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Abstract

Giant cell granuloma is rare in the head and neck region and most commonly affects the maxilla and mandible. Giant cell granulomas are benign but occasionally aggressive lesions that are traditionally treated with surgery. Because it is a benign process, less radical and non-surgical treatment alternatives are required. Corticosteroid injection is a viable alternative in the treatment of central giant cell granuloma to avoid surgery. We aim to present a case which was successfully treated with intralesional corticosteroid injection in the maxilla

Keywords

• Giant cell granuloma; intralesional corticosteroid injection; maxilla; nonsurgical intraleztonel kortikostreroid enjeksiyonu; üst çene; treatment; surgical treatmentcerrahi olmayan tedavi; cerrahi tedavi

Dev Hücreli Reparatif Granulomanın İntralezyonel Kortikosteroid Enjeksiyonu ile Tedavisi: Olgu sunumu

Abstract

Dev Hücreli Reparatif Granuloma (DHRG) baş boyun bölgesinde nadir görülmekle birlikte genellikle maksilla ve mandibulayı etkiler. DHRG selim bir lezyondur ancak genellikle agresif olup tedavisi geleneksel olarak cerrahidir. Lezyonun selim karakteri nedeniyle daha az radikal olan ve cerrahi olmayan tedavi şekilleri tercih edilmektedir. DHRG tedavisinde cerrahiden kaçınıldığı durumlarda kortikosteroid enjeksiyonu alternatif bir tedavi olarak düşünülebilir. Bu yayında amacımız; maksillada intralezyonel kortikosteroid enjeksiyonu ile başarıyla tedavi ettiğimiz bir olgumuzu sunmaktır.

Keywords

• Dev hücreli granuloma, intraleztonel kortikostreroid enjeksiyonu, üst çene, cerrahi olmayan tedavi, cerrahi tedavi

References

1. Jaffe HL. Giant-cell reperative granuloma, traumatic bone cyst, and fibrous (fibro-osseous) dysplasia of the jawbones. Oral Surg Oral Med Oral Pathol 1953;6(1):159-175.
2. Regezi JA. Comments on pathogenesis and medical treatment of central giant cell granulomas. J Oral Maxillofac Surg 2004;62(1):116-118.
3. Barnes L, Eveson JW, Reichart P, Sidransky D (eds), Pathology and genetics of head and neck tumours. In: Kleihues P, Sobin LH (eds), World Health Organization classification of tumours. Lyon, France: IARC Press, 2005
4. Cawson RA, Odell EW, Porter S. Cawson’s Essentials of Oral Pathology and Oral Medicine.Edinburg:Churchill Livingstone;Seventh edition.2002;139-141.
5. Miloro M, Quinn PD. Synchronous central giant cell lesions of the jaws: report of a case and review of the literature. J Oral Maxillofac Surg 1995;53(11):1350-1355.
6. Whitaker SB, Waldron CA. Central giant cell lesions of the jaws. A clinical, radiologic, and histopathologic study. Oral Surg Oral Med Oral Pathol 1993;75(2):199-208.
7. Chuong R, Kaban LB, Kozakewich H, Perez-Atayde A. Central giant cell lesions of the jaws: a clinicopathologic study. J Oral Maxillofac Surg 1986;44(9):708-713.
8. Gungormus M, Akgul HM. Central giant cell granuloma of the jaws: a clinical and radiological study. J Contemp Dent Pract 2003;4(3):87-97.

9. Tosco P, Tanteri G, Iaquinta C, Fasolis M, Roccia F, Berrone S, Garzino-Demo P. Surgical treatment and reconstruction for central giant cell granuloma of the jaws: a review of 18 cases. J Craniomaxillofac Surg 2009;37(7):380-387.
10. de Lange J, van den Akker HP, Klip H. Incidence and disease-free survival after surgical therapy of central giant cell granulomas of the jaw in The Netherlands: 1990-1995. Head Neck 2004;26(9):792-795.
11. 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(8):756–760.
12. Terry BC, Jacoway JR. Management of central giant cell lesion: an alternative to surgical therapy. Oral Maxillofac Surg Clin North Am 1994;6:579-600.
13. Sabanas AO, Dahlin DC, Childs DS Jr, Ivins JC. Postradiation sarcoma of bone. Cancer 1956;9(3):528-542.
14. Eisenbud L, Stern M, Rothberg M, Sachs SA. Central giant cell granuloma of the jaws: experiences in the management of thirty-seven cases. J Oral Maxillofac Surg 1988;46(5):376–384.
15. Cheng YY, Huang L, Kumta SM, Lee KM, Lai FM, Tam JS. Cytochemical and ultrastructural changes in the osteoclast-like giant cells of giant cell tumor of bone following bisphosphonate administration. Ultrastruct Pathol 2003;27(6):385-391.
16. Kaban LB, Mulliken JB, Ezekowitz RA, Ebb D, Smith PS, Folkman J. Antiangiogenic therapy of a recurrent giant cell tumor of the mandible with interferon alpha-2a. Pediatrics 1999;103(6 Pt 1):1145-1149.
17. Kaban LB, Troulis MJ, Ebb D, August M, Hornicek FJ, Dodson TB. Antiangiogenic therapy with interferon alpha for giant cell lesions of the jaws. J Oral Maxillofac Surg 2002; 60(10):1103-1111.
18. Harris M. Central giant cell granulomas of the jaws regress with calcitonin therapy. Br J Oral Maxillofac Surg 1993;31(2):89-94.
19. Allon DM, Anavi Y, Calderon S. Central giant cell lesion of the jaw: nonsurgical treatment with calcitonin nasal spray. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107(6):811-818.
20. de Lange J, van den Akker HP, Veldhuijzen van Zanten GO, Engelshove HA, van den Berg H, Klip H. Calcitonin therapy in central giant cell granuloma of the jaw: a randomized double-blind placebo-controlled study. Int J Oral Maxillofac Surg
21. ;35(9):791-795.
22. Pogrel MA, Regezi JA, Harris ST, Goldring SR. Calcitonin treatment for central giant cell granulomas of the mandible: report of two cases. J Oral Maxillofacial Surg 1999;57(7): 848-853.
23. Flanagan AM, Nui B, Tinkler SM, Horton MA, Williams DM, Chambers TJ. The multinucleate cells in giant cell granulomas of the jaw are osteoclasts. Cancer 1988;62(6): 1139-1145.
24. Jacoway JR, Howell FV, Terry BC. Central giant cell granuloma: an alternative to surgical therapy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1988;66:572.
25. Kermer C, Millesi W, Watzke IM. Local injection of corticosteroids for central giant cell granuloma: a case report. Int J Oral Maxillofac Surg 1994;23(6 Pt 1):366-368.
26. Carlos R, Sedano HO. Intralesional corticosteroids as an alternative treatment for central giant cell granuloma. Oral Surg Oral Med Oral Pathol Orla Radiol Endod 2002;93(2): 161-166.
27. Kurtz M, Mesa M, Alberto P. Treatment of a central giant cell lesion of the mandible with intralesional glucocorticosteroids. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;91(6):636-637.
28. Rajeevan NS, Soumithran CS. Intralesional corticosteroid injection for central giant cell granuloma. A case report. Int J Oral Maxillofac Surg 1998;27(4):303-304.
29. Sezer B, Koyuncu B, Gomel M, Gunbay T. Intralesional corticosteroid injection for central giant cell granuloma: a case report and review of the literature. Turk J Pediatr 2005; 47(1):75-81.