Impressive regression of aggressive central giant cell granuloma with the use of intralesional corticosteroid injections

Abstract

Introduction

and importance: Giant cell granuloma (GCG) is a begnin tumor usually occurring in the mandible or maxilla. Clinical presentation can vary from small peripheral GCG to aggressive central GCG for which a surgical procedure can damage functional structures and have a poor aesthetic outcome. Alternative therapies are of essential interest in those cases, as a monomodal treatment modality or as a neoadjuvant therapy.

Case presentation

We herein present a case of aggressive central GCG in a 11 year old infant with a suspected pycnodysostosis treated with neoadjuvant intralesional injections of corticosteroids. Impressive reduction of the lesion was observed and the patient underwent surgical curretage of the remaining mass. The GCG recurred 7 months after surgery and the patient benefited from the same treatment plan. No sign of recurrence was observed after 29 months. The case has been reported in line with the SCARE criteria.(1)

Clinical discussion

GCGs commonly occur in a young population making the conditions management challenging in the maxillofacial region because of its anatomical relationship with vital and functional structures as well as the associated deformity risk. Different medical therapies have been described such as corticosteroid injections, biphosphonates, interferon alpha and calcitonin with a various degrees of success.

Conclusion

Surgery is the gold standard in treating GCGs, however alternative therapies should be discussed in the management of extensive lesions.