CASE REPORT Surgery and calcitonin therapy in childhood central giant cell granuloma Nalan Yazici a, * , Bilgehan Yalc ¸in a , Taner Yilmaz b , Canan Akyu ¨z a , Kader Karli Oguz c , Arzu Sungur d ,Mu¨nevverBu¨yu ¨kpamukc ¸u a a Department of Pediatric Oncology, Hacettepe University, Institute of Oncology, 06100 Ankara, Turkey b Department of Otolaryngology—Head & Neck Surgery, Hacettepe University, Faculty of Medicine, 06100 Ankara, Turkey c Department of Radiology, Hacettepe University, Faculty of Medicine, 06100 Ankara, Turkey d Department of Pathology, Hacettepe University, Faculty of Medicine, 06100 Ankara, Turkey Received 29 July 2006; received in revised form 5 September 2006; accepted 8 September 2006 1. Introduction Central giant cell granuloma (CGCG) is a relatively rare and benign lesion which constitutes 7—17% of all benign tumors affecting the jaws [1,2]. The incidence of the disease is reported as 0.00011% in a population-based retrospective study [3]. As defined by WHO, it is an intraosseous lesion which comprises cellular fibrous tissue including multiple hemorrhagic aggregations of multinucleated giant cells and presence of trabeculae of wowen bone [4]. Herein, a child with maxillary CGCG who was trea- ted effectively by surgery after unsuccessful calci- tonin treatment is reported. 2. Case A 4-year-old, previously healthy girl was admitted with a painless, slowly growing mass on the left side of her face. In her past medical history, interferon alpha 2a was administered at another hospital for about 3 months with a biopsy-proven diagnosis of ‘giant cell mesenchymal tumor’. At initial physical examination pallor and a huge, hemorrhagic mass were detected. The mass was protruding from the mouth and the swelling on her left cheek was causing a compression to the left orbit leading to the closure of the left eye (Fig. 1A). The initial hemoglobin level was 4.8 g/dl considered to be the result of frequent bleeding from the mass either spontaneously or dur- ing oral intake. Additional laboratory investigations including WBC, platelets and differential count, serum biochemistry and serum parathyroid hormone International Journal of Pediatric Otorhinolaryngology Extra (2006) 1, 297—300 www.elsevier.com/locate/ijporl KEYWORDS Central giant cell granuloma; Calcitonin; Surgery; Children Summary Central giant cell granuloma is a rare and a benign lesion of the jaws. Conventional treatment is surgery but other approaches including calcitonin are being used in unresectable cases. Herein, we report a case of maxillary tumor causing prominent asymmetry and swelling in the face of a young girl who was effectively treated with surgery following unsuccessful calcitonin therapy. # 2006 Elsevier Ireland Ltd. All rights reserved. * Corresponding author. Tel.: +90 312 3052990; fax: +90 312 3107018. E-mail address: nalanyaz@yahoo.com (N. Yazici). 1871-4048/$ — see front matter # 2006 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.pedex.2006.09.002