Denosumab, an adjunctive method in central giant cell granuloma treatment: A case report
Abstract
Central giant cell granuloma (CGCG) is a benign intraosseous pathology. A 17 years old male patient was referred and diagnosed with CGCG from mandibular right first molar to mandibular left second premolar. Enucleation and curettage of the lesion were completed as the main treatment. Involved teeth on the right, 41, 42, 43, 44, and 45 (FDI) were extracted. As adjunctive therapy, 120 mg Denosumab was injected subcutaneously. The patient received sixteen sessions of therapy through 11 months. Two, sixteen, and eighteen months follow-up after the first session of injection showed an acceptable improvement in bone contour. The patient experienced no functional or aesthetic impairment. Alongside the promising results of Denosumab as adjunctive therapy in the management and treatment of diseases such as CGCG, some questions have remained unanswered and no protocol has been determined. The authors of the current study recommend further researches to confirm Denosumab as a potential adjunctive or alternative in the treatment of CGCG.
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2. de Mendonça RP, Mitre GP, Real FH, da Silva Kataoka MS, de Melo Alves Júnior S, Vianna P, et al. 2020 Central Giant Cell Granuloma Treated with Intralesional Corticosteroid Injections and Bisphosphonates: A Long-Term Follow-Up Case Study. Head Neck Pathol [Internet].14:497?502. Available from: https://doi.org/10.1007/s12105-019-01053-x
3. Everts-Graber J, Reichenbach S, Gahl B, Ziswiler HR, Studer U, Lehmann T. 2021 Risk factors for vertebral fractures and bone loss after denosumab discontinuation: A real-world observational study. Bone. 144:115830. Available from: https://doi.org/10.1016/j.bone.2020.115830
4. van der Heijden L, Dijkstra S, van de Sande M, Gelderblom H. 2020 Current concepts in the treatment of giant cell tumour of bone. Curr Opin Oncol. 32:332?338.
5. Jiang T, Mao Y, Ma W, Mao Q, You Y, Yang X, et al. 2016 CGCG clinical practice guidelines for the management of adult diffuse gliomas. Cancer Lett. 375:263?273. Available from: http://dx.doi.org/10.1016/j.canlet.2016.01.024
6. Shrestha S, Zhang J, Yan J, Zeng X, Peng X, He B. 2021 Radiological features of Central Giant Cell Granuloma: Comparative study of 7 case reports and literature review. Dentomaxillofac radiolog.50:1?14.
7. Muramatsu K, Tani Y, Seto T, Roces G, Yamamoto M, Ichihara Y, et al. 2020 Two cases with giant cell tumor arising from the sternum: Diagnosis and options for treatment. J Orthop Sci. 19:10?15. Available from: https://doi.org/10.1016/j.jos.2019.10.014
8. Elmezwghi AM, Alarabi NM, Elsagali AH, Zariba SS, BenGharbia NE MN. 2020 an aggressive central giant cell granuloma of the maxilla: diagnostic dilemma, precise differential diagnosis and successful traditional surgical approach: a case report. Ecyptian Dent J.66:2075?2083.
9. Upfill-Brown A, Bukata S, Bernthal NM, Felsenfeld AL, Nelson SD, Singh A, et al. 2019 Use of Denosumab in Children With Osteoclast Bone Dysplasias: Report of Three Cases. JBMR Plus. 3:1?7.
10. Lipplaa A, Dijkstra S, Gelderblom H. 2019 Challenges of denosumab in giant cell tumor of bone, and other giant cell-rich tumors of bone. Curr Opin Oncol. 31:329?335.
11. Nasir U, Maryam B, Marwat T, Nausheen N. 2019 Clinical and Radiographic Presentation of Central Giant Cell Granulomas of Jaws. Khyber Med Univ J. 11:231?235.
12. Scoccianti G, Totti F, Scorianz M, Baldi G, Roselli G, Beltrami G, et al. 2018 Preoperative denosumab with curettage and cryotherapy in giant cell tumor of bone: Is there an increased risk of local recurrence? Clin Orthop Relat Res.476:1783?1790.
13. Dds SS, Dds RF. 2009 Archive of SID Central Giant Cell Granuloma : endodontic misdiagnosis Archive of SID. 4:158?160.
14. Jadu FM, Pharoah MJ, Lee L, Baker GI, Allidina A. 2011 Central giant cell granuloma of the mandibular condyle: A case report and review of the literature. Dentomaxillofacial Radiol.40:60?64.
15. Bredell M, Rordorf T, Kroiss S, Rücker M, Zweifel DF, Rostetter C. 2018 Denosumab as a Treatment Alternative for Central Giant Cell Granuloma: A Long-Term Retrospective Cohort Study. J Oral Maxillofac Surg. 76:775?784. Available from: https://doi.org/10.1016/j.joms.2017.09.013
16. Atarbashi Moghadam S, Ghorbanpour M. 2017 Central Giant Cell Granuloma of the Jaws: Correlation between Vascularity and Biologic Behavior. J Dent Mater Tech. 6:35?39.
