Kim Tara S, Usera Gianina L, Ruggiero Salvatore L, Weinerman Stuart A
Division of Endocrinology Diabetes and Metabolism Hofstra Northwell School of Medicine at Hofstra University Manhasset NY USA.
New York Center for Orthognathic and Maxillofacial Surgery Lake Success NY USA.
JBMR Plus. 2017 Jul 25;1(2):101-106. doi: 10.1002/jbm4.10010. eCollection 2017 Oct.
Giant cell tumors (GCTs) and central giant cell granulomas (CGCGs) are aggressive lesions that appear in the jaw. These lesions occur in the second and third decades of life and often arise in the mandible. Clinical manifestations of these lesions vary from asymptomatic to symptomatic tooth displacement with cortical perforation. GCTs, which are characterized by multinucleated osteoclast-type giant cells that express receptor activator of nuclear factor-κB (RANK) ligand, rarely present in the jaw and have overlapping histopathologic features with CGCGs, which are composed of fibroblastic stromal cell lesions. GCTs and CGCGs have overlying histopathologic features that make distinction between the two challenging. There is a real controversy as to whether giant cell tumors and central giant cell granulomas are in fact, one and the same lesion. The majority of GCTs occur in the long bone, with surgery being the typical therapeutic option. Denosumab as a treatment modality is a fairly new concept that has been used effectively in GCTs affecting long bones. There is less experience, however, with its use for jaw lesions. This seven-case series describes the effective use of both low-dose and high-dose denosumab in the treatment of GCTs and CGCGs affecting the jaw and special dosing considerations for younger patients who present with disease. © 2017 The Authors. Published by Wiley Periodicals, Inc. on behalf of the American Society for Bone and Mineral Research.
巨细胞瘤（GCTs）和中央巨细胞肉芽肿（CGCGs）是发生于颌骨的侵袭性病变。这些病变出现在生命的第二个和第三个十年，且常发生于下颌骨。这些病变的临床表现各异，从无症状到出现有皮质穿孔的有症状的牙齿移位。GCTs以表达核因子κB受体激活剂（RANK）配体的多核破骨细胞样巨细胞为特征，很少出现在颌骨，并且与由成纤维细胞性基质细胞病变组成的CGCGs具有重叠的组织病理学特征。GCTs和CGCGs具有重叠的组织病理学特征，这使得区分两者具有挑战性。关于巨细胞瘤和中央巨细胞肉芽肿实际上是否为同一病变存在真正的争议。大多数GCTs发生于长骨，手术是典型的治疗选择。地诺单抗作为一种治疗方式是一个相当新的概念，已有效地用于影响长骨 的GCTs。然而，其用于颌骨病变的经验较少。这个七例系列病例描述了低剂量和高剂量地诺单抗在治疗影响颌骨的GCTs和CGCGs中的有效应用，以及对患有该疾病的年轻患者的特殊给药考虑。© 2017作者。由Wiley Periodicals, Inc.代表美国骨与矿物质研究学会出版。
