%0 Journal Article
%T Treatment of central giant cell lesions using bisphosphonates with intralesional corticosteroid injections
%A Newton da Silva
%A Aline Semblano Carreira
%A Erick Pedreira
%A Fabr¨ªcio Tuji
%A Karem Ortega
%A Jo£¿o de Jesus Viana Pinheiro
%J Head & Face Medicine
%D 2012
%I BioMed Central
%R 10.1186/1746-160x-8-23
%X Central giant cell lesions (CGCLs) are benign intraosseous proliferative lesions that occur in the maxilla and mandible primarily during the first to third decades of life [1]. Histologically, multinucleated giant cells are prominent throughout the fibroblastic stroma and are often clustered around areas of haemorrhage [2].CGCLs represent a treatment challenge. The clinical behaviour is extremely variable in that certain lesions are completely silent and grow very slowly whereas others behave more aggressively [3]. In recurrent or aggressive lesions, en bloc resection is a treatment option, but this procedure results in large surgical defects [4,5]. Nonsurgical treatment methods, such as intralesional corticosteroid injections and systemic calcitonin or interferon-¦Á, are increasingly being used [4,6-11].Steroids appear to inhibit the production of extracellular lysosomal proteases in multinucleated giant cells. In addition, steroids reduce bone resorption and induce the apoptosis of osteoclastic cells [5].Bisphosphonates are widely used to inhibit osteolysis in conditions such as osteoporosis, Paget¡¯s disease and bone destruction through metastatic cancer. Landesberg et al. [1] reported three cases of CGCLs treated with bisphosphonates. The first case showed the successful treatment with a single administration of intravenous bisphosphonates, the second resulted in a 30% reduction of the lesion, and the last case showed stabilisation but no regression of the lesion.Based on such evidence, the purpose of this study was to report a case of CGCL that had been treated with intralesional corticosteroids and oral bisphosphonates.A 36-year-old male with no relevant medical history was referred for the evaluation of swelling on the left side of his jaw, which had been associated with paraesthesia for the previous 5 months. On extra-oral examination, a slight swelling in the chin region was noted. Intraorally, the examination revealed swelling of the mouth vestibule and high
%K Giant central granuloma
%K Nonsurgical management
%K Corticosteroids
%K Bisphosphonates
%U http://www.head-face-med.com/content/8/1/23