Central giant cell granulomas (CGCG) of the jaws usually present as a painless lesion and a solitary radiolucent expansion is seen on the simple radiographs. This disease is most commonly diagnosed in the third decade of life, and females are twice as likely to be affected as males (1). The gnathic cases of giant cell granuloma have accounted for 1-7% of all the benign lesions in several previously reported oral surgical series. Jaw lesions affect women more frequently than men (2:1 ratio) (2). The presence of multiple CGCGs in the maxillofacial region is suggestive of hyperparathyroidism or a number of syndromes (3, 4). To the best of our knowledge, only 5 cases of multifocal CGCGs without any concomitant systemic disease have currently been reported (4, 5). We report here on a case of multifocal CGCGs in the maxillofacial region of a 17-year-old male and the patient was without any concomitant systemic disease.
Case ReportA 17-year-old man presented with right nasal obstruction and rhinorrhea that he had suffered with for the previous five months. There was no history of prior trauma or surgery to the mandible. The clinical examination revealed a mass in the right posterior nasal cavity. We then performed computed tomography (CT) and magnetic resonance imaging (MRI) of the paranasal sinuses and nasal cavity.The CT scan of the right maxilla with the bone window setting showed a relatively well defined, heterogeneous isodense mass with mineralized septa, expansile boney remodeling with cortical thinning of the medial and lateral walls of the antrum and opacification of the antrum and the posterior nasal cavity. The mass had eroded the adjacent bony structures, such as the anterior wall of the sphenoid sinus, and it extended to the surrounding spaces, such as the right maxillary sinus and the posterior nasal cavity. There were also bilateral oste- J Korean Soc Radiol 2010;62:11-15 ─ 11 ─