Prognostic marker in giant cell granulomas

Abstract

Giant cell granulomas intraosseous or extraosseous are a group of pathological entities with similar histopathological features characterized by MGCs in fibroblastic vascularized connective tissue background with a varying clinical behavior. Peripheral giant cell granuloma (PGCG) is a reactive lesion. Central giant cell granuloma (CGCG) exhibits a non-neoplastic proliferative behavior and can be aggressive and nonaggressive based upon clinical and radiographic features and has a high rate of recurrence. A marker to predict its behavior may be helpful in assessing the clinical outcome. The aim of this study was to compare and determine the biologic nature and clinical behavior of these lesions by immunohistochemical expression of Factor VIII-RA in CGCG and PGCG. : Immunohistochemical expression of Factor VIII-RA was assessed in formalin fixed paraffin embbeded tissue block of 12 cases of PGCG and CGCG (aggressive and non- aggressive) each. In total, 12 cases of PGCG and 12 cases of CGCG were studied. The average age of CGCG, and PGCG was 21.2 ± 10.43 and 38.17 ± 21.58 respectively. Both occurred more often in the mandible than the maxilla (Table I). CGCG presented as painless swelling in 66.6% (8case) and 33.4% (4case) different cases were symptomatic. Immunohistochemical evaluation of the two groups examined showed a positive reaction for factor VIII-RA. Number of stained cells and intensity of staining decreased from PGCG, non-aggressive CGCG to aggressive CGCG. Higher factor VIII RA in endothelial cells of central giant cell lesions indicates a less aggressive form, suggesting its potential use in clinical assessment and treatment planning.