Conservative management of central giant cell granuloma - A case report

Surgical resection is the gold standard for an aggressive variant of central giant cell granuloma (CGCG) which causes permanent disfigurement, especially in young individuals. Therefore, the conservative line of treatment should be tried first. Jacoway and colleagues proposed that the intralesional administration of corticosteroids acts on the giant cells that have osteoclasts receptors present on their surface and thus, corticosteroids induce apoptosis, causing remission of the lesion. An 11-year girl reported non-tender bony swelling in the left mandibular region for 3 months. CBCT revealed a large lytic lesion from teeth 33 to 37 measuring about 4 cm x 4 cm approximately. A biopsy was done, which diagnosed the lesion as central giant cell granuloma. 10 mg/ml of triamcinolone acetonide intralesional injection per cm of the lesion was injected. The protocol of initially giving intralesional corticosteroid injections can be used as a first treatment option for the management of CGCG rather than going for an initial aggressive surgical approach.