Non-syndromic multi-focal central giant cell granuloma- Report of 2 rare cases and review of literature

• Author Details:   
• Shiladitya Sil
• Rudra Pyne ^*
• Subhankar Ghosh
• Nilanjana Saha

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Introduction: Central giant cell granuloma (CGCG) is a rare, benign but potentially aggressive intraosseous lesion affecting the jaws, predominantly amongst females under 30 years. First described by Jaffe in 1953 and later termed by Lichtenstein, CGCG is classified by the World Health Organization as a benign tumor-like lesion. Radiologically, CGCG presents as unilocular or multilocular radiolucencies. Management includes surgical and non-surgical approaches, with high recurrence rates.
Case Report: A 31-year-old female presented with bilateral painless swellings in the lower jaw, progressively increasing over 12 months. Clinical examination revealed bony hard growths in the posterior mandible, confirmed as CGCG through imaging and histopathology. Surgical wide margin excision resulted in uneventful healing and no recurrence over 10 months.
A 32-year-old female reported pain and tooth mobility in the lower jaw. Clinical and radiographic evaluations showed heterogenous radiolucent-radiopaque lesions, confirmed as CGCG histo-pathologically. Wide margin surgical excision and hemi-mandibulectomy with fibula graft led to successful recovery with no recurrence over 13 months. Biochemical tests ruled out hyper-parathyroidism and RASopathy syndromes in both the patients.
Conclusion: This case series highlights two rare cases of multi-focal CGCG, both occurring in the mandible and in female patients without any systemic manifestation.

Keywords: Giant cell tumor, RASopathy, Central lesion, RANKL, Honey-comb, Excision.