Giant cell reparative granuloma of the mandibular condyle: A rare presentation and literature review

Abstract

Giant cell reparative granuloma (GCRG) is an extremely rare occurrence in the mandibular condyle. Here we describe the case of a 41-year-old man with a GCRG of the right mandibular condyle. Clinical, radiographic, and magnetic resonance imaging was unable to confirm the pathologic process. Surgery was performed, during which 20 mm of vertical height of the condylar head and neck was resected, including the articular discs. A vertical ramus sagittal osteotomy was performed to reposition the neo-condyle into the fossa for reconstruction of the joint. The patient's condition has been stable for 18 months with no evidence of recurrence of the tumor. He has 42 mm of intermaxillary opening with no arthralgia or marked change in occlusion. Histopathologic evaluation of the resected specimen revealed a tumor situated in the superior area of the condyle that contained an abundance of multinucleated cells with eosinophilic collagenous tissue and hemorrhage around the fissure, indicating a diagnosis of GCRG. There are only seven other reported cases of GCRG occurring in the mandibular condyle. The differential diagnoses in these cases were brown tumor (hyperparathyroidism) and cherubism, which were excluded by blood tests, physical signs, and diagnostic imaging, including technetium bone scans and computed tomography. Surgical intervention with resection of the condyle and reconstruction using bone grafts or sliding ramus osteotomy is recommended in such cases.