Oral and Maxillofacial Pathology
Clinical and radiological features of central giant-cell lesions of the jaw

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Objective

The purpose of this study was to evaluate the clinical and radiological features of central giant-cell lesions that were diagnosed in The Netherlands between January 1, 1990, and January 1, 1995.

Study design

A population-based retrospective study was carried out, examining all patients with a central giant-cell lesion from this period.

Results

In 83 patients there was a central giant-cell granuloma (89 lesions). Aggressive signs and symptoms (pain, paresthesia, or root resorption) were found in 16 (19.3%) patients. Multiple lesions occurred in 3 (3.6%) patients. The overall recurrence rate was 26.3%, and there was a higher recurrence rate in patients who exhibited aggressive signs and symptoms than in patients without these features (RR 1.6). In 5 patients a clinical diagnosis of cherubism or concomitant neurofibromatosis type 1 was made (14 lesions).

Conclusion

In a general population, large and aggressive lesions are less common than suggested by the literature. Multiple lesions, however, occur more frequently than previously assumed. In patients with aggressive signs and symptoms, surgical curettage is not an effective therapy.

Section snippets

Material and methods

We reviewed all histologically confirmed giant-cell lesions in The Netherlands from 1990 to 1995 through PALGA (Pathologisch Anatomisch Landelijk Geautomatiseerd Archief). PALGA is an automated registration system with 100% coverage of all histology diagnoses in The Netherlands.

The data were retrieved from the records of the patients with CGCG who we screened for our earlier paper.20 The data were evaluated in 2002, so that sufficient time had elapsed to reliably evaluate the clinical course of

Results

From 1990 to 1995, 124 patients with giant-cell lesions were recorded, of whom 24 patients exhibited extra osseous or peripheral lesions. In 4 patients hyperparathyroidism was found and in 5 patients cherubism or a concomitant syndrome was diagnosed. This resulted in 91 patients with CGCG. In 8 patients the CGCG was a recurrence of a lesion from an earlier period, so that 83 patients with new CGCGs were diagnosed over the period from 1990 to 1995 (male/female = 36/47). The mean age at the time of

Discussion

Until recently, information on the epidemiological features of CGCGs was based on clustered groups of patients, and as such provided no indication of the occurrence of CGCGs in a general population. In a previous paper on epidemiological findings of CGCG in The Netherlands,20 we found an incidence of 0.00011% in the Dutch population. In the absence of similar data from other general populations, we assume that this figure approximately represents the incidence of CGCG elsewhere in the world. In

Conclusion

This 5-year population-based study includes all patients with central giant-cell lesions of the jaw in The Netherlands.

In a general population, large and aggressive CGCGs are less common than suggested by the literature. Multiple lesions in patients with CGCG, however, occur more frequently than previously assumed. There was also a strong association between multiple lesions and disorders such as neurofibromatosis type 1 and Noonan syndrome.

Evaluation of the surgical therapy in the population

References (34)

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