Surgical treatment is warranted in aggressive central giant cell granuloma: A report of 2 cases

March 1, 2009     Jason Roberts, MD, Carol Shores, MD, and Austin S. Rose, MD


Central giant cell granuloma (CGCG) is a benign but locally destructive lesion of the mandible or maxilla that presents most often in the second and third decades of life. Reports of treatment include curettage or complete en bloc resection and nonsurgical approaches such as intralesional steroid injections, interferon alfa-2a, and calcitonin. We describe the cases of 2 young adults with CGCG of the maxilla involving the palate. The first patient, an 18-year-old man, was initially treated with a partial maxillectomy via a facial degloving approach and a postoperative series of transoral intralesional steroid injections to the site of the residual hard palate disease. The partial maxillectomy achieved a near-total debulking of the mass and immediate cosmetic improvement, and the steroid injections resulted in initial regression of the residual disease. However, the patient experienced a recurrence 8 months postoperatively, so a bilateral total inferior maxillectomy via a facial degloving approach was performed with subsequent placement of an obturator. No recurrence was seen 15 months following revision surgery. In view of the incomplete resolution of disease with the use of steroid injections in the first patient, we treated the second patient, a 22-year-old woman, with a subtotal maxillectomy without steroid injection. No recurrence of disease was noted 12 months postoperatively. We conclude that a combination of partial surgical resection and intralesional steroid injection may not be sufficient for the treatment of large CGCGs of the maxilla. Complete surgical resection should be considered for the initial treatment of CGCG, particularly in aggressive cases.

An unusual presentation of Teflon granuloma: Case report and discussion

January 1, 2009     Nitin A. Pagedar, MD, Catherine M. Listinsky, MD, and Harvey M. Tucker, MD, FACS


For more than 25 years, Teflon was the most commonly used material for injection laryngoplasty. However, the incidence of Teflon granuloma and the consequent deterioration of glottic function ultimately led to the development of other injectable materials, and as a result, Teflon granulomas are no longer frequently encountered. We present a case of Teflon granuloma that was unusual in that (1) a long period of time had elapsed between the injection and the granuloma formation and (2) there was no change in the patient's glottic function.

Laryngeal sarcoidosis

April 30, 2008     Enrique Palacios, MD, FACR, Andrew Smith, MD, and Neel Gupta, MD

Neurosarcoidosis presenting as complicated sinusitis: A case report and review

February 1, 2008     Lt. Matthew T. Brigger, MD, Maj. Ian K. McLeod, MD, and Cdr. Martin P. Sorensen, MD


Sarcoidosis is a systemic granulomatous disease with widely variable clinical characteristics, including numerous head and neck manifestations. We describe the case of a 49-year-old man who presented to the emergency department with symptoms consistent with complicated sinusitis. He was ultimately found to have an atypical case of neurosarcoidosis. This case illustrates the varied multisystem presentation of sarcoidosis and the diagnostic considerations that are merited.

Eosinophilic granuloma: Bilateral temporal bone involvement

May 31, 2007     Chester P. Barton III, MD; Drew Horlbeck, MD
Eosinophilic granuloma is an uncommon condition that is characterized by unifocal or multifocal osteolytic lesions that often affect the skull. Unilateral lesions of the temporal bone are not uncommon, but bilateral temporal bone lesions are rare. In fact, to the best of our knowledge, fewer than 20 such cases have been reported during the past 40 years. We report a new case of bilateral temporal bone eosinophilic granuloma, and we review the disease process and its treatment.

Multifocal tuberculosis of the nose and lymph nodes without pulmonary involvement: A case report

April 30, 2007     M. Panduranga Kamath, MS; Kiran M. Bhojwani, MS; Shivananda Prabhu, MS; Ramdas Naik, MD; Geo P. Ninan, MBBS; Yeshwanth Chakravarthy, MBBS

Vocal process granuloma

March 31, 2007     Robert Eller, MD; Linda Marks, RN; Mary Hawkshaw, BSN, RN, CORLN; Robert T. Sataloff, MD, DMA

Teflon granuloma

March 1, 2007     James R. Tate, MD; Peter C. Belafsky, MD, PhD; Kristen Vandewalker, MD

Recalcitrant arytenoid granuloma

January 1, 2007     Robert Eller, MD; Mary Hawkshaw, BSN, RN, CORLN; Robert T. Sataloff, MD, DMA

Poststapedectomy reparative granuloma

August 31, 2006     Willis S.S. Tsang, FRCS (ORL); John K.S. Woo, FRCS (ORL); Michael C.F. Tong, MD

Larynx contact ulcer

May 31, 2005     Lester D.R. Thompson, MD

Cholesterol granuloma

April 30, 2005     Arun K. Gadre, MD
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