Aggressive giant cell lesion of the jaws: a review of management options and report of a mandibular lesion treated with denosumab.
Giant cell lesions (GCLs), previously referred to as giant cell granulomas, are benign tumors of the jaws of unknown etiology. Surgical management of aggressive GCLs is challenging, as these lesions demonstrate a tendency to recur following surgical removal. In addition, surgical treatment can be associated with significant morbidity. In an attempt to reduce both the extent of morbidity and the recurrence rate following surgery, a number of pharmacologic therapies have been advocated on the basis of assumptions about the predominant cell types and receptors, for the management of these lesions. This report describes the use of denosumab, an agent originally used for its anti-resorptive effects, in the management of an aggressive GCL of the mandible in an older patient, who was unsuitable for extensive surgery and in whom treatment with intralesional triamcinolone had proved unsuccessful. Denosumab may be a viable alternative or adjunct to surgery in the management of GCLs of the jaws.
Registrar, Department of Oral and Maxillofacial Surgery, St. James's Hospital, Dublin, Ireland. Electronic address: Johnedoconnell@yahoo.com.
John Edward
JE
O'Connell
Registrar, Department of Oral and Maxillofacial Surgery, St. James's Hospital, Dublin, Ireland.
Conor
C
Bowe
Registrar, Department of Oral and Maxillofacial Surgery, St. James's Hospital, Dublin, Ireland.
Colm
C
Murphy
Consultant Histopathologist, St. James and Dublin Dental Hospitals and Trinity College, Sir Patrick Dunne Research Laboratory, and St. James Hospital, Dublin, Ireland.
Mary
M
Toner
Consultant, Department of Oral and Maxillofacial Surgery, St James's Hospital, Dublin, Ireland.
Gerard J
GJ
Kearns
D000369:Aged, 80 and over; D001706:Biopsy; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D002118:Calcium / Q000627:therapeutic use; D000069448:Denosumab / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D005260:Female; D018212:Giant Cell Tumor of Bone / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D015552:Injections, Intralesional; D008339:Mandibular Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D056687:Off-Label Use; D011862:Radiography, Panoramic; D014057:Tomography, X-Ray Computed; D014221:Triamcinolone / Q000627:therapeutic use; D014807:Vitamin D / Q000627:therapeutic use
D050071:Bone Density Conservation Agents; D005938:Glucocorticoids; D014807:Vitamin D; D014221:Triamcinolone; D000069448:Denosumab; D002118:Calcium