DOI  10.17613/svzd-2r36 

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Case Report

Central Giant Cell Granuloma of the Jaws Complicated with Hemorrhagic Hypovolemic Shock: A Case Report 

Quiroz-Valencia, Nora Elena1; Soriano-Padilla, Fernando1; Boehler-Reyes, Anayantzin1; Romero-Guerra, Ana Laura1; Cheung-Lopez, Mariana1; Paredes-Cuanalo, Miguel Angel1; Gonzalez-Muñiz, Sonia1; Malagon-Calderon, Gina Mariana1; Moya-Sánchez, Crisaixela1; Salazar-Rios, Maria E.1*; Castillo De la Peña, Erik1.

1High Specialty Medical Unit, Pediatric Hospital “Dr. Silvestre Frenk Freund”, National Medical Center “Siglo XXI”, IMSS, Mexico City, Mexico.

*Correspondence: Salazar-Rios, M; m.salazar.rios2013@gmail.com 

KEYWORDS: Trau Central giant cell granuloma, Jaw tumors, Pediatric, Giant cell tumor, Embolization, Hemorrhage, Case report.

ABSTRACT

Central giant cell granulomas (CGCGs) are localized, benign proliferations of fibrous tissue that, in some cases, exhibit aggressive biological behavior. These last are more common in pediatric patients. CGCGs are unusual, accounting for less than 7% of benign maxillary tumors. The mandible is the most common location. Surgical treatment is the gold standard to manage aggressive CGCGs. Prognosis is favorable if complete removal is achieved. Herein, we present a case of a right mandibular CGCG in a teenage female patient. Among the differential histopathological diagnoses, the brown tumor of hyperparathyroidism was discarded. During hospitalization, she presented with profuse active bleeding from the tumor. Unsuccessful hemostasis was initiated using gauze pads with epinephrine and sutures due to the extremely friable tissue. During the event, approximately 1500 ml of blood loss was reported, with clinical signs of hypovolemic shock. She was admitted urgently for right mandibular embolization. Finally, a hemimandibulectomy, tumoral lesion resection and cervical ganglion biopsy was performed. Within, we document the multidisciplinary approach that led to a successful treatment and recovery as well as the expected course in her future. Nevertheless, there are still opportunities to establish the ideal management in patients with further anatomical, aesthetic, and functional growth ahead of them. In conclusion we strongly recommend establishing a prompt and accurate diagnosis; a complete resection with surgical and non-surgical strategies and an early definitive management to reduce recurrence.

CONFLICTS OF INTERESTS

The authors have no conflict of interest

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