Giant cell reparative granuloma of the nasal cavity in an elderly man: A case report and literature review

Abstract

Giant cell reparative granuloma (GCRG) is an uncommon and benign reactive tumor which was first described in the 1950s. It is a reactive tumor that is believed to occur after trauma or inflammation. The lesion is considered central if there is involvement of bone or peripheral if affecting only the soft tissue, such as gingiva or mucosa. It is most commonly found in the bones of the maxilla and mandible, and rarely affects the nasal cavity. It is often seen in children and young adults in the second to third decade of life and it is more common in females. Histopathological classification of GCRG shows a large number of osteoclast-like, multinucleated giant cells within a background of mononuclear stromal cells and spindle-shaped fibroblasts associated with areas of hemorrhage. It is important to distinguish GCRG from giant cell tumors (GCT) since GCTs have a high rate of recurrence, can metastasize, and undergo malignant transformation. Non-surgical treatments of GCRG have been reported in the literature including the use of corticosteroid injections, calcitonin, interferon alpha, radiation therapy, intravenous bisphosphonates, thermal sterilization using laser or cryoprobe, and partial resection. However, surgical resection remains the mainstay of treatment of GCRG to ensure a low chance of recurrence. A case of a left-sided nasal mass that arose from the mucosa of the nasal cavity in an elderly gentleman was removed with surgical resection. Subsequent histopathology yielded the diagnosis of Giant Cell Reparative Granuloma. Keywords: Giant cell reparative granuloma (GCRG), Giant cell tumor (GCT)