Surgical management and rehabilitation of recurrent central giant cell granuloma of the jaw: a case report

Central giant cell granuloma (CGCG) is a rare, benign, but locally aggressive lesion that commonly occurs in the jaws. It accounts for approximately 7% of benign jaw tumours and predominantly affects patients younger than 30 years, with a female predilection. Its clinical behaviour ranges from an asymptomatic, slowly growing lesion to an aggressive form associated with recurrent bone destruction and tooth loss. Management should be individualized according to lesion aggressiveness, size, location, patient age and anticipated morbidity. Surgery remains an important treatment modality, while pharmacological approaches, such as intralesional corticosteroids, calcitonin and denosumab, may be considered in selected patients. We report an 8-year-old boy diagnosed with mandibular CGCG in 2000 who developed six local recurrences through 2007, each managed by local surgical removal and curettage. After durable disease control, severe post-treatment mandibular atrophy was reconstructed by vertical distraction osteogenesis, followed by implant-supported prosthetic rehabilitation. At the latest review in 2026, the total follow-up from diagnosis was 26 years and the recurrence-free interval from the last documented recurrence was 19 years. This case illustrates durable control of recurrent CGCG and staged rehabilitation using distraction osteogenesis. It also emphasizes that contemporary treatment planning should balance surgical control against conservative pharmacological options, particularly in young patients.