Ostectomy

Mandible (arthropod mouthpart)

Biology

Genus

Surgery

Platelet-rich fibrin

Botany

Lesion

Immunology

Central giant-cell granuloma

Anatomy

Giant cell

Medicine

Enucleation

Fibrin

Curettage

Aneurysmal bone cyst

Pathology

Annals of Maxillofacial Surgery

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.

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