Management Considerations of Mandibular Central Giant Cell Granuloma

Abstract

Background: Primary central giant cell granuloma (CGCG) not associated with hyperparathyroidism] is a rare, benign, and locally aggressive tumor. It is osteolytic and predominantly affects long bones, however it accounts for 7% of tumors in the facial skeleton. The accepted treatment modalities for mandibular CGCG are enucleation and aggressive curettage, or resection and reconstruction. Denosumab is a monoclonal antibody that inhibits osteoclast activity, and its use has been established for the treatment of CGCG in long bones. Our aim is to increase awareness of the use of denosumab as a treatment modality for mandibular CGCG. Case Report: A 22-year-old female presented with expansion of the right mandible. Computed tomography (CT) imaging and bone biopsies confirmed a diagnosis of CGCG, affecting the right mandibular body with spread to the subcondylar region. Considering her age and history of depression, anxiety and self-harm, the conclusion was made to use denosumab. This holistic decision was made by the patient and the multidisciplinary team.