Recurrent benign giant-cell lesions of the jaws with metastasis?

THE existence of a giant-cell tumour in the jawbones has been a matter of discussion for many years. In an excellent review Jaffe, Lichtenstein and Portis (1940) tried to clarify some of the problems by denning true giant-cell tumours of bone and separating them from reparative giant-cell granulomas. Later Jaffe (1953) further discussed some of the giant-cell containing lesions of the jaws and stated that he had only seen one case of true giant-cell tumour in the jaws. Extensive reviews by Waldron (1953), Austin, Dahlin and Royer (1959), Bhaskar, Bernier and Godby (1959) and Shklar and Meyer (1961) all concluded that giant-cell tumours very seldom occur in the jaws; Bhaskar et al. even denied the existence of this tumour in the jaws. In his recent textbook, Jaffe (1958) discussed the nature and genesis of these tumours, regarded the tumour cells as being derived from primitive mesenchymal cells in the bone marrow, and pointed out that the stromal cells are the essential tumour cells and the giant-cells are products of these stromal cells; at the same time these cells are responsible for the growth of the tumour. He divided the tumour into three grades, I II III, I: no appreciable, II: moderate and III: pronounced atypism of the stromal cells, grade III presenting a sarcomatous stroma, frankly malignant.