Giant cell granuloma of the facial bones

Giant cell granuloma of the facial bones is a benign, reparative metabolic lesion that usually presents as a painful, expansile mass of the mandible. However, 1 of our patients had the extremely rare findings of multiple other facial bone involvement. In this series of 3 patients followed for > 6 years, the combination of biopsy and clinical presentation provided a stereotypical pattern that enabled an accurate diagnosis in all cases. Our patients were treated successfully with aggressive, but not radical, therapy, excisional curettage, and cauterization of remaining bone. Satisfactory reconstruction and stabilization of the mandible and maxilla were achieved with split rib grafts. The rib graft reconstruction and new bone formation provided excellent contour at 6 years in our adult patients and resulted in normal mandibular growth in the child we treated and followed for 12 years.