Reparative giant cell granuloma of the maxilla

Abstract

Giant cell reparative granuloma accounts for 1–7% of all benign lesions of the jaw. It often arises in the maxilla followed by mandible and affects children and young adults. It is usually a slow-growing lesion. The fast growing lesions are rare and despite the innocent histological appearance, has an aggressive behavior mimicking a malignant lesion. In the present report, the clinical features, diagnosis, and surgical treatment of an unusually large aggressive variety of reparative giant cell granuloma found in the cheek with extensions into maxilla, antrum, and infratemporal region in a 23-year-old female is described. The impact of delay in correct diagnosis on massive enlargement of the lesion, the importance of computed tomography-guided biopsy in the diagnosis of such inaccessible lesions, and the role of a general dentist in the early detection are also emphasized.

Sinonasal Ameloblastoma: A Case Report and a Review of Gnathic Lesions That Occur in the Sinonasal Tract

“…Giant cell reparative granulomas have the potential to be aggressive and can erode adjacent bone 55 . The radiographic features are nonspecific and are similar to those of other cyst-like lesions 56 . Computed tomography demonstrates a heterogeneous lesion with fluid levels.…”

“…55 The radiographic features are nonspecific and are similar to those of other cyst-like lesions. 56 Computed tomography demonstrates a heterogeneous lesion with fluid levels. Histologically, GCRGs are lobulated masses that comprised aggregates of giant cells within fibrovascular stroma and hemorrhage.…”

“…54,57 Brown tumors and aneurysmal bone cysts are histologically identical; however, GCRGs lack the metabolic derangements seen in brown tumors and the Ubiquitin Specific Peptidase 6 translocations of aneurysmal bone cysts. 56,[58][59][60] Surgery is the treatment of choice, 56 but steroid treatment to avoid disfiguring surgery has had some success. 61 Bone and fibro-osseous lesions make up a large part of the gnathic lesions that can be seen in the sinonasal tract and include osteomas, fibrous dysplasia, and ossifying fibromas (OFs).…”

Pediatric Mandibular Central Giant Cell Granuloma: Neoadjuvant Immunotherapy to Minimize Surgical Resection

“…A modality such as corticosteroids is also contraindicated in patients with medical comorbidities such as diabetes mellitus, peptic ulcer disease, and immunocompromised conditions. 12 Radiation therapy is a contraindicated treatment with limited case reports of malignant transformation. 13 Denosumab is a human monoclonal antibody RANKL inhibitor.…”

“…These treatments have shown variable success, more so in slower growing lesions but less effective in aggressively expanding granulomas. A modality such as corticosteroids is also contraindicated in patients with medical comorbidities such as diabetes mellitus, peptic ulcer disease, and immunocompromised conditions 12 . Radiation therapy is a contraindicated treatment with limited case reports of malignant transformation 13 …”