Adjuvant Calcitonin Therapy Following Surgical Treatment for Central Giant Cell Granuloma: Case Series with...

Central Giant Cell Granuloma (CGCG) is defined as an intraosseous lesion consisting of cellular fibrous tissue that contains multiple foci of haemorrhage, aggregations of multinucleated giant cells, and occasionally trabeculae of woven bone. Calcitonin is suggested as a therapeutic agent based on its action on multinucleated giant cells in CGCG as they possess osteoclast-specific characteristics including lacunar bone resorption.

In this case series, five patients with mean age of 20.6 yrs. (6-30 yrs.) with diagnosis of CGCG underwent surgical excision of lesion. Surgical plan was decided based upon radiological and preoperative pathological findings. Post-surgical adjuvant therapy was initiated in form of calcitonin nasal spray for 7 days to prevent recurrence. Dosage was prescribed at 200 IU twice a day in alternate nostrils for 3 months postoperatively. All patients performed well in postoperative period and discharged on mean postoperative day 3. No patient had increased swelling or gross facial asymmetry postoperatively. Patients were kept on regular follow up in the postoperative period. On 1 month follow up, a clinical examination revealed significant decrease in swelling and improvement in pain. Nasal calcitonin spray has better patient compliance than subcutaneous injections of calcitonin due to its ease of administration.

Adjuvant calcitonin is a proven safe and effective therapy to reduce the recurrence after surgical treatment of CGCG. However, further analytical studies are required to measure the effect of adjuvant calcitonin therapy in such cases.