Combined treatment of aggressive central giant cell granuloma in the lower jaw

Background: The aggressive type lesions of central giant cell granuloma (CGCG) require wide resection that leads to major defects in the jaws. This form of surgical treatment can be particularly disfiguring. A number of alternative non-surgical therapies have been advocated in recent years for the management of the central giant cell granuloma (CGCG). These include calcitonin injections and nasal spray, intralesional steroid injections and subcutaneous interferon injections. Materials and methods: A large central giant cell granuloma aggressive type lesion in the mandible of a 24-year-old patient was treated successfully by intralesional injection of corticosteroid and nasal spray calcitonin that was followed by curettage with peripheral ostectomy with preservation of the continuity of the mandible and the teeth. At the 5-year clinical and radiological follow up there was no sign of recurrence. Conclusions: This combined medical and surgical treatment is advantageous for large aggressive lesions in order to reduce the size of the lesion and thus minimize the need for extensive bone resection and loss of teeth that can result in functional and aesthetic defects. (C) 2011 European Association for Cranio-Maxillo-Facial Surgery.