CENTRAL GRANULOMA OF GIANT CELLS IN THE MAXILLA: DIFFERENTIAL DIAGNOSIS AND SURGICAL PROCEDURE

Abstract

Central giant cell granuloma (CGCG) is a rare benign tumor of unknown etiology. A 59-year-old female patient presented with a history of painful symptoms and mobility in teeth 12, 13, 14, and 15. The patient had an unsuccessful endodontic treatment associated with photodynamic therapy, evidenced by the presence of recurrent fistula with progressive bone reabsorption and swelling. The patient was forwarded to the maxillofacial surgeon under the hypothesis that there was a tumor in this region. For planning of the case, 3D reconstruction and lesion enucleation were performed after negative aspiration with the assistance of a fine needle. Microscopic images revealed proliferation of multinucleated giant cells in the stroma with spindle and osteoid cells, suggestive of CGCG. The biochemical examination reported normal parathyroid hormone parathormone levels, calcium, and phosphorus levels, ruling out the hypothesis of a brown tumor of hyperparathyroidism. The patient is currently on a 2-year follow-up, with no recurrences so far.