Abstract
Central giant cell granuloma is a localized osteolytic leion of variably aggressive nature that affects the jaws. We describe a case of central giant cell granuloma arising in the mandible.
The patient was a male in his 40s who had been aware of a painless swelling in the anterior portion of the mandible since May 2006, but left it untreated. Since the swelling increased gradually in size, he was referred to our department. On the initial examination, the oral mucosa was not affected, however, parchment swelling with tenderness was palpated in the left posterior portion of the mandible. No abnormal finding was noted in the cervical lymph node. No hypoesthesia was noted in the lower lip. X-ray CT detected an expansile, destructive, clear boundary multilocular lesion in the mandible. A thin shell of cortical bone was preserved around much of the lesion.
Based on the clinical diagnosis of odontogenic myxoma or ameloblastoma, biopsy was performed. In the biopsy specimen, no odontogenic epidermis was obtained in the connective tissue. In consideration of sampling error, ameloblastoma was suspected by the clinical findings. Tumorectomy was performed under general anesthesia. The surgical specimen had an elastic soft consistentcy, and the cut surface was solid, dull red, and showed granulomatous lesion.
Histopathological examination showed a large number of multinucleated giant cells in a highly vascular connective tissue. No cell atypia or mitotic figures were observed. The histopathological diagnosis was central giant cell granuloma.
There was no evidence of local recurrence in about 11 months after the operation.
