case_images: PMC11742083_01
case_images: Coronal CT in bone windows through the mandible at the level of the giant cell tumor. (A) Prior to denosumab commencement: A large lytic lesion with endosteal scalloping (arrow) involving the mandibular dental roots and a focal region of cortical demineralization (arrowhead). (B) Six months after denosumab commencement: Progressive infilling of the tumor with osteoid post treatment (arrow) and cortical new bone formation and thickening (arrowhead). (C) Thirty months after denosumab commencement: Further progressive tumor osteoid formation (arrow) and healed buccal surface cortical defect (arrowhead).
case_images: ziae164f1.jpg
case_images: PMC11742083_01_ziae164f1.jpg
case_images: f1
case_images: The lesion involved the roots of the left mandibular pre-molars and molars without root resorption (Figure 1A). Repeat CT mandible 6 months later showed slight reduction in the lesion size, measuring 36 x 18 mm (Figure 1B). Recent CT of the mandible showed a stable 36 x 18 mm left mandibular lesion, with marginal increase in osteoid formation (Figure 1C).
case_images: Histopathology of the mandibular giant-cell lesion. (A) Giant-cell lesion on the right within reactive woven trabecular bone (H&E, 10x). (B) Numerous multinucleated giant cells in hemorrhagic cellular stroma (H&E, 20x).
case_images: ziae164f2.jpg
case_images: PMC11742083_01_ziae164f2.jpg
case_images: f2
case_images: A biopsy of the lesion demonstrated numerous osteoclast-like giant cells in cellular stroma, consistent with central giant cell granuloma (Figure 2).