Combined management of large aggressive central giant cell granuloma of the mandible: A case report

The aim of this study is to report a case of large aggressive central giant cell granuloma (CGCG) of the mandible treated with corticosteroids and surgery. A 22-year-old male presented with painless progressive swelling in the chin region. Biopsy confirmed the diagnosis of CGCG. Management of the lesion was carried out in 3 phases. Phase-1 comprised of intra-lesional corticosteroids, phase-2 comprised of surgical management and phase-3 consisted of post-surgical intra-lesional corticosteroid. In this extensive case, although intra-lesional corticosteroid was given pre-operatively, there was no evidence of a reduction in size of the lesion both clinically and radio-graphically. This case suggests that injection of a low dose of corticosteroids pre-operatively may not be effective in such large aggressive CGCGs. Nevertheless, combined medical and surgical management is always advantageous for extensive aggressive lesions in order to reduce the size and thus minimize the need for mutilating bone resections and loss of teeth that ultimately result in functional and esthetic defects.