Aggressive Central Giant Cell Granuloma: A Case Report

Central giant cell granuloma (CGCG) is an uncommon benign intraosseous lesion of the jaws that typically affects the anterior mandible in young females. Aggressive variants may demonstrate rapid growth, cortical expansion, pain, root resorption, and recurrence. This report presents an unusual case of aggressive CGCG involving the posterior maxilla in a 20-year-old female patient who presented with progressive swelling and facial asymmetry. Radiographic evaluation revealed a well-defined expansile lytic lesion involving the right maxilla and maxillary sinus. Differential diagnoses included adenomatoid odontogenic tumor, aneurysmal bone cyst, odontogenic myxoma, ameloblastoma, and Brown tumor of hyperparathyroidism. Histopathological examination confirmed the diagnosis by demonstrating multinucleated giant cells within a fibrocellular stroma with hemorrhagic areas and woven bone formation. The lesion was managed by surgical enucleation, curettage, peripheral osteoplasty, and adjunctive cryotherapy. The postoperative period was uneventful, although mild gingival recession and localized interradicular bone loss were observed at two-month follow-up.