Pharmacological and surgical therapy for the central giant cell granuloma: A long-term retrospective cohort study

• Published in: Journal of cranio-maxillo-facial surgery 2017-02, Vol.45 (2), p.232-243
• Main Authors: Schreuder, Willem Hans, DMD, MD, van den Berg, Henk, MD PhD, Westermann, Anneke Marie, MD PhD, Peacock, Zachary Scott, DMD, MD, de Lange, Jan, DMD, MD, PhD
• Format: Article
• Language: English
• Subjects: Adolescent; Adrenal Cortex Hormones - therapeutic use; Adult; Benign bone lesion; Calcitonin; Calcitonin - therapeutic use; Central giant cell granuloma; Child; Child, Preschool; Combined Modality Therapy; Dentistry; Female; Granuloma, Giant Cell - drug therapy; Granuloma, Giant Cell - surgery; Granuloma, Giant Cell - therapy; Humans; Interferon; Jaw Neoplasms - drug therapy; Jaw Neoplasms - surgery; Jaw Neoplasms - therapy; Male; Mandible; Mandibular Neoplasms - drug therapy; Mandibular Neoplasms - surgery; Mandibular Neoplasms - therapy; Maxilla; Maxillary Neoplasms - drug therapy; Maxillary Neoplasms - surgery; Maxillary Neoplasms - therapy; Middle Aged; Retrospective Studies; Surgery; Treatment Outcome; Young Adult
• ISSN: 1010-5182; 1878-4119
• DOI: 10.1016/j.jcms.2016.11.011

Summary Purpose This is a retrospective cohort study of patients with a central giant cell granuloma (CGCG) treated at a single center to assess and compare the different surgical and non-surgical approaches. Material and Methods A cohort with a single histologically proven non−syndrome-related CGCG was selected and reviewed. Patients were allocated to group I (surgery), group II (pharmacotherapy), and group III (pharmacotherapy and surgery). The primary outcome was long-term radiologic response using computed tomography. Secondary outcomes were intermediate radiologic responses and occurrence and severity of side effects. Results Thirty-three subjects were included in the study. The surgical group (n=4) included 1 patient with progression during follow-up and a relatively high post-surgical morbidity. Twenty-nine patients started on various pharmacological treatment regimens (groups II and III). Fourteen patients could be managed without additional surgery. One of these lesions showed progression during follow-up. The other 15 lesions underwent additional surgery, and none showed progression during follow-up. Interferon treatment was associated with the most side effects. Conclusion Pharmacological agents have a role in the treatment of aggressive and non-aggressive CGCGs by limiting the renewed progression during long-term follow up and the extent and morbidity of surgical treatment.