17. Motamedi MHK, Eshghyar N, Jafari SM, Lassemi E, Navi F, Abbas FM, et al. 2007 Peripheral and central giant cell granulomas of the jaws: A demographic study. Oral Surg, Oral Med Oral Pathol Oral Radiol Endodontolog. 103:39?43.
18. Palmerini E, Chawla NS, Ferrari S, Sudan M, Picci P, Marchesi E, et al. 2017 Denosumab in advanced/unresectable giant-cell tumour of bone (GCTB): For how long? Eur J Cancer. 76:118?124. Available from: http://dx.doi.org/10.1016/j.ejca.2017.01.028
19. Tenore G, Palaia G, Capocci M, Impellizzeri A, Romeo U. 2014 The central giant cells granuloma of the mandible : a report of two cases and a review of the literature. Senses Sci. (1):30?38.
20. Kim TS, Usera GL, Ruggiero SL, Weinerman SA. 2017 Improvement of Giant Cell Lesions of the Jaw Treated With High and Low Doses of Denosumab: A Case Series. JBMR Plus. 1:101?106.
21. De Lange J. UvA-DARE (Digital Academic Repository) 2006 Central giant cell granuloma of the jaw: epidemiology, therapy and related disorders. Elsevier. Available from: http://dare.uva.nl
22. Afsoun S, Saied S, Amir N, Hamed J. 2018 En-bloc resection of a giant cell tumor causing cervical vertebral collapse. Asian J Neurosurg. 13:150?153. Available from: /pmc/articles/PMC5820874/
23. Naidu A, Malmquist M, Denham CA, Schow SR. 2014 Management of central giant cell granuloma with subcutaneous denosumab therapy. J Oral Maxillofac Surg. 72:2469?2484. Available from: https://www.sciencedirect.com/science/article/pii/S027823911401115X
24. Rutkowski P, Gaston L, Borkowska A, Stacchiotti S, Gelderblom H, Baldi GG, et al. 2018 Denosumab treatment of inoperable or locally advanced giant cell tumor of bone – Multicenter analysis outside clinical trial. Eur J Surg Oncol. 44:1384?1390. Available from: https://doi.org/10.1016/j.ejso.2018.03.020
25. Reid R, Ruggiero SL. 2017 Case-Based Review of Osteonecrosis of the Jaw (ONJ) and Application of the International Recommendations for Management From the International Task Force on ONJ. J Clin Densitom Assess Manag Musculoskelet Heal. 10:8?24. Available from: http://dx.doi.org/10.1016/j.jocd.2016.09.0058
2. de Mendonça RP, Mitre GP, Real FH, da Silva Kataoka MS, de Melo Alves Júnior S, Vianna P, et al. 2020 Central Giant Cell Granuloma Treated with Intralesional Corticosteroid Injections and Bisphosphonates: A Long-Term Follow-Up Case Study. Head Neck Pathol [Internet].14:497?502. Available from: https://doi.org/10.1007/s12105-019-01053-x
3. Everts-Graber J, Reichenbach S, Gahl B, Ziswiler HR, Studer U, Lehmann T. 2021 Risk factors for vertebral fractures and bone loss after denosumab discontinuation: A real-world observational study. Bone. 144:115830. Available from: https://doi.org/10.1016/j.bone.2020.115830
4. van der Heijden L, Dijkstra S, van de Sande M, Gelderblom H. 2020 Current concepts in the treatment of giant cell tumour of bone. Curr Opin Oncol. 32:332?338.
5. Jiang T, Mao Y, Ma W, Mao Q, You Y, Yang X, et al. 2016 CGCG clinical practice guidelines for the management of adult diffuse gliomas. Cancer Lett. 375:263?273. Available from: http://dx.doi.org/10.1016/j.canlet.2016.01.024
6. Shrestha S, Zhang J, Yan J, Zeng X, Peng X, He B. 2021 Radiological features of Central Giant Cell Granuloma: Comparative study of 7 case reports and literature review. Dentomaxillofac radiolog.50:1?14.
7. Muramatsu K, Tani Y, Seto T, Roces G, Yamamoto M, Ichihara Y, et al. 2020 Two cases with giant cell tumor arising from the sternum: Diagnosis and options for treatment. J Orthop Sci. 19:10?15. Available from: https://doi.org/10.1016/j.jos.2019.10.014
8. Elmezwghi AM, Alarabi NM, Elsagali AH, Zariba SS, BenGharbia NE MN. 2020 an aggressive central giant cell granuloma of the maxilla: diagnostic dilemma, precise differential diagnosis and successful traditional surgical approach: a case report. Ecyptian Dent J.66:2075?2083.
