Central giant cell granuloma of the jaws

Abstract

Central giant cell granuloma was classified by the World Health Organization in 2005 as a rarely aggressive idiopathic benign intraosseous lesion that occurs almost exclusively in the jaws. It occurs most frequently in young women (aged <30 y). This osteolytic lesion histologically consists of proliferation of fibrous tissue, hemorrhagic focuses, hemosiderin deposits, osteoclast-like giant cells, and reactive bone formation. Differential diagnosis has to be made with other osteolytic neoformations of the jaws, both unicystic and multicystic (odontogenic tumors, fibrous dysplasia, cysts, etc). From 2002 to 2008, we surgically treated 8 cases of giant cell granuloma. Our article focuses on a 59-year-old woman who came to our department with a swelling on the right side of the face. Computed tomography examination showed an osteolytic and expansive neoformation spreading up from the lateral wall of the nose to the anterior wall of maxillary sinus and above up to the inferior margin of the eye socket. Besides, it was contiguous to the canine root apex, the first and second bicuspids. Intraoral incisional biopsy confirmed the histologic picture of central giant cell granuloma. After a few days, she underwent surgical excision of the neoformation, preserving the lateral wall of the nose, the anterior wall of maxillary sinus, the eye socket, and the dental elements, respectively. Results of the histopathologic examination confirmed the previous biopsy. A follow-up at 30 months excluded any relapse.