Combination of surgery followed by intralesional steroids in treatment of aggressive mandibular giant cell granuloma: A case report

Central Giant Cell Granuloma (CGCG) is an intraosseous lesion consisting of cellular fibrous tissue that present clinically as an expansile lesion affecting the jaws, which may severely thin the cortices, including the inferior border of the mandible, displace teeth, resorb interradicular bone, and has a relatively high rate of reccurrence. The combination of surgical debulking followed by injection of intralesional corticosteroids is employed to treat a case of aggressive CGCG of the left posterior mandible in a 15 year old female as an alternative for radical surgery, which is the recommended treatment in conditions with such behaviour. The lesion was treated successfully by 2 courses of intralesional corticosteroids injections with a follow up of 3 years with no evidence of recurrence. We found that the use of intralesional corticosteroids following debulking to treat the presented aggressive variant of CGCG is a safe, minimally invasive and reversible option that spares patients the high morbidity associated with radical surgical treatment and can be repeated in large CGCG lesions if satisfactory regression was not evident following the primary treatment. 2009 DAR Publishers/University of Jordan. All Rights Reserved.