Glucocorticoid Receptor and Calcitonin Receptor in Central Giant Cell Granuloma

Objectives: To investigate the expression of glucocorticoid receptor (GCR) and calcitonin receptor (CTR) in a large series of central giant cell granuloma (CGCG). Material and Methods: The study included 41 cases of CGCG, 18 males, 23 females, with a mean age of 38.6 years. Percentage of positive mononuclear cells (MC) and giant cells (GC) was calculated for GCR and CTR. Statistical analysis was performed by Spearman's correlation test. Results: MC were positive for GCR in 100% and for CTR in 52.4% of cases. MC positivity for GCR ranged between 10% to 100% of cells. In 32 cases, 50% or more of MC were GCR positive. MC positivity for CTR ranged between 50% and 100%. No significant statistical correlation was found between GCR and CTR stains in MC. GC were positive for GCR in 95% and for CTR in 46.3% of cases. GC positivity for GCR ranged between 10% to 100% of cells. In 26 cases, 50% or more of GC were GCR positive. GC positivity for CTR ranged between 10% and 90%. In 15 cases, 50% or more of GC were CTR positive. No significant statistical correlation was found between GCR and CTR stains in GC. Conclusions: It appears that CGCG is a heterogeneous group of lesions rather than one entity, where almost each lesion demonstrated a different profile of staining percentage for GCR and CTR. These stains can serve as an evidence-based, reliable and selective tool to determine the most adequate therapeutic strategy (calcitonin and/or intralesional steroids) in each individual case of CGCG. This therapeutic strategy can limit or avoid extensive mutilating and disabling surgery required for aggressive, large and expanding lesions. Study was supported by the Ed and Herb Stein Chair in Oral Pathology, Tel Aviv University.