Central giant cell granuloma (CGCG) is a relatively uncommon benign bony lesion accounting for approximately 7% of all non-neoplastic lesions of the jaw. The clinical behavior of CGCG can vary from a slow-growing, painless lesion to fast-growing and locally destructive. When such a lesion involves the mandible, this can be quite debilitating for the patient, inhibiting oral intake and requiring an extensive resection and bone graft reconstruction. The authors present a case of effectively decreasing the surgical morbidity associated with a large and rapidly growing CGCG of the mandible in a pediatric patient. Neoadjuvant immunotherapy with denosumab (human monoclonal antibody) facilitated treatment of the tumor without the need for a large resection which would have otherwise necessitated a vascularized bony mandibular reconstruction. Consideration of neoadjuvant medical management of CGCG as the primary treatment is advocated.
Address correspondence and reprint requests to Salvatore Lettieri, MD, Mayo Clinic Division of Plastic Surgery, 13400 E. Shea Blvd, Scottsdale, AZ 85259; E-mail: lettieri.salvatore@mayo.edu
Received 7 July, 2020
Accepted 23 August, 2020
Denosumab use for central giant cell granuloma is considered an off-label use. Denosumab has been FDA approved for treatment of giant cell tumor of bone and its use for central giant cell granuloma has been documented in other case series and reports.7,16,17
The authors have no conflicts of interest to disclose.
© 2020 by Mutaz B. Habal, MD.
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