Surgical dilemma in a mandibular central giant cell granuloma – a case report

Isadora Vilas Boas Cepeda; Bernardo da Fonseca Orcina; Fernando Aguiar Corrêa; Marcos Antonio Torriani; Otacílio Luiz Chagas Júnior; Ana Paula Neutzling  Gomes; Adriana Etges

doi:10.5327/2525-5711.439

Authors

Isadora Vilas Boas Cepeda Federal University of Pelotas, School of Dentistry, Diagnostic Center of Oral Diseases – Pelotas (RS), Brazil. https://orcid.org/0000-0001-6608-1358
Bernardo da Fonseca Orcina Federal University of Pelotas, School of Dentistry, Diagnostic Center of Oral Diseases – Pelotas (RS), Brazil. https://orcid.org/0000-0003-3367-483X
Fernando Aguiar Corrêa Federal University of Pelotas, School of Dentistry, Diagnostic Center of Oral Diseases – Pelotas (RS), Brazil. https://orcid.org/0009-0009-1088-4288
Marcos Antonio Torriani Federal University of Pelotas, School of Dentistry, Department of Oral and Maxillofacial Surgery – Pelotas (RS), Brazil. https://orcid.org/0000-0003-1079-0125
Otacílio Luiz Chagas Júnior Federal University of Pelotas, School of Dentistry, Department of Oral and Maxillofacial Surgery – Pelotas (RS), Brazil. https://orcid.org/0000-0002-0930-8568
Ana Paula Neutzling Gomes Federal University of Pelotas, School of Dentistry, Diagnostic Center of Oral Diseases – Pelotas (RS), Brazil. https://orcid.org/0000-0003-2214-5246
Adriana Etges Federal University of Pelotas, School of Dentistry, Diagnostic Center of Oral Diseases – Pelotas (RS), Brazil. https://orcid.org/0000-0002-6066-869X

DOI:

https://doi.org/10.5327/2525-5711.439

Keywords:

Giant cell, Granuloma, Trauma surgery, Drug therapy, Traumas

Abstract

Central giant cell granuloma (CGCG) is a benign osteolytic lesion that may display non-aggressive or aggressive behavior. This report describes a 27-year-old male with a mandibular CGCG initially classified as non-aggressive due to its radiographic features and absence of cortical perforation or root resorption. Initial treatment with intralesional corticosteroid injections and enucleation failed to control the lesion, which progressed rapidly, reaching 7 cm and causing buccal cortical perforation. A new biopsy confirmed aggressive features, prompting surgical management via segmental osteotomy with curettage and cryotherapy, preserving the lingual cortex. Immediate reconstruction was performed using an autogenous iliac bone graft and titanium plate fixation. Postoperative healing was uneventful, with good functional and aesthetic outcomes. After 9 years and 7 months of follow-up, no recurrence was observed. This case highlights the potential for behavioral shift in CGCG and emphasizes the need for individualized treatment and timely surgical intervention when conservative therapy fails.

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