group (n = 4) included 1 patient with progression during follow-up and a relatively high post-surgical morbidity. Twenty-nine patients started on various pharmacological treatment regimens (groups II and III). Fourteen patients could be managed without additional surgery. One of these lesions showed progression during follow-up. The other 15 lesions underwent additional surgery, and none showed progression during follow-up. Interferon treatment was associated with the most side effects.

Conclusion: Pharmacological agents have a role in the treatment of aggressive and non-aggressive CGCGs by limiting the renewed progression during long-term follow up and the extent and morbidity of surgical treatment.

Keywords: Benign bone lesion; Calcitonin; Central giant cell granuloma; Interferon; Mandible; Maxilla.

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Calcitonin / therapeutic use
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Female
  • Granuloma, Giant Cell / drug therapy*
  • Granuloma, Giant Cell / surgery*
  • Granuloma, Giant Cell / therapy
  • Humans
  • Jaw Neoplasms / drug therapy*
  • Jaw Neoplasms / surgery*
  • Jaw Neoplasms / therapy
  • Male
  • Mandibular Neoplasms / drug therapy
  • Mandibular Neoplasms / surgery
  • Mandibular Neoplasms / therapy
  • Maxillary Neoplasms / drug therapy
  • Maxillary Neoplasms / surgery
  • Maxillary Neoplasms / therapy
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult

Substances

  • Adrenal Cortex Hormones
  • Calcitonin