Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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October 30, 2014
Giant Cell Granuloma
- Giant cell granulomas (GCG) are rare, non-neoplastic lesions that are histologically distinct from giant cell tumors of a bone. Jaffe, in 1953, first coined the term “giant cell reparative granuloma” when he described the lesion as a local reparative reaction to intraosseous hemorrhage induced by trauma. However, it has been reported without a definite history of antecedent trauma and with a lack of significant elements of reparative tissue. It is now known as a giant cell granuloma.
- Clinical Presentation: Insidious clinical course, slowly-enlarging mass, often identified incidentally
- They account for a small percentage of all head and neck masses. The incidence is highest in the second decade of life, and GCG is more frequent in women.
- Key Diagnostic Features:
- CT shows expansile lytic lesion remodeling the adjacent bone with intralesional mineralization and septation, ± root resorption and tooth displacement.
- Uni- or multilocular
- MRI offers better soft-tissue discrimination.
- Postcontrast imaging demonstrates avid heterogeneous enhancement.
- Key Diagnostic Features:
- Giant cell tumor
- Aneurysmal bone cyst
- Ameloblastoma
- Brown tumor of hyperparathyroidism
- Rx: Surgical excision. Intralesional steroid injections and systemic calcitonin may be used as adjunctive therapies.
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