CENTRAL GIANT CELL GRANULOMA- A CASE REPORT

Abstract

Central giant cell granuloma (CGCG) is a benign intraosseous lesion of the jaw that is found predominantly in children and young adult. It is an uncommon pathological condition occurring in less than 7% of all benign lesions of the jaw and diagnosed during the first two decades of life. It is considerably more common in the mandible than in the maxilla. A case of 30 yr old male with CGCG in mandible is presented. A single, focal, diffuse swelling of size 9cm x 6cm was seen on the lower anterior region of jaw which was hard in consistency, non tender with no local rise in temperature. Intraorally, solitary well circumscribed oval shaped swelling was present on the anterior mandible extending from right second premolar to left second premolar region obliterating the labial vestibule. It was associated with expansion of labial cortical plate.Pulp vitality test was carried out from right mandibular first premolar to left mandibular second premolar which revealed no response suggesting it to be non- vital. Radiographs of the patient included occlusal view to check expansion of cortical plate and panoramic view to check extent of lesion which revealed presence of solitary multilocular lesion extending from mesial aspect of 36 till mesial aspect of 46 with minute loculations giving honey comb appearance. There is profuse expansion of buccal and lingual plate along with resorption of roots in anterior region., incisional biopsy was carried out which showed cellular vascular stroma with large number of multinucleate giant cells proliferating fibroblasts, histiocytes areas of hemorrhage and new bone formation.Treatment was started with Kenacort –A (10mg/ml) and lidocaine solution 2% with epinephrine 1: 200,000 (50% mixture by volume). Post-operative and follow up, panoramic view and Cone Beam Computed Tomography was taken which revealed regression in the size of the lesion along with osteoblastic activity resulting in formation of the lost bone measuring thickness of about 0.5cm at the inferior border of mandible