What is a jaw giant cell tumor?

A giant cell tumor of the bone is a relatively uncommon tumor. It accounts for about 5% of all biosied primary bone tumors. Of those giant cell tumors diagnosed, only about 2% will arise in the head and neck region. It is characterized by the presence of multinucleated giant cells on histology. Giant cell tumors are normally benign with unpredictable behavior. Malignancy in giant cell tumor is uncommon and occurs in about 2% of all cases.

How is a giant cell tumor diagnosed?

Symptoms typically start with a mass or swollen area and sometimes pain. After a thorough history and physical, a CT scan is helpful to determine the extent of the disease and if there are malignant features of the mass. To make a definite diagnosis, a biopsy is needed of the mass which is sent to pathology for evaluation.

How do you treat a giant cell tumor of the mandible?

Giant cell tumors are typically benign but need to be surgically removed because they can become locally destructive; especially in an area like the head and neck where space is limited. The type of surgery depends on how much of the jaw is affected. Below are before and afters of a young patient with a giant cell tumor of the left jaw. Notice that the mass had started to erode the bone over the molar roots (red circle). The mass also surrounded the inferior alveolar nerve (the nerve that supplies lower lip and lower teeth sensation). This patient needed a partial mandibulectomy and inferior alveolar nerve resection to remove the tumor. A free fibula flap was performed to reconstruct the missing mandible so that this patient could have a strong jaw in the future and be able to get dental implants to restore the missing molars. Additionally, the inferior alveolar nerve was reconstructed using a sural nerve graft from the leg to restore sensibility to the lower lip. One year postop, the patient has solid healing of the free fibula flap and sensibility in the lower lip has returned.

 

The specialists at the Craniofacial Team of Texas have extensive experience surgically managing tumors of the head and neck. We use cutting edge technology to ensure a proper resection yet preserving as much normal tissue as possible to avoid morbidity; additionally this technology allows for more efficient and precise reconstruction. Read about how we use virtual surgical planning for our patients  – https://www.craniofacialteamtexas.com/virtual-surgery-and-technology/

Call today for an appointment with one our specialists (512) 377-1142!