Central Giant Cell Granuloma Resistant to Calcitonin Nasal Spray: A Case Report

Lucia Gerzanic

doi:10.4172/2161-1173.1000119

Abstract

Purpose: We describe successful treatment of a recurrent central giant cell granuloma (CGCG). This is a rare benign intraosseous lesion that occurs before age 30 and can quickly recur as a painless lesion of the mandible.Because of its aggressive growth and tendency to progress as well as its morphological similarity to a giant cell tumour, it justifies radical surgery. Patients and methods: A female patient aged 18 years presented with a CGCG lesion in the mandible that recurred despite standard treatment with calcitonin nasal spray after enucleation of the initial lesion. Results: The recurrence in the mandible required radical surgery and reconstruction with a microvascular iliac bone flap; there was no injury to cranial nerves and facial appearance was normal. Conclusion: Radical surgical treatment of CGCG recurrence is the best option when calcitonin nasal spray fails to prevent recurrence.

Highlights

Central giant cell granulomas (CGCGs) of the jaws are rare benign intraosseous lesions that can quickly recur as indolent lesions in mandible, where they are more commonly found than in the maxilla
Lim and Gibbins reported that immunohistochemistry suggests that stromal cells or fibroblasts are the etiologic basis of CGCG and that the giant cells themselves may be secondary or reactive [9]
This 18-year-old woman has been followed for three years after first presenting with an aggressive lesion that was enucleated surgically and proved upon biopsy to be a central giant cell granuloma

Summary

Introduction

Central giant cell granulomas (CGCGs) of the jaws are rare benign intraosseous lesions that can quickly recur as indolent lesions in mandible, where they are more commonly found than in the maxilla. Conventional treatment is local curettage, which is associated with a high success rate and low recurrence rate [1]. Because of its aggressive growth and tendency to progress, the central giant cell granuloma has been described as a benign lesion, its morphological similarity to a giant cell tumour demands a radical surgical approach. This case report describes successful radical surgery after calcitonin nasal spray failed to prevent recurrence of a CGCG lesion

Methods

Results

Conclusion