Abstract

Central Giant Cell Granuloma (CGCG) is a relatively uncommon benign intraosseous lesion of the jaws, typically characterized by the presence of multinucleated giant cells within a fibroblastic stroma. It shows a variable clinical behavior ranging from slow-growing asymptomatic lesions to aggressive lesions causing significant bone destruction. The lesion predominantly affects children and young adults, with a higher prevalence in females. This article reviews the etiology, clinical features, histopathological characteristics, differential diagnosis, and current treatment modalities for CGCG. Central Giant Cell Granuloma (CGCG) is a benign intraosseous lesion of the jaws that presents with variable clinical and radiographic features, ranging from slow-growing asymptomatic swellings to aggressive lesions with rapid expansion and cortical bone perforation. Despite being non-neoplastic in nature, its behavior can sometimes mimic malignant processes, necessitating a nuanced approach to diagnosis and management. CGCG predominantly affects children and young adults, with a higher incidence in females and a predilection for the anterior region of the mandible. Histopathologically, it is characterized by the presence of multinucleated giant cells dispersed in a fibroblastic stroma with hemorrhagic foci and hemosiderin deposits. The etiology of CGCG remains uncertain, although its histological resemblance to lesions such as giant cell tumors of long bones and brown tumors in hyperparathyroidism complicates differential diagnosis. Advanced imaging modalities and histopathologic evaluation remain the cornerstones of diagnosis. Biochemical screening is critical to exclude systemic causes such as hyperparathyroidism, which can present with similar features. Management strategies for CGCG are diverse and depend on the lesion's size, location, and biological behavior. Surgical curettage remains the most common approach, although aggressive cases may require en bloc resection. In recent years, alternative therapies including intralesional corticosteroids, calcitonin, interferon-α, and denosumab— have shown promise in minimizing surgical morbidity and preserving vital anatomical structures. Long-term follow-up is essential due to the risk of recurrence, particularly in aggressive variants.