Towards better understanding of giant cell granulomas of the oral cavity

Successful Management of Cherubism Patient With Staged Bone Grafting and Fat Grafting

Cherubism is a rare hereditary dysplasia of the craniofacial skeleton with unpredictable course and controversial management. The authors report a case managed at the onset with limited mandibular resection and primary autogenous bone grafting, as well as staged secondary fat grafting for contour definition. Over 5 years, the patient demonstrated no recurrence of deformity except for mild hypoplasia, which was improved with fat grafting. The advantages of this early treatment were the ability to address the social stigma and anxiety at a young age versus conservative management strategies with minimal comorbidity.

Medication Management of Selected Pathological Jaw Lesions

Most jaw lesions are treated surgically. Areas of abnormal proliferation or destruction in bone are commonly treated by regional curettage, excision, or resection. However, surgery is invasive and leaves a defect where the lesion was removed. Surgical trauma to adjacent healthy tissue, including vital neurovascular bundles is often unavoidable, and can be especially traumatizing to the pediatric patient. Select jaw lesions with well-studied nonsurgical pharmaceutical treatments are presented here.

Spontaneous Regression of Brown Tumor in a Patient Treated With Peritoneal Dialysis

A 52-year-old man, with a history of diabetic nephropathy and renal cancer, had been treated with peritoneal dialysis for four months before consulting our hospital. At the time of imaging evaluation, three years after surgery for renal cancer, fluorodeoxyglucose accumulation was found at the distal metaphysis of the left radius. After the biopsy, he was diagnosed with giant cell tumor of bone (GCTB), and surgery was scheduled. However, osteogenesis was observed in the images retaken before surgery. It was found that his intact parathyroid hormone level had been abnormally high four months prior to his visit to us but had subsequently normalized. The tissue obtained by re-biopsy revealed osteogenesis with the disappearance of multinucleated giant cells, suggesting a brown tumor (BT). The tumor was thought to have been caused by secondary hyperparathyroidism (HPT) associated with peritoneal dialysis. When osteolytic lesions mimicking GCTB are found, the possibility of BT should be considered based on comorbidities and clinical information.