Central giant cell granuloma in a 10-year-old girl: microsurgical reconstruction with a microvascularized fibula flap
DOI:
https://doi.org/10.18203/2349-2902.isj20231975Keywords:
CGCG, Central giant cell lesion, Mandibular diseases, Surgical approachAbstract
Central giant cell granuloma (CGCG) are rare, proliferative, benign bone tumors characterized by an abundance of multinucleated giant cells. It affects children and young adults, predominantly women, in the second and third decade of life, it’s commonly found in the mandible. The main treatment for giant cell tumors is surgical excision with free histologic margins; in case of mandibular involvement, the use of a vascularized composite bone flap represents the standard for a functional reconstruction. We present the case of a female patient in the first decade of life with a CGCG of aggressive type, located in the ascending branch and right mandibular angle. En bloc resection of the lesion was performed, with a 2-cm margin and mandibular reconstruction at the same surgical time with a free microvascularized flap from the right fibula. CGCG are rare and infrequent tumors during childhood. Due to its uncertain behavior, it is important to rule out other differential diagnoses prior to definitive treatment.
Metrics
References
Kerdoud O, Aloua R, Slimani F. Central Giant cell tumor of jaw bone in child: A case report. Int J Surg Case Rep. 2021;79:97-100.
Kim TS, Usera GL, Ruggiero SL, Weinerman SA. Improvement of giant cell lesions of the jaw treated with high and low doses of denosumab: A case series: Giant cell lesions of the jaw treated with high & low doses of denosumab. JBMR Plus. 2017;1(2):101-6.
Giri GVV, Sukumaran G, Ravindran C, Narasimman M. Giant cell tumor of the mandible. J Oral Maxillofac Pathol. 2015;19(1):108.
Krakowczyk L. Multifocal central giant cell granuloma of the mandible in 9-year-old boy with one stage surgery using fibula free flaps with virtual surgical planning. Ann Nutr Disord Ther. 2018;5(8).
González-García R, Naval-Gías L, Rodríguez-Campo FJ, Muñoz-Guerra MF, Sastre-Pérez J. Vascularized free fibular flap for the reconstruction of mandibular defects: clinical experience in 42 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;106(2):191-202.
Kaffe I, Ardekian L, Taicher S, Littner MM, Buchner A. Radiologic features of central giant cell granuloma of the jaws. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;81(6):720-6.
Bataineh AB, Al-Khateeb T, Rawashdeh MA. The surgical treatment of central giant cell granuloma of the mandible. J Oral Maxillofac Surg. 2002;60(7):756-61.
Runyan CM, Sharma V, Staffenberg DA, Levine JP, Brecht LE, Wexler LH et al. Jaw in a day: State of the art in maxillary reconstruction. J Craniofac Surg. 2016;27(8):2101-4.