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

Abstract

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. 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) 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. Surgery is the gold standard in treating GCGs, however alternative therapies should be discussed in the management of extensive lesions. • Aggressive giant cell granulomas can have critical vital, functional and aesthetic consequences in the orofacial region. • Giant cell granuloma can mimick several other diseases andhHistopathological examination is key to assess the diagnosis. • Surgery is the treatment of choice for giant cell granuloma but is at risk of damaging functional structures. • Practionners should be aware of alternative therapies such as used in our case to avoid mutilating surgeries.