Histological analysis of a clinical case of central giant cell lesion treated with triamcinolone
DOI:
https://doi.org/10.5935/2525-5711.20170023Palabras clave:
Giant Cells, Triamcinolone, HistologyResumen
Introduction: Central giant cell lesion (CGCL) is an osteolytic lesion mainly found in gnathic bones of children and young adults. It is a benign lesion with variable clinical and radiographic behavior but it may be aggressive. Intralesional corticoid application has been proposed as an alternative and complementary procedure to radical surgical treatment, to minimize functional and aesthetic damage. Objectives: This paper aims to report a case of a pediatric patient with CGCL of the jaw, which was treated withconservative treat- ment of two intralesional applications of triamcinolone and discuss if there is an ideal waiting period between nonoperative treatment and the need for surgical intervention. Methods: This report shows a quantitative analysis of histological alterations induced by intralesional infiltrations of triamcinolone into a clinical resistant CGCL. A 7-year-old patient was submitted to a conservative treatment of two intralesional applications of triamcinolone into a mandible CGCL. Results and Conclusion: Histological evaluation showed reduction in the number of blood vessels and of giant multinucleated cells, besi- de an increased collagen production. The triamcinolone induced histological alterations seem to interfere in the clinical behavior of the lesion thus, recommending a less radical surgical treatment.
Citas
Teixeira RC, Horz HP, Damante JH, Garlet GP, Santos CF, Nogueira RL, et al. SH3BP2-encoding exons involved in cherubism are not associated with central giant cell granuloma. Int J Oral Maxillofac Surg. 2011;40:851-5.
Kruse-Lösler B, Diallo R, Gaertner C, Mischke K, Joos U, Kleinheinz J. Central giant cell granuloma of the jaws: a clinical, radiologic, and histopathologic study of 26 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101:346-54.
Rachmiel A, Emodi O, Sabo E, Aizenbud D, Peled M. Combined treatment of aggressive central giant cell granuloma in the lower jaw. J Craniomaxillofac Surg. 2012;40:292-7.
de Lange J, van den Akker H. Clinical and radiological features of central giant-cell lesions of the jaw. Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;99:464-70.
Tosco P, Tanteri G, Iaquinta C, Fasolis M, Roccia F, Berrone S, et al. Surgical treatment and reconstruction for central giant cell granuloma of the jaws: a review of 18 cases. J Craniomaxillofac Surg. 2009;37:380-7.
Sezer B, Koyuncu B, Gomel M, Günbay T. Intralesional corticosteroid injection for central giant cell granuloma: a case report and review of the literature. Turk J Pediatr. 2005;47:75-81.
Delgado-Azañero WA, Concha-Cusihuallpa H, Cabello-Morales EA, Guevara-Canales JO, Beltrán Silva JA. Granuloma central de células gigantes en un niño tratado con corticoide intralesional. Rev Estomatol Hered. 2007;17:76-83.
de Lange J, van den Akker HP, van den Berg H. Central giant cell granuloma of the jaw: a review of the literature with emphasis on therapy options. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104:603-15.
Theologie-Lygidakis N, Telona P, Michail-Strantzia C, Iatrou I. Treatment of central giant-cell granulomas of the jaws in children: conservative or radical surgical approach? J Craniomaxillofac Surg. 2011;39:639-44.
Carlos R, Sedano HO. Intralesional corticosteroids as an alternative treatment for central giant cell granuloma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;93:161-6.
Nogueira RL, Faria MH, Osterne RL, Cavalcante RB, Ribeiro RA, Rabenhorst SH. Glucocorticoid and calcitonin receptor expression in central giant cell lesions: implications for therapy. Int J Oral Maxillofac Surg. 2012;41:994-1000.
Vered M, Buchner A, Dayan D. Immunohistochemical expression of glucocorticoid and calcitonin receptors as a tool for selecting therapeutic approach in central giant cell granuloma of the jawbones. Int J Oral Maxillofac Surg. 2006;35:756-60.
Tiffee JC, Aufdemorte T. Markers for macrophage and osteoclast lineages in giant cell lesions of the oral cavity. J Oral Maxillofac Surg. 1997;55:1108-12.
Tobón-Arroyave SI, Franco-González LM, Isaza-Guzmán DM, Floráz-Moreno GA, Bravo-Vásquez T, Castañeda-Peláez DA, et al. Immunohistochemical expression of RANK, GRalpha and CTR in central giant cell granuloma of the jaws. Oral Oncol. 2005;41(5):480-8.
