An Aggressive Variant of Central Giant Cell Granuloma of the Posterior Maxilla With Reactive Osteogenesis: A Case Report and Review of the Literature

Central giant cell granuloma (CGCG) is a benign but locally destructive central lesion of the jaws with variable clinical behavior and overlapping histopathological features with other giant cell-rich lesions, posing diagnostic challenges. We report a case of a 41-year-old female patient presenting with a painless, progressively enlarging swelling in the posterior maxilla. Clinical and radiographic evaluation suggested multiple differential diagnoses. Histopathological examination revealed numerous osteoclast-like multinucleated giant cells (MGC) within a richly vascular fibrous stroma, along with areas of hemorrhage and reactive woven bone formation. Immunohistochemical analysis using p63 demonstrated negative expression, aiding in differentiation from giant cell tumor of bone and confirming the diagnosis of CGCG. The case highlights the importance of comprehensive clinicoradiological and histopathological correlation, supplemented by immunohistochemistry, for accurate diagnosis, particularly in atypical presentations. Considering the potential for aggressive behavior and recurrence, appropriate surgical management and long-term follow-up are essential for optimal outcomes.