Giant Cell Granuloma – pro

There are no prospective or comparative trials supporting interferon for this rare condition.

The peripheral giant cell granuloma has an unknown etiology, with some dispute as to whether this lesion represents a reactive or neoplastic process. It is often a dental disease. Most authorities believe peripheral giant cell granuloma is a reactive lesion. Surgical management of the CGCG with aggressive curettage is regarded as the treatment of choice. Resection is performed for recurrent or more aggressive variants, which leads to major defects and loss of teeth. This is particularly mutilating in a growing child or young adult. In such cases, extensive reconstructive procedures are required for anatomic restoration and rehabilitation to achieve satisfactory form and function.

Alternative treatmetns have been reported. All of these reports and the literature in general is based on case reports and series. These treatments include calcitonin, intralesional steroids or interferon.

Interferon alfa-2a inhibits angiogenesis and was discovered through a series of laboratory experiments that began in 1980. It was first used in 1989 in the management of a child with pulmonary haemangiomatosis. Interferon alfa A was then subsequently use to treat life threatening haemangiomas and other vascular tumours in various organs. Kaban reported on anti-angiogenic therapy of a recurrent giant cell tumour of the mandible in a 5 year old girl with interferon alfa-2a reasoning that as it was a rapidly proliferating vascular lesion it could be treated as an haemangioma. Since then a number of reports have apeared. Becasue of their rarity, no treatment guidelines are available.

Int J Oral Maxillofac Surg. 2006 Sep;35(9):865-9.
Comment in:

de Lange J, van den Akker HP, van den Berg H, Richel DJ, Gortzak RA.
Limited regression of central giant cell granuloma by interferon alpha after failed calcitonin therapy: a report of 2 cases.Int J Oral Maxillofac Surg. 2006 Nov;35(11):1074-5; author reply 1076.
Intralesional corticosteroid injection for treatment of central giant-cell granuloma J Am Dent Assoc, Vol 132, No 2, 186-190.

Shohat I, Shoshani Y, Taicher S.
[Medical treatment of central giant cell granuloma of the jaws, Refuat Hapeh Vehashinayim (Treatment of Mouth and teeth). 2002 Oct;19(4):37-44, 70.

Collins A.Experience with anti-angiogenic therapy of giant cell granuloma of the facial bones.
Ann R Australas Coll Dent Surg. 2000 Oct;15:170-5.

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