Expansive Central Giant Cell Granuloma Of Maxilla Invading Nasal Cavity

Central Giant Cell Granuloma (CGCG) is a rare non-neoplastic lesion that occurs due to a proliferative repair reaction resulting from inflammation or trauma. It is mostly seen in young females and occurs quite often in the mandible. This report aims to present the management of a maxillary CGCG case invading the nasal cavity. A 42-year-old female patient with pain and swelling causing obliteration of the nasolabial fold and left-sided facial asymmetry applied. Computed tomography revealed a 20x20mm well-circumscribed lesion causing expansion and destruction in the nasal floor, palatine, and buccal borders. Incisional biopsy revealed the diagnosis as a giant cell lesion. Parathormone and serum calcium levels were within normal limits. Total excision was carried out via an intraoral approach under general anesthesia. The histopathological report confirmed the diagnosis as CGCG. The postoperative course was uneventful. CGCG accounts for less than 7 % of all benign lesions of the jaws. CGCG has a slow-growing pattern and presents a high recurrence rate of up to 24%. CGCG has to be differentiated from giant cell tumors, aneurysmal bone cysts, and brown tumors of hyperparathyroidism. Surgical excision curettage remains the mainstay treatment of choice in CGCG. Because of its aggressive nature, expansion, and destruction can be seen in the adjacent structures. An early diagnosis is crucial to allow a minimally invasive treatment. A holistic approach with clinical, radiological, and histological examinations should be performed for definitive diagnosis. Patients should be followed up due to the high risk of recurrence.