Central Giant Cell Granuloma Misdiagnosed as Mandibular Osteomyelitis: A Case Report.

This case report presents the diagnostic workflow of a patient initially suspected of osteomyelitis of the jaw who was ultimately diagnosed with central giant cell granuloma (CGCG). A 60-year-old male patient with no significant medical history presented with a painful intraoral swelling in the posterior region of the left mandible. The patient reported the extraction of the left mandibular first molar six months prior to presentation. Radiographic evaluation included periapical, panoramic, and cone-beam computed tomography (CBCT) imaging, which revealed an osteolytic lesion with ill-defined borders, as well as erosion and destruction of the cortical plates. Based on the clinical presentation and radiographic findings, the initial diagnosis was osteomyelitis of the mandible. Surgical removal of the lesion was performed, and subsequent histopathological examination unexpectedly established the diagnosis of CGCG. During the one-year follow-up period, the patient showed no evidence of recurrence. This case underscores the importance of a comprehensive, multidisciplinary diagnostic approach and highlights the need to maintain a broad differential diagnosis when evaluating destructive lesions of the jaws, as biopsy and histopathological examination remain essential for definitive diagnosis.