Aggressive Central Giant Cell Granuloma of the Mandible

An 11-year-old Egyptian boy presented with mild pain in his eft lower jaw accompanied by swelling. Clinical examination howed a hard, tender mandibular enlargement extending rom the chin to the left molar area. The orthopantomogram OPG) showed poorly defined multilocular radiolucency inolving the mandibular body from the right lateral incisor to he left first molar (Fig 1A). There were discrete signs of esorption of root apices of the adjacent teeth. Computed omography examination disclosed a large expansive osteoytic lesion with a soap bubble appearance and erosion of both estibular and lingual mandibular cortices (Fig 1B). Incisional biopsy was performed under local anesthesia. ections contained spindle cells within fibrous stroma and rregularly distributed multinucleated giant cells clustering round areas of hemorrhage. Periphery of the lesion howed reactive osteoid tissue formation (Fig 1C). The overall clinical, radiologic, and histopathologic picture as consistent with central giant cell granuloma. Laboratory nvestigations including complete blood count, alkaline phoshatase, calcium, and parathormone levels were within noral limits, while phosphorus level was slightly elevated.