9. Upfill-Brown A, Bukata S, Bernthal NM, Felsenfeld AL, Nelson SD, Singh A, et al. 2019 Use of Denosumab in Children With Osteoclast Bone Dysplasias: Report of Three Cases. JBMR Plus. 3:1?7.
10. Lipplaa A, Dijkstra S, Gelderblom H. 2019 Challenges of denosumab in giant cell tumor of bone, and other giant cell-rich tumors of bone. Curr Opin Oncol. 31:329?335.
11. Nasir U, Maryam B, Marwat T, Nausheen N. 2019 Clinical and Radiographic Presentation of Central Giant Cell Granulomas of Jaws. Khyber Med Univ J. 11:231?235.
12. Scoccianti G, Totti F, Scorianz M, Baldi G, Roselli G, Beltrami G, et al. 2018 Preoperative denosumab with curettage and cryotherapy in giant cell tumor of bone: Is there an increased risk of local recurrence? Clin Orthop Relat Res.476:1783?1790.
13. Dds SS, Dds RF. 2009 Archive of SID Central Giant Cell Granuloma : endodontic misdiagnosis Archive of SID. 4:158?160.
14. Jadu FM, Pharoah MJ, Lee L, Baker GI, Allidina A. 2011 Central giant cell granuloma of the mandibular condyle: A case report and review of the literature. Dentomaxillofacial Radiol.40:60?64.
15. Bredell M, Rordorf T, Kroiss S, Rücker M, Zweifel DF, Rostetter C. 2018 Denosumab as a Treatment Alternative for Central Giant Cell Granuloma: A Long-Term Retrospective Cohort Study. J Oral Maxillofac Surg. 76:775?784. Available from: https://doi.org/10.1016/j.joms.2017.09.013
16. Atarbashi Moghadam S, Ghorbanpour M. 2017 Central Giant Cell Granuloma of the Jaws: Correlation between Vascularity and Biologic Behavior. J Dent Mater Tech. 6:35?39.
17. Motamedi MHK, Eshghyar N, Jafari SM, Lassemi E, Navi F, Abbas FM, et al. 2007 Peripheral and central giant cell granulomas of the jaws: A demographic study. Oral Surg, Oral Med Oral Pathol Oral Radiol Endodontolog. 103:39?43.
18. Palmerini E, Chawla NS, Ferrari S, Sudan M, Picci P, Marchesi E, et al. 2017 Denosumab in advanced/unresectable giant-cell tumour of bone (GCTB): For how long? Eur J Cancer. 76:118?124. Available from: http://dx.doi.org/10.1016/j.ejca.2017.01.028
19. Tenore G, Palaia G, Capocci M, Impellizzeri A, Romeo U. 2014 The central giant cells granuloma of the mandible : a report of two cases and a review of the literature. Senses Sci. (1):30?38.
20. Kim TS, Usera GL, Ruggiero SL, Weinerman SA. 2017 Improvement of Giant Cell Lesions of the Jaw Treated With High and Low Doses of Denosumab: A Case Series. JBMR Plus. 1:101?106.
21. De Lange J. UvA-DARE (Digital Academic Repository) 2006 Central giant cell granuloma of the jaw: epidemiology, therapy and related disorders. Elsevier. Available from: http://dare.uva.nl
22. Afsoun S, Saied S, Amir N, Hamed J. 2018 En-bloc resection of a giant cell tumor causing cervical vertebral collapse. Asian J Neurosurg. 13:150?153. Available from: /pmc/articles/PMC5820874/
23. Naidu A, Malmquist M, Denham CA, Schow SR. 2014 Management of central giant cell granuloma with subcutaneous denosumab therapy. J Oral Maxillofac Surg. 72:2469?2484. Available from: https://www.sciencedirect.com/science/article/pii/S027823911401115X
24. Rutkowski P, Gaston L, Borkowska A, Stacchiotti S, Gelderblom H, Baldi GG, et al. 2018 Denosumab treatment of inoperable or locally advanced giant cell tumor of bone – Multicenter analysis outside clinical trial. Eur J Surg Oncol. 44:1384?1390. Available from: https://doi.org/10.1016/j.ejso.2018.03.020
25. Reid R, Ruggiero SL. 2017 Case-Based Review of Osteonecrosis of the Jaw (ONJ) and Application of the International Recommendations for Management From the International Task Force on ONJ. J Clin Densitom Assess Manag Musculoskelet Heal. 10:8?24. Available from: http://dx.doi.org/10.1016/j.jocd.2016.09.0058
| Files | ||
| Issue | Vol 8, No 4 (Autumn 2021) | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/jcr.v8i4.11076 | |
| Keywords | ||
| Central giant-cell granuloma Denosumab Follow-up Mandible | ||
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How to Cite
1.
Rezaie A, Dalili Kajan Z, Maleki D, Shokuhi Fard R, Golshekan H. Denosumab, an adjunctive method in central giant cell granuloma treatment: A case report. J Craniomaxillofac Res. 2022;8(4):220-226.
