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ORIGINAL ARTICLE - EVALUATIVE STUDY
Year : 2019  |  Volume : 9  |  Issue : 1  |  Page : 37-47

Management of central giant cell granulomas of the jaws: An unusual case report with critical appraisal of existing literature


Military Dental Centre (Gough Lines), Secunderabad, Telangana, India

Correspondence Address:
Dr. Priya Jeyaraj
Commanding Officer, Military Dental Centre (Gough Lines), Secunderabad, Telangana, Pin-500015
India
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DOI: 10.4103/ams.ams_232_18

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Central giant cell granuloma (CGCG) is an uncommon, benign but aggressive osteolytic neoplasm of the craniomaxillofacial region, histologically characterized by an abundance of evenly distributed multinucleated giant cells within a sea of spindle-shaped mesenchymal stromal cells, scattered throughout the fibrovascular connective tissue stroma containing areas of hemorrhage. A rapid diagnostic assessment, together with an adequate histopathologic verification, is essential to improve the management and the prognosis of this locally destructive lesion. A rare case of a large destructive CGCG involving the entire right angle of mandible, causing extensive bony resorption, and buccal, medial as well as inferior border cortical expansion with multiple perforations, in a young child is presented. It was treated successfully by enucleation and aggressive curettage followed by peripheral ostectomy preserving the continuity of the mandible. Two adjunctive measures were employed; first, chemical cauterization of the residual bony walls to prevent possible recurrence, for which this tumor is notorious, and second, placement of fresh autologous platelet-rich fibrin within the bony defect to hasten bone fill and reossification, thus obviating the need for a bone graft.


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