Central Giant Cell Granuloma of the Sinonasal Region with Orbital Extension Causing Severe Facial Deformity: A Case Report

Abstract

Background: Central giant cell granuloma (CGCG) is a benign osteolytic lesion that predominantly arises in the jaws of children and young adults. Involvement of the sinonasal region is exceptionally rare and may present significant diagnostic and therapeutic challenges because of the close proximity to critical craniofacial structures.

Case Presentation: We report an adult patient who presented with progressive nasal obstruction and marked facial asymmetry caused by an expansile sinonasal mass. Magnetic resonance imaging demonstrated a homogeneously enhancing lesion measuring approximately 45 × 45 × 62 mm involving the left frontal and ethmoid sinuses, with extension into the medial left orbit and compression of the globe without intracranial invasion. Histopathological examination confirmed the diagnosis of central giant cell granuloma. Complete surgical excision was considered technically challenging because of the lesion’s extent and anatomical location. Following multidisciplinary tumor board discussion, adjuvant radiotherapy was recommended to improve local disease control while minimizing treatment-related morbidity.

Conclusion: Although uncommon, central giant cell granuloma should be included in the differential diagnosis of aggressive sinonasal masses. Management of extensive craniofacial lesions requires multidisciplinary evaluation, and adjuvant radiotherapy may represent a reasonable therapeutic option when complete surgical resection is not feasible.