Treatment of Giant Cell Granuloma of the Mandible Using Denosumab Therapy

Central giant cell granuloma (CGCG) is a rare, benign but potentially aggressive jaw lesion. While surgery is a standard treatment, it carries high recurrence rates and morbidity, particularly in young patients. Denosumab, a RANK-L inhibitor, has emerged as a non-surgical alternative, though its long-term efficacy remains uncertain. We present a 16-year-old female with aggressive mandibular CGCG, treated with multiple resections and bone grafting. To avoid radical reconstruction, denosumab was administered for 12 months, leading to complete ossification and over 4 years of disease stability. However, late recurrence with facial deformity and functional impairment occurred, raising concerns about the durability of denosumab monotherapy. This case underscores denosumab's potential to delay progression and preserve mandibular integrity while highlighting unresolved issues regarding optimal dosing, maintenance therapy, and recurrence prevention. Larger studies are needed to establish standardized treatment protocols.