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Clinical Problem Solving: Radiology
Jan 2012

Radiology Quiz Case 2: Diagnosis

Arch Otolaryngol Head Neck Surg. 2012;138(1):92. doi:10.1001/archoto.2011.221-b

Diagnosis: Giant cell granuloma (GCG) of the maxilla

Giant cell granuloma is an uncommon benign intraosseous lesion that was first described as an aggressive focal inflammatory reaction to hemorrhage by Jaffe1 in 1953 and was thought to reflect a reparative process within bone secondary to trauma or chronic inflammation. The lesion has also been termed giant cell reparative granuloma. The descriptor reparative has recently fallen out of favor because the etiology remains unclear2 and because the lesion has also been reported to occur in the setting of chronic inflammation rather than trauma. Giant cell granuloma most often occurs as a solitary lesion in the mandible and maxilla but has also been found in the paranasal sinuses; in the nasal cavity, with or without extension into the lacrimal sac or the sphenoid bone; and, rarely, in the small tubular bones of hands and feet.3-5