Isolated orbital giant cell reparative granuloma in a 4-year-old: case report and literature review.

Giant cell reparative granuloma (GCRG) is a rare, benign fibro-osseous lesion, with orbital involvement being particularly uncommon in young children. We describe a 4-year-old boy with progressive right orbital inferior dystopia and proptosis, without history of trauma, sinus disease, or systemic illness. Imaging showed a well-circumscribed superonasal orbital mass with osseous erosion. Through an upper conjunctival fornix approach combined with superior lateral cantholysis, the mass was debulked to preserve vital orbital structures. The lesion appeared highly vascular and yellowish-brown intraoperatively, and histopathology confirmed GCRG. Postoperatively, a short course of low-dose oral corticosteroids was given. The patient achieved complete resolution with no recurrence at 22-month follow-up. This case represents one of the youngest reported patients with isolated orbital GCRG and demonstrates that conservative, function-preserving surgery with adjuvant corticosteroids can be effective. The favorable outcome supports a possible inflammatory component in its pathogenesis and suggests that radical excision may not be necessary in all pediatric cases.