Central giant cell reparative granuloma is an infrequent, benign, proliferating lesion affecting the maxilla, mandible and, rarely, cranial bones. A 16-year-old girl presented with a 6-month history of recurrent nasal bleeding, a mass in the nose, difficulty in nasal breathing, a change in voice, and bilateral proptosis. Radiologically, an extensive ethmoidal mass was seen. Histologic examination revealed a central giant cell reparative granuloma. After endoscopic removal, the patient was symptom-free at the 12-month follow-up. The clinical picture of central giant cell reparative granuloma of the ethmoids is discussed, along with the differential diagnosis, histologic evaluation, appearance on computed tomography, and endoscopic management of this lesion.
Jaffe first described giant cell reparative granuloma in 1953.1 It is a reactive osseous proliferation that is benign despite its aggressive clinical course.2 In the head and neck area, it usually involves the maxilla or mandible; it rarely involves the ethmoidal region. We report a case of giant cell reparative granuloma of the ethmoids with bilateral proptosis and intracranial extension in a 16-year-old Hindu girl that was managed endoscopically.