1 International Journal of Medical and Dental Case Reports (2021), Article ID INS161 600721, 4 Pages CASE REPORT Central giant cell granuloma: A case report Tejavathi Nagaraj 1 , Ijum Doye 1 , Durga Okade 1 , Soniya Kongbrailatpam 2 1 Department of Oral Medicine and Radiology, Sri Rajiv Gandhi College of Dental Sciences, Bengaluru, Karnataka, India, 2 Department of Oral Medicine and Radiology, Sri Rajiv Gandhi College of Dental Sciences and Hospital, Bengaluru, Karnataka, India Abstract Central giant cell granuloma (CGCG) is an uncommon, benign, and proliferative lesion of the jaw with an unknown etiology. It is considered widely to be a non-neoplastic lesion. The actual etiology of CGCG is still unclear, although infammation, hemorrhage, and local trauma have all been suggested. The incidence in the general population is very low, and patients are generally younger than 30 years. The biologic behavior of CGCG of the jaw ranges from quiescent to aggressive with destructive expansion. Here, we report a case of GCG in a 29-year-old male patient. Keywords: Aggressive jaw lesion, Giant cell lesion, Histopathological, Diagnosis, Radiographic feature Correspondence: Dr. Ijum Doye, Department of Oral Medicine and Radiology. Sri Rajiv Gandhi College of Dental Science and Hospital, Bengaluru - 560 032, Karnataka, India. E-mail: doyechristina@gmail.com Received: 19 June 2021; Accepted: 22 July 2021 doi: 10.15713/ins.ijmdcr.179 How to cite the article: Nagaraj T, Doye I, Okade D, Kongbrailatpam S. Central giant cell granuloma: A case report. Int J Med Dent Case Rep 2021;13:1-4. Introduction Central giant cell granuloma (CGCG) is a benign, proliferative, intraosseous, and non-odontogenic lesion of unknown etiology. The term giant cell reparative granuloma (GCRG) was frst used by Jafe in 1953, to distinguish these lesions from giant cell tumor of long bones. [1-3] The nature of this lesion is controversial; three competing theories prevailing is being reactive, a developmental anomaly, or benign neoplasm. [4] Neville et al. considered this entity to be a nonneoplastic lesion and the World Health Organization also classifes it as a bone-related lesion and not a tumor, although its clinical behavior and radiographic features often are those associated with a benign tumor. [5] According to the World Health Organization 1992 classifcation, CGCG is defned as “an intraosseous lesion consisting of more or less fbrous tissue containing multiple foci of hemorrhage, aggregates of multinucleated giant cells, some amount of trabeculae of woven bone forming within the septa of more mature fbrous tissue that may traverse the lesion.” [5] Case Report A 29-year-old male patient came to the department of oral medicine and radiology with a complaint of swelling on the lower left back tooth region for 3 months [Figure 1]. History revealed that the patient had pain on that same region which subsided after taking medication. Swelling was gradual in onset and increased till the present size with numbness (paresthesia in the lower lip). The patient’s medical, dental, and family histories were non-contributory. The patient had a habit of chewing gutkha 4–5 packets/day for 4 years. On examination, a difuse ill-defned swelling was seen on the left middle and lower third of the face measuring approximately 5x6 cm in size, extending anteroposteriorly from the left commissure of the mouth to 2 cm before the earlobe and superoinferiorly from the infraorbital margin to the lower border of the mandible. On palpation, the swelling was tender and bony hard in consistency. Submandibular lymph nodes were not palpable. Intraorally, the presence of well-defned swelling on the lower left vestibule and buccal mucosa was seen, which was ovoid in shape, with buccal cortical expansion and mild lingual expansion, measuring approximately 6 × 5 cm in size, extending bucally from distal of 32 to distal of 37 and lingually from the mesial of 32 to distal of 35 with widening in the middle buccal area showing “egg-shell crackling” [Figure 2]. On palpation, it was tender and bony hard in consistency. Based on the clinical presentation, a provisional diagnosis of ameloblastoma was given. CGCG, aneurysmal bone cyst, and odontogenic keratocyst (OKC) were considered as diferential diagnosis. The orthopantomogram [Figure 3] showed a single radiolucent lesion in the left mandibular body extending from 33 to 37, ovoid is shape, well-defned periphery with sclerotic border, measuring about 5 × 4 cm in size with multiplanar root