We read the article entitled “SH3BP2-encoding exons involved in cherubism are not associated with central giant cell granuloma” by Teixeira et al. with great interest . They claim that SH3BP2-encoding exons, as involved in cherubism, are not associated with central giant cell granuloma (CGCG). However, only patients with a solitary lesion were included in their study. In the case of multiple lesions, we have observed a relationship with cherubism and RASopathies. Extensive reviews on these conditions have been published by Hyckel et al. and Rauen .

An analysis of all 58 patients with CGCG seen in our department identified 16 patients with multiple lesions. Details of these 16 patients are given in Table 1 below.

Table 1

Characteristics of the 16 patients with multiple central giant cell granuloma lesions.

Sex	Age, years	Symptoms	Genetic analysis
Female	13	Noonan syndrome	PTPN11 mutation
Male	8	Noonan syndrome	SOS1 mutation
Female	13	Noonan syndrome	No KRAS/PTPN11/HRAS/SOS1 mutations detected
Male	10	Noonan syndrome with multiple lentigines	PPN11 mutation
Male	5	Cherubism	SH3PB2 mutation
Female	6	Cherubism	SH3PB2 mutation
Male	14	Cherubism	SH3-adjacent mutation
Female	4	Cherubism	SH3PB2 mutation
Male	5	Cherubism	SH3PB2 mutation
Male	12	Cherubism	No SH3PB2 mutation detected
Female	3	Cherubism	SH3PB2 mutation
Male	11	Cherubism	SH3PB2 mutation
Female	9	Cherubism	No SH3PB2 mutation detected
Female	14	Cherubism	Not done
Female	6	Cherubism	Not done
Female	24	Neurofibromatosis	NF1 mutation

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