Department of Oral and Maxillofacial Radiology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Oral and Maxillofacial Radiology, School of Dentistry, North Khorasan University of Medical Sciences, Bojnurd, Iran.
J Med Case Rep. 2024 May 21;18(1):255. doi: 10.1186/s13256-024-04571-7.
A central giant cell granuloma (CGCG) is a benign, proliferative, intraosseous, and non-odontogenic lesion occurring primarily in children and young adults. On the histological level, it is characterized by numerous multinucleated giant cells scattered randomly throughout a sea of spindle-shaped mesenchymal stromal cells which are dispersed throughout the fibrovascular connective tissue stroma containing areas of haemorrhage. When it comes to radiographic features, CGCG can have an array of variations, ranging from well-defined expansile lesions to ill-defined and destructive lesions, with or without expansion.
This case report reviews an 11-year-old Caucasian patient with a chief complaint of slow-growing swelling involving the right posterior mandibular region. The cone beam computed tomography (CBCT) revealed an ill-defined mixed lesion mimicking both fibro-osseous lesion and hemangioma. However, microscopic examination revealed multinucleated giant cells in a fibrous stroma suggestive of central giant cell granuloma.
Our intent in reporting this case is to highlight the importance of thorough clinical, radiographical and histopathological examination for accurate diagnosis and therapeutic interventions as well as to emphasize the importance of taking different possibilities into consideration when examining bony swellings in the head and neck region.
中央性颌骨 giant 细胞肉芽肿（CGCG）是一种良性、增殖性、骨内、非牙源性病变，主要发生在儿童和年轻成人中。在组织学水平上，其特征是大量多核巨细胞随机散布在梭形间充质基质细胞海中，这些细胞散布在富含出血区的纤维血管结缔组织基质中。在影像学特征方面，CGCG 可以有多种变化，从界限清楚的膨胀性病变到界限不清的破坏性病变，有或无膨胀。
本病例报告回顾了一名 11 岁白人患者，主要症状为右下颌后区缓慢生长的肿胀。锥形束 CT（CBCT）显示界限不清的混合性病变，类似于纤维骨性病变和血管瘤。然而，显微镜检查显示纤维基质中有多核巨细胞，提示中央性颌骨 giant 细胞肉芽肿。
我们报告这个病例的目的是强调全面的临床、影像学和组织病理学检查对于准确诊断和治疗干预的重要性，并强调在检查头颈部骨肿胀时要考虑到不同可能性的重要性。
