Professional Documents
Culture Documents
1. Lucas classification
Bony lesions
2. Chattopadyay classification
Type I giant cells are pathognomic
pathognomic
Pagets disease
osteitis deformans
3% of adults over 45 yrs of age
Malignant transformation in 1-2% of cases
Etiology :
Benign tumor of osteoclasts
Viral infection paramyxo virus or respiratory
syncytial virus
Clinical features
Deformities of skull, jaw, back pelvis legs
Painless irregular over growth of bones
Initial bone resorption followed by dense sclerotic bony
deposition
Fracture of long bones
Repeated complaints of ill fitting dentures and hats
Narrowing of skull bones neurologic pain
In jaw bones maxilla common leontiasis ossea
Loss of lamina dura and root resorption
Excessive post surgical bleeding and delayed healing after
Xn.
Radiologic features
Stage I osteolytic phase
Mixed radiodensity
Histologic features
Pagetoid bone pattern
Investigations
Serum alkaline phosphatase, urine hydroxyproline raised
3. Hormones
4. Cytotoxic agents
Plicamycin, dactinomycin
Types
Central
Peripheral
Differential diagnosis
Giant cell tumor
Clinical features
Peripheral: central = 5:1
Peripheral lesions
Central lesions
Radiographic features
Mixed radiodensity with diffuse margins
Histologic features
Resorbed bony cavities with
Multinucleated giant cells in inflammatory
stroma
Numerous capillaries and areas of hge
Increased no. of fibroblasts and collagen fibres
Treatment
Medical
Reduce the size of lesion by reducing resorption
and increasing deposition of bone
Bisphosphonates - intralesional
Calcitonin nasal spray
Corticosteroids intralesional triamcinolone
40mg/ml
Surgical
Complete elimination
Curettage (recurrance 12-37%)
Curettage and cryosurgery of bony walls
Aggressive lesions segmental resection
Cherubism
Etiology exact cause unknown
Hereditary dominant gene
age
Self limiting condition - Regress by 12 yrs and
resolve by adulthood
Fullness of cheeks
Maxilla
respiration
Radiologic features
Multiple well defined multilocular radioluscencies
teeth floating in cavity appearance
Displaced and impacted teeth
Histologic features
Similar to cgcg more fibrous tissue and less giant cells
Distinct feature perivascular eosinophilic cuffing
Treatment
No active treatment self limiting
Extraction of malposed teeth
Surgical contouring and curettage
Other lesions
Giant cell epulis
Pyogenic granuloma
Browns tumor
Hodgins lymphoma
Aneurysmal bone cyst
Ewings sarcoma