No abstract

Lichen planus (LP) is a chronic disease of the skin and mucous membrane. Oral lichen planus (OLP), the mucosal counterpart of cutaneous lichen planus that presents with a variety of clinical features, about 25% present with oral lesions alone. Patients may develop white striations, white papules, white plaques, erythema, erosions, or blisters affecting predominantly the posterior buccal mucosa bilaterally. The clinical presentation of OLP ranges from mild painless white keratotic lesions to painful erosions and ulcerations. The diagnosis of OLP was based on history, clinical findings and histopathological features. There is no consensus on a single set of criteria for the diagnosis of OLP. Some investigators use only the clinical criteria, while others use both clinical and histopathologic criteria. Furthermore final diagnosis was confirmed by Immunohistochemical staining (IHC) with CD8 precursor cells. The possibility of this lesion to turn malignant justifies the importance of early definitive diagnosis and long term follow up for patients with such disease.

Central Giant Cell Granuloma (CGCG) is a benign, proliferative, intraosseous and nonodontogenic lesion of unknown etiology accounting for approximately 10% of all benign lesions of the jawbones. Lesion usually occurs in patients younger than 30 years, is more common in females than males, and is more common in mandible than maxilla. The clinical feature of CGCG ranges from a slow growing asymptomatic swelling to a rapidly enlarging aggressive lesion. CGCG of the jaws are histologically benign lesions characterized by the presence of giant cells in the richly vascularized stroma of the spindle cells. Differential diagnosis should be performed with other lesions that have multinucleated giant cells (MGCs). Definitive diagnosis relies on correct interpretation of clinical, radiographical and histopathological data. The treatment of CGCG ranges from curettage to resection. Alternative treatments are worthy of consideration, although surgical excision remains the treatment of choice. The aim of this presented case highlights a diagnostic challenge of an aggressive CGCG arising from the maxilla and to discuss a precise differential diagnosis, as well as the surgical approach and follow up which is decisive for successful conventional surgical treatment with no lesion recurrence.