Familial Giant Cell Lesions of the Mandible-Unusual Occurence
Materials and Methods:
A twenty year old female with relevant medical history attended the maxillofacial surgery department with a persistent swelling of the right posterior mandible. This had displaced the lower right second premolar. The patient reported a family history of tumours of the lower jaw wit her mother and maternal uncle having surgery in the past. In view of her family history, serum parathyroid hormone levels and bone chemistry were performed on mother and daughter. The parathyroid hormone levels, calcium and phosphate levels were all within normal limits. Imaging of the neck showed no pathology of the thyroid and parathyroid glands. The patient underwent curettage of the lesion in the lower right 56 region under general anaesthesia.
Results:
Histopathology reported giant cell lesion/ benign fibro-osseus lesion. A second opinion from the Royal National Orthopaedic Hospital, London of the patient pathology stated the lesion was a giant cell granuloma. We also obtained a second opinion of the patient’s mother’s histopathology from the Royal National Orthopaedic Hospital of biopsies from 2000 and 2011 and reported similar features to that of the daughter. The histopathology of the maternal uncle was also giant cell granuloma and remains recurrnec frr 15 years post-op. The patients mother had surgical curettage in 2000 with a second procedure in 2011 for recurrence. No evidence of recurrence 2 years post treatment. The patient remains recurrence free 2 yrs post-op.
Conclusion :
Familial Giant cell lesions of the mandible are rare. It is important to rule out other differential diagnoses including Hereditary Hyperparathyroidism jaw tumour syndrome
References:
Kutcher MR, Rigby MH, Bullock M, Trites J, Taylor SM, Hart RD. Hyperparathyroidism jaw tumour syndrome Head Neck. 2012 Feb 2. doi: 10.1002/hed.22918.