Denosumab as a Treatment Alternative for Central Giant Cell Granuloma: A Long-Term Retrospective Cohort Study

J Oral Maxillofac Surg. 2018 Apr;76(4):775-784. doi: 10.1016/j.joms.2017.09.013. Epub 2017 Sep 21.

Abstract

Purpose: Giant cell granuloma (GCG) of the jaw is a rare disease with high morbidity. Various treatment options have been discussed in the past. Since 2010, a pharmaceutical therapy with denosumab seems to have been successful for giant cell tumors of the femur. The authors hypothesized the equally successful use of denosumab for GCGs of the jaws.

Materials and methods: In the present retrospective cohort study, 5 patients with large GCGs of the jaws were treated with denosumab with a follow-up of 25 to 49 months. Frequent clinical follow-ups and a radiologic follow-up were performed and systematically analyzed.

Results: All patients showed a curative treatment response and complete metabolic resolution of the GCGs under treatment with denosumab.

Conclusion: A brief review of the relevant literature and a detailed evaluation of current cases led to the conclusion that denosumab therapy should be considered a therapeutic option for large central GCGs of the jaws. The results of this study suggest denosumab is a successful treatment option. A treatment length no shorter than 12 months is recommended and monitoring of treatment response can be well managed by positron-emission tomographic computed tomography or magnetic resonance imaging.

MeSH terms

  • Adolescent
  • Adult
  • Bone Density Conservation Agents / therapeutic use*
  • Child, Preschool
  • Cone-Beam Computed Tomography
  • Denosumab / therapeutic use*
  • Female
  • Granuloma, Giant Cell / diagnostic imaging
  • Granuloma, Giant Cell / drug therapy*
  • Humans
  • Jaw Diseases / diagnostic imaging
  • Jaw Diseases / drug therapy*
  • Male
  • Radiography, Panoramic
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult

Substances

  • Bone Density Conservation Agents
  • Denosumab