Intralesional corticosteroid injections in the treatment of central 
giant cell lesions of the jaws: A meta-analytic study

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Abstract

Objective: The aim of this study was to evaluate the response of treatment of central giant cell lesion to intralesional corticosteroid injections. Study Design: Review of articles indexed in PubMed on the topic between the years 1988 and 2011, and development of a descriptive meta-analysis of the results. Results: Sample of 41 patients primarily treated with intralesional corticosteroid injections was obtained, with a male female ratio of 1:0.95, being 23 aggressive and 18 non-aggressive central giant cell lesions. Triamcinolone acetonide and triamcinolone hexacetonide were the drugs used, and 78.0% cases were considered as good result, 14.6% were considered as moderate response and 7.3% were considered as negative result to treatment. Considering the aggressiveness, 88.9% of non-aggressive lesions presented a good response to treatment, in aggressive central giant cell lesions, 69.6% presented a good response to intralesional corticosteroid injections. Conclusion: In view of the results analyzed, intralesional corticosteroid injections could be considered as first treatment option for central giant cell lesion.

Key words:Central giant cell lesion, corticosteroids injections, triamcinolone hexacetonide, triamcinolone acetonide.

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Most cited references 35

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Central giant cell lesions of the jaws: a clinicopathologic study.

R Chuong, Vinicio A De Jesus Perez, H Kozakewich … (1986)

The biologic behavior of central giant cell lesions of the jaws ranges from quiescent to aggressive with destructive expansion. To date, these variations have not been explained by the findings of routine histologic examination. This retrospective clinicopathologic study of giant cell lesions was performed to search for histologic correlates of biologic behavior. Lesions in 17 patients were classified clinically as nonaggressive (group I) or aggressive (group II). In general, group II lesions affected children at an earlier age, were larger at the time of diagnosis, and recurred more frequently. The following histologic parameters were assessed: fractional surface area occupied by giant cells (FSA), relative size index of giant cells (RSI), stromal characteristics, mitotic index, inflammatory cells, and hemosiderin content. Histologic differences between the two groups were not as clear as the differences in biologic behavior. However, aggressive lesions had a higher RSI, and recurrent giant cells lesions had a higher RSI and FSA; these parameters warrant further study. In addition, electron microscopic differences in a small number of aggressive and nonaggressive lesions were documented.

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Central giant cell granuloma of the jaws: a clinical, radiologic, and histopathologic study of 26 cases.

Ulrich Joos, Karl Mischke, Florian C. Gaertner … (2006)

The clinical behavior of central giant cell granuloma (CGCG) of the jaws is variable and difficult to predict. Clinical data and follow-up information of 26 patients with CGCG were analyzed. Histologic features were correlated with the clinical course of the disease. In 16 patients the CGCGs were asymptomatic; 10 lesions presented with aggressive growth, pain, massive swelling, root resorption, cortical perforation, and/or recurrence. These patients were younger and the lesions were larger than in the nonaggressive group. The histomorphometric analysis proved a significant increase in large giant cells, fractional surface area, and mitotic activity in aggressive CGCG lesions. Immunohistologic investigation (Ki-67 and p53 stain) revealed no significant differences. After surgical treatment, 3 patients with aggressive lesions developed a recurrence. The data show that clinical and histomorphometric features may be reliable indicators for the differentiation between aggressive and nonaggressive CGCG. This should be accounted for to improve the individual planning of the treatment and follow-up.

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Clinical and radiological features of central giant-cell lesions of the jaw.

Karolien P B Van den Bergh, Robert P J de Lange (2005)

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

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Author and article information

Journal

Journal ID (nlm-ta): Med Oral Patol Oral Cir Bucal

Journal ID (iso-abbrev): Med Oral Patol Oral Cir Bucal

Journal ID (publisher-id): Medicina Oral S.L.

Title: Medicina Oral, Patología Oral y Cirugía Bucal

Publisher: Medicina Oral S.L.

ISSN (Print): 1698-4447

ISSN (Electronic): 1698-6946

Publication date (Print): March 2013

Publication date (Electronic): 5 February 2013

Volume: 18

Issue: 2

Pages: e226-e232

Affiliations

[1 ]DDS, MSc, Assistant Professor, Department of Pathology, Fortaleza University School of Medicine, Fortaleza, Brazil

[2 ]DDS, MSc student, Federal University of Ceará School of Dentistry, Fortaleza, Brazil

[3 ]DDS, MSc, PhD, Assistant Professor, Faculdade Católica Rainha do Sertão, School of Dentistry, Quixadá, Brazil

[4 ]DDS, MSc, PhD, Associate Professor, Department of Oral and Maxillofacial Pathology, Fortaleza University School of Dentistry, Fortaleza, Brazil

[5 ]DDS, MSc, PhD, Associate Professor of Oral and Maxillofacial Surgery, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil

[6 ]DDS, MSc, PhD, Associate Professor, Department of Dental Clinic, Discipline of Oral and Maxillofacial Surgery and Stomatology, Federal University of Ceara School of Dentistry, Fortaleza, Brazil. Oral and Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, Memorial Batista Hospital, Fortaleza, Brazil

Author notes

Universidade de Fortaleza Fortaleza University/ Universidad de Fortaleza Av. Washington Soares 1321, Edson Queiroz 60811-905 Fortaleza Ceará, Brasil P.O. Box 1258 , E-mail: rlimaverde@ 123456unifor.br

Article

Publisher ID: 18345

DOI: 10.4317/medoral.18345

PMC ID: 3613330

PubMed ID: 23385503

SO-VID: b94fffb8-31b6-4e6c-bdd2-891d3ca3f939

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This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Intralesional corticosteroid injections in the treatment of central giant cell lesions of the jaws: A meta-analytic study

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Most cited references 35

Central giant cell lesions of the jaws: a clinicopathologic study.

Central giant cell granuloma of the jaws: a clinical, radiologic, and histopathologic study of 26 cases.

Clinical and radiological features of central giant-cell lesions of the jaw.

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