Aggressive Variant of Central Giant Cell Granuloma

Special Article – Surgery Case Reports

Austin J Surg. 2018; 5(4): 1136.

Aggressive Variant of Central Giant Cell Granuloma

Ustaad F¹*, Saleem Bhat MY², Abouzeid HL³, Ali FM4 and Patil K5

1Oral & Maxillofacial Surgery, M.A Rangoonwala Dental College, India

2Department of Periodontics, Community Dental Sciences College of Dentistry, King Khalid University, Saudi Arabia

3Department of Lecturer SDS, College of Dentistry, King Khalid University, Saudi Arabia

4Department of Dentistry, Jazan University, Saudi Arabia

5Department of Oral Pathology & Microbiology, SMBT Dental College & Hospital, India

*Corresponding author: Farheen Ustaad, Oral & Maxillofacial Surgery, M.A Rangoonwala Dental College, Pune, India

Received: January 02, 2018; Accepted: February 20, 2018; Published: February 27, 2018


Central Giant Cell Granuloma (CGCG) is relatively an uncommon central bony lesion in the head and neck region, commonly affecting the jaw bones of maxilla and mandible and has a female predilection. The clinical feature of CGCG ranges from a slow growing asymptomatic swelling to a rapidly enlarging aggressive lesion. The present case report illustrates a rare aggressive central giant cell granuloma leading to the continuity defect in the mandible and required en-bloc resection and reconstruction.

Keywords: Aggressive lesion; Central giant cell granuloma; Jaw lesions


World Health Organization has defined Central giant cell granuloma as a “localized benign but sometimes aggressive osteolytic proliferation consisting of fibrous tissue with hemorrhage and hemosiderin deposits, presence of osteoclast-like giant cells and reactive bone formation” [1]. The clinical behavior of CGCG varies from a slowly enlarging asymptomatic swelling to an rapidly enlarging aggressive lesion that manifesting with pain, cortical perforation, and root resorption [2,3].

The pathogenesis of the CGCG of oral region has not been clearly established till date. But it is suggested as the result of an exacerbated reactive process related to previous history of trauma and hemorrhage intraosseously triggering the reparative granulomatous process. Understanding features of these benign tumors is important because they clinically mimic a malignant lesion [2-4]. The present report illustrates a rare aggressive variety of CGCG, with a typical clinical presentation in a 12-year-old female patient.

Case Report

A 12 year-old female patient reported with a complaint of swelling in the right side of body of mandible since one year. The swelling had remained asymptomatic, but gradually enlarging to cause the facial disfigurement. Neither history of trauma nor any systemic or local infections was found. The prenatal history also not found significant.

The patient presented with facial asymmetry with a poorly defined solitary swelling measuring 3 x 4 cm (Figure 1). The overlying skin appeared normal. Intraoral examination showed a diffuse enlargement of body of mandible from 43 to 45 regions, with buccal vestibule obliteration in the same region. Tooth displacement and mobility was seen with 44 and 45 but the pulp was vital with open apex. The overlying mucosa was found to be normal.