CENTRAL GIANT CELL LESION TREATMENT IN MAXILLA WITH DENOSUMAB: A NOVEL APPROACH

Abstract

Central giant cell lesion (CGCL) is a benign nonneoplastic intraosseous lesion usually treated with aggressive surgical excision. Denosumab, a monoclonal antibody, is widely used in the treatment of giant cell tumors in long bones and has been proposed as an alternative therapy for CGCL in the jaw. A 16-year-old patient presented with recurrence of CGCL after 1 year of surgical resection, with removal of the lesion and extraction of 7 maxillary teeth. Therefore, pharmacologic treatment with subcutaneous denosumab was proposed with an injection of 120 mg on days 0, 7, 14, and 21 of the first month, followed by equal doses every 40 days. After 6 months of treatment, the imaging exams showed a significant lesion reduction of 45%. Treatment with denosumab was continued for another 6 months to allow a less aggressive surgery or eliminate the need for surgery.