An unusual case of Central Giant Cell Granuloma

Introduction: Central Giant Cell Granuloma (CGCG) in jaw bones have characteristic diagnostic features. But rarely they may present with slightly different features or features related to other lesions. It can be challenging when histopathological features of two or more different entities are seen within a single lesion. Case report: We report a jaw lesion in a 47-year-old male patient who presented unusually as a painful diffuse left mandibular swelling. Although the 2-dimensional imaging study suggested a cystic lesion, the 3-dimensional imaging study pointed to a more well-demarcated pathology. A complete excision of the lesion when examined in detail confirmed a histopathologic diagnosis of a CGCG. The challenge however was the large reactive bone areas that raised a suspicion of an Ossifying Fibroma lesion. Conclusion: Diagnosing a jaw lesion consisting of areas showing two or more different features is always challenging. This report highlights the key histopathologic findings that can help distinguish between a hybrid lesion and a case of CGCG with large reactive bone areas.