Central giant cell reparative granuloma of the Jaws

Abstract

Central giant cell reparative granuloma (CGCRG) has been defined by The World Health Organization as a localized benign however sometimes aggressive osteolytic proliferation, consisting of fibrous tissue along with hemorrhage and hemosiderin deposits, with the presence of osteoclast-like giant cells and reactive bone formation.They are mostly localized in the maxilla and mandible , however lesions sourced from the orbit, paranasal sinuses, skull base, skull bones such as the temporal, sphenoid, ethmoid bones, and the small bones of the hands and feet have also been published.CGCRG often presents itself as a painless swelling of the face or mouth and it is divided into 2 groups according to its clinical findings, as aggressive and nonaggressive type.Nonaggressive lesions are slow-growing, mostly asymptomatic lesions which don't cause perforation of the cortical bone and root resorption. Aggressive lesions however are fast-growing; larger than 5 cm in size; cause pain and paraesthesia, root resorption and cortical perforation; and commonly show recurrence after surgery.The differential diagnosis for CGCRG includes other giant cell lesions such as the true giant cell tumor of the bone, aneurysmal bone cysts, and chondroblastoma.The traditional treatment for CGCRG is surgical abortion and this treatment is sufficient in 80% of the cases. Alternative methods to surgery are; intralesional corticosteroid therapy, calcitonin treatment, interferon alpha-2a, and imatinib treatment.