Affiliations 

  • 1 Department of Oral Surgery, Guy's & St. Thomas Hospital, London, United Kingdom. Electronic address: vinod.patel@hotmail.co.uk
  • 2 Department of Oral and Maxillofacial Surgery, Northwick Park Hospital, Harrow, United Kingdom
  • 3 Department of Head and Neck Surgery, Liverpool Head & Neck Centre, University of Liverpool, Liverpool, United Kingdom; Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
  • 4 Department of Head and Neck Pathology, Liverpool Head and Neck Centre, Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, United Kingdom
  • 5 Department of Head and Neck Surgical Oncology, Guy's & St. Thomas Hospital, London, United Kingdom
  • 6 Department of Oral and Maxillofacial Surgery, Wirral University Teaching Hospital, Wirral, United Kingdom
  • 7 Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, Kuala Lumpur, Malaysia; Faculty of Dentistry, Oral, and Craniofacial Sciences, King's College London, Great Maze Pond, London, United Kingdom
PMID: 39709299 DOI: 10.1016/j.oooo.2024.11.086

Abstract

OBJECTIVE: The management of large central giant cell granuloma (CGCG) can pose a significant surgical challenge. In such circumstances, the use of denosumab has been proposed with the literature reporting varying degrees of success. Histopathological assessment of CGCG post-denosumab treatment remains unknown. The current case series aims to address this lack of information and supplement the literature and the debate with evidence.

STUDY DESIGN: The current case series is a retrospective review of historic cases accumulated from 3 different hospitals. Patients treated with denosumab for large or unresectable GCGC who subsequently underwent either surgical debulk or resection post drug treatment with histological tissue for assessment were included.

RESULTS: A total of 4 patients were included in this study. All cases showed radiographic response. However histological assessment identified giant cells in 3 of the 4 cases, 2 of which showed clinical recurrence. All cases demonstrated irregular woven bone formation toward the periphery of the lesion suggesting partial response.

CONCLUSIONS: The current case series provides some insight regarding the response of CGCG to denosumab and preliminary histopathological information toward the ongoing debate regarding the medical management of CGCG. (Oral Surg Oral Med Oral Pathol Oral Radiol YEAR;VOL:page range).

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.