Giant cell reparative granuloma of nasal cavity, a case report

Giant cell reparative granuloma of the nasal cavity: a rare site of presentation with review of literature

Giant cell reparative granuloma (GCRG) was first described in the 1950s. It is an uncommon and benign reactive tumor that is believed to occur after trauma or inflammation. It most commonly occurs in the maxilla and mandible and rarely affects the nasal cavity. It is often seen in children and during the second to third decades of life, predominantly seen among females. Histopathologically, GCRG shows many osteoclast-like multinucleated giant cells scattered in a background of mononuclear stromal cells and spindle-shaped fibroblasts also associated with areas of hemorrhage. The distinction between GCRG and giant cell tumors (GCT)is crucial since both have a similar clinical and histological presentation, but both have different management. GCTs have malignant potential, may metastasize, and have a high rate of recurrence. Surgical excision is the mainstay therapy of GCRG to ensure a low rate of recurrence. Here we discuss two cases GCRG, both presenting as nasal mass.

"Giant cell reparative tumor: An exceptional differential diagnosis for a lytic lesion of the temporal bone"

BACKGROUND AND IMPORTANCE

Giant cell reparative granuloma is a very rare benign osteolytic lesion. It typically arises in the mandible and rarely involves the skull.

CLINICAL PRESENTATION

A 25-year-old male was admitted in August 2002 for a painless left preauricular mass of several months duration. CT scan revealed an osteolytic extradural lesion located in the temporal bone, with extension to infratemporal fossa. We performed a surgical partial resection of the tumour via a frontotemporal approach. At 36 months after surgery, the lesion continued growth and subsequently we decided to perform a preauricular infratemporal approach. After a ten year-follow-up, the patient remained asymptomatic and a small tumour remnant was visible and stable.

CONCLUSION

Giant cell reparative granulomas that originate from the temporal bone are exceptional. There are no typical radiological features of this disease. Diagnosis is confirmed by analysis of the surgical specimen. Tumor growth requires surgical resection.

Giant cell reparative granuloma in the temporal bone of the skull base: report of two cases

Giant cell reparative granuloma (GCRG) in the temporal bone of the skull base is a very rare benign osteolytic lesion. Here, we report two cases that were initially misdiagnosed according to the patients' histories, clinical symptoms, and brain imaging prior to surgery. One case had a history of resection of a middle cranial fossa meningioma. The other case had a history of otitis media and mastoiditis. Pathological examination of the surgical specimens led to the diagnosis of GCRG for both cases. Both patients recovered well after surgical removal of the lesion without radiotherapy. Follow-up for 2 years indicated no recurrence of GCRG. These two cases support the hypothesis that repairing responses of bone tissue to either trauma or inflammation may underlie the pathogenesis of GCRG.