ADVANCED GIANT-CELL GRANULOMA - A 20-YEAR STUDY

Giant cell granuloma is a benign lesion that generally involves the ma ndible and maxilla. It may be locally aggressive and result in extensi ve tissue destruction in advanced cases. A retrospective analysis of g iant cell granuloma during the interval 1970 to 1990 revealed 18 cases of advanced disease, as defined by bone destruction and a greatest di mension of 2.0 cm or more. Epidemiologic factors, physical findings, i maging studies, pathologic specimens, treatment modalities, and outcom e were reviewed for each case. Eight lesions were treated by local exc ision and curettage, and 10 were treated by partial mandibulectomy. Fi ve mandibular defects were reconstructed with iliac bone grafts and on e with a free flap. Only one patient with maxillary giant cell granulo ma who underwent curettage had regrowth of what is suspected to have b een residual disease. Individualized treatment, tailoring the extent o f resection to the extent of disease, provided excellent results.