IL GRANULOMA CENTRALE A CELLULE GIGANTI DEI MASCELLARI

Central giant cell granuloma ( CGCG ), is a fibro-osseous lesion. The majority of lesions are observed in the mandible and mainly in children and young adults, more often in females than in males. This lesion, which the pathogenesis still remains obscure, appears as radiolucency, well or ill-defined, uni or multilocular with trabeculations coursing through the lesion. Histologic study shows giant cells, fibroblastic cells, and foci of hemorrhage and osteoid tissue. On the basis of clinical, radiological and histologic features, central giant cell granulomas can be classified as "non-aggressive" or "aggressive"; the histomorphometric analysis prove a significant increase in large giant cells, fractional surface area, and mitotic activity in aggressive CGCG lesions. Immunohistologic investigation (Ki-67 and p53 stain) reveal no significant differences. The patients with aggressive lesions show aggressive growth, pain, massive swelling, root resorption, cortical perforation, and/or recurrence. Clinical and histomorphometric features may be reliable indicators for the differentiation between aggressive and nonaggressive CGCG. This should be accounted for to improve the individual planning of the treatment and follow-up. Alternative treatments are worthy of consideration, although surgical excision remains the treatment of choice.