CGCG vs Brown Tumour — MFDS Part 1 MCQ

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ModerateOral PathologyCGCG vs Brown TumourMFDS Part 1

An intraosseous radiolucent lesion of the jaw is biopsied. Histology shows numerous multinucleated giant cells in a fibrovascular stroma with haemorrhage and haemosiderin deposition. A brown tumour of hyperparathyroidism is excluded by appropriate biochemical investigation. What is the most likely diagnosis?

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Correct answer: D — Central giant cell granuloma

The correct answer is **A, central giant cell granuloma**. It is an intraosseous jaw lesion composed of multinucleated osteoclast-type giant cells in a fibrovascular, often haemorrhagic stroma with haemosiderin deposition. A brown tumour caused by hyperparathyroidism can have essentially the same microscopic appearance, so the distinction requires clinical and biochemical assessment, particularly albumin-adjusted calcium and, when indicated, PTH. Ameloblastoma is an epithelial odontogenic tumour and would show odontogenic epithelial islands rather than a diffuse giant-cell proliferation. Odontogenic keratocysts have a characteristic keratinised epithelial lining, while dentigerous and radicular cysts are epithelial-lined inflammatory or developmental cysts. The original reference to “brown fluid” was removed because it is not a reliable defining feature of central giant cell granuloma.

Reference: Buchholzer S, Lombardi T. Rare Case of a Peripheral Giant Cell Granuloma of the Jaw as First Manifestation of Primary Hyperparathyroidism. Diagnostics. 2022;12(12):3018. https://pubmed.ncbi.nlm.nih.gov/36553029/