In regard to the valuable points made in the Letter to Editor concerning our recent publication entitled “Can calcitonin nasal spray reduce the risk of recurrence of central giant cell granuloma of the jaws? A double-blind clinical trial”, the following two points should be noted.
Firstly, giant cell tumours (GCT) are occasionally reported in the jaws, and in our study the diagnosis of aggressive central giant cell granulomas (CGCG) was performed based on clinical behaviour and histopathological evaluation. The diagnosis of aggressive CGCGs and non-invasive CGCGs was done according to the clinical pattern of such lesions. Saxena et al. studied recurrent and primary GCTs and found the high grade of mitosis in recurrent types; however, their study did not make any differential diagnosis between GCTs and CGCGs. Gomes et al. conducted a study on nine cases of GCT and CGCG. They concluded with caution on the absence of H3F3A p.Gly34 Trp or p.Gly34 Leu mutations in sporadic CGCGs of the jaws. It is as yet unclear whether or not every aggressive CGCG is a GCT. GCTs and aggressive CGCGs represent a spectrum of a single disease pattern, and the treatment of GCTs and aggressive CGCGs is generally surgical resection with or without adjunctive treatments.
Secondly, calcitonin nasal spray has been shown to be a treatment option for CGCGs. However, we did not use calcitonin primarily for the treatment of CGCGs; rather, it was applied after surgical treatment to reduce the risk of possible recurrence. Calcitonin nasal spray was applied in our study to reduce the recurrence rate after surgery.
Shiraz University of Medical Sciences funded the original research.