Central giant cell granuloma in a 10-year-old girl: microsurgical reconstruction with a microvascularized fibula flap

Abstract

Central giant cell granuloma (CGCG) are rare, proliferative, benign bone tumors characterized by an abundance of multinucleated giant cells. It affects children and young adults, predominantly women, in the second and third decade of life, it’s commonly found in the mandible. The main treatment for giant cell tumors is surgical excision with free histologic margins; in case of mandibular involvement, the use of a vascularized composite bone flap represents the standard for a functional reconstruction. We present the case of a female patient in the first decade of life with a CGCG of aggressive type, located in the ascending branch and right mandibular angle. En bloc resection of the lesion was performed, with a 2-cm margin and mandibular reconstruction at the same surgical time with a free microvascularized flap from the right fibula. CGCG are rare and infrequent tumors during childhood. Due to its uncertain behavior, it is important to rule out other differential diagnoses prior to definitive treatment.