Challenges of mandible central giant cell granuloma treatment: a case report

Central giant cell granuloma (CGCG) is considered to be a rare benign intraosseous lesion of unknown etiology, that is non-neoplastic but locally aggressive, and is present in gnathic bones. This study aimed to present the challenges of a CGCG treatment. A 27-year-old woman was referred for treatment of CGCG in the mandible. Clinical examination, panoramic X-ray, and cone-beam tomography revealed a large lesion involving the right posterior region of the mandible, causing facial asymmetry. The lesion was initial treated with 18 sessions of intralesional triamcinolone acetonide infiltrations. There was a partial response in forming the basal cortical bone. After, a surgical procedure fully enucleated the lesion. After 6 years, radiographic exams showed adequate bone formation, and a third approach was performed for rehabilitation with implants and prothesis. After 9 years of follow-up, the patient is asymptomatic, showing satisfactory functional and esthetic conditions. Central giant cell granuloma (CGCG) is considered to be a rare benign intraosseous lesion of unknown etiology, that is non-neoplastic but locally aggressive, and is present in gnathic bones. This study aimed to present the challenges of a CGCG treatment. A 27-year-old woman was referred for treatment of CGCG in the mandible. Clinical examination, panoramic X-ray, and cone-beam tomography revealed a large lesion involving the right posterior region of the mandible, causing facial asymmetry. The lesion was initial treated with 18 sessions of intralesional triamcinolone acetonide infiltrations. There was a partial response in forming the basal cortical bone. After, a surgical procedure fully enucleated the lesion. After 6 years, radiographic exams showed adequate bone formation, and a third approach was performed for rehabilitation with implants and prothesis. After 9 years of follow-up, the patient is asymptomatic, showing satisfactory functional and esthetic conditions.