Adornato M C, Paticoff K A
Department of Oral and Maxillofacial Surgery, Nassau County Medical Center, 2201 Hempstead Turnpike, East Meadow, N.Y. 11554, USA.
J Am Dent Assoc. 2001 Feb;132(2):186-90. doi: 10.14219/jada.archive.2001.0153.
The central giant cell granuloma, or CGCG, is a benign intraosseous lesion of the jaw. It is found predominantly in children and young adults. It is an asymptomatic lesion, which often becomes evident on routine radiographic examination. Giant cell lesions have been described as both nonaggressive and aggressive in nature, with recurrence noted in cases of aggressive lesions. Central giant cell lesions present as unilocular or multilocular radiolucent defects on radiographs. Multinucleated giant cells within a collagenous stroma are the characteristic histopathologic feature of CGCG.
The authors describe a 10-year-old girl with an expansile lesion of the mandible. The panoramic radiograph showed a well-circumscribed mixed radiolucent-radiopaque lesion of the left mandibular body. An incisional biopsy of the lesion was performed to establish a histologic diagnosis. The specimen was submitted for frozen-section examination, and a diagnosis of CGCG was made. Serum calcium, parathyroid hormone and phosphorous levels were normal. The patient was treated successfully with intralesional corticosteroid injections.
Central giant cell lesions have been treated surgically with aggressive curettage. More aggressive and recurrent lesions require resection, which leads to major defects of the jaws. This form of surgical treatment can be particularly disfiguring for a child or young adult. An alternative nonsurgical approach is the intralesional administration of corticosteroids, which have been effective in the treatment of CGCG. If a dentist suspects a patient may have CGCG, he or she should refer the patient to an oral surgeon for follow-up.
中央巨细胞肉芽肿（CGCG）是颌骨的一种良性骨内病变。主要见于儿童和年轻人。它是一种无症状病变，常在常规影像学检查时被发现。巨细胞病变在性质上既有非侵袭性的，也有侵袭性的，侵袭性病变有复发的报道。中央巨细胞病变在X线片上表现为单房或多房的透射性缺损。胶原基质内的多核巨细胞是CGCG的特征性组织病理学特征。
作者报告一名10岁女孩，下颌骨有一膨胀性病变。全景X线片显示左下颌骨体有一个边界清晰的透射性与阻射性混合病变。对该病变进行了切开活检以确立组织学诊断。标本送做冰冻切片检查，诊断为CGCG。血清钙、甲状旁腺激素和磷水平正常。患者通过病灶内注射皮质类固醇成功治愈。
中央巨细胞病变过去采用积极刮治术进行手术治疗。更具侵袭性和复发性的病变需要切除，这会导致颌骨的重大缺损。这种手术治疗方式对儿童或年轻人可能特别毁容。另一种非手术方法是病灶内注射皮质类固醇，这已被证明对治疗CGCG有效。如果牙医怀疑患者可能患有CGCG，应将患者转诊给口腔外科医生进行后续治疗。
