Giant cell reparative granuloma of the sphenoid: Case report and review of the literature

Abstract

Background:Giant cell reparative granulomas (GCRGs) are rare lesions in the cranial bones. We present a case of this rare lesion emanating from the clivus and replacing the sphenoid sinus, a highly unusual location for this entity.Case Description:The case and clinical course of a 29-year-old female who presented with a large sphenoid mass are described here. The patient presented with symptoms of severe headache and diplopia; imaging demonstrated a large sphenoid mass which was completely resected via an endoscopic endonasal approach. It was based on the clivus and was shown to be a GCRG.Conclusion:GCRGs are benign granulomatous lesions which should be considered in the differential in the setting of a sphenoid mass.

Radiological features of Central Giant Cell Granuloma: Comparative study of 7 case reports and literature review

“…The histologic ndings of CGCG, Giant Cell Tumor (GCT) and brown tumor of hyperparathyroidism have virtually identical histologic features and closely resembles granulomas. Immunohistochemical studies have reported CGCG positive for CD 68 [5,6]. In our study also, 4 cases of Immunohistochemistry were positive for CD 68.…”

“…Histological examination of CGCG suggests the lesions are composed of hypercellular brous stroma containing numerous multinucleated giant cells within the background of mononuclear stromal cells and spindle shaped broblasts along with areas of hemorrhages or foci of cystic degeneration and osteoid production [5,6,7,10,11,12]. The histologic ndings of CGCG, Giant Cell Tumor (GCT) and brown tumor of hyperparathyroidism have virtually identical histologic features and closely resembles granulomas.…”

“…It can be present in patients from age of 2 years above. But most cases are seen between 20 to 40 years of age [1,5]. Females are affected slightly more than males, the reason for this is thought to be because of hormonal factors despite the fact that lesions rarely express estrogen receptors [6,10].…”

“…Other theories on pathogenesis of CGCG including infectious and repair process, developmental disturbance, or even in ammatory causes had been proposed, but no single theory has been widely accepted [12]. It has also been hypothesized as genetic etiology but lacks the convincing evidence to support the hypothesis [5,6].…”

“…The differential diagnosis of CGCG includes aneurysmal bone cyst, benign chondroblastoma, brown tumor of hyperparathyroidism, cherubism, brous dysplasia, non-osteogenic broma, osteosarcoma and true giant cell tumor [5,7,12].…”