Giant cell reparative granuloma (GCRG) is a non-neoplastic hyperplasia of bones that mostly happens in the mandible and maxilla in any age group but has a predilection for children and young adults. GCRGs that cause bone destruction are of very low frequency. Orbital-involved cases have been rarely reported since 1981, especially in children. We now report a 1-year-old girl with a rapidly enlarging post-traumatic orbital mass. CT scan and surgical resection showed a well-defined mass occupying the upper right orbit, causing bone destruction. Microscopically there was a proliferation of histocytes and some osteoclast-like multinucleated giant cells with hemosiderin, finally confirmed to be GCRG. 22 months\' follow up showed no evidence of recurrence. This case suggests infant orbital GCRG can be locally aggressive.

Giant cell reparative granuloma (GCRG) is a benign nonneoplastic granulomatous lesion and is rare in the cranial bone. We present a pediatric case of this lesion arising from the condyle and lower clivus. A 9-year-old girl presented with slowly progressive hoarseness and dysphagia. She showed left glossopharyngeal, vagus, and hypoglossal nerve palsy. An osteolytic lesion around the lower clivus and condyle joint was accompanied by deformation of the craniovertebral junction. An endoscopic endonasal approach was used to decompress the cranial nerve and confirm the pathological finding. The lesion around the condyle was not resected to preserve occipito-cervical stability. The residual lesion has been observed carefully for 6 months, and regrowth has not occurred. GCRG is a rare granulomatous lesion in the cranial bone. This case is the first report of a pediatric clival GCRG. Treating pediatric GCRG may be helpful.

BACKGROUND: Giant cell reparative granuloma (GCRG) is a rare benign tumor. The jawbone is the most common site of occurrence, followed by sphenoid bone, craniofacial bone, hand and foot bones. The etiology of GCRG is unknown but may be related to an intraosseous hemorrhage following trauma. Despite its benign nature, it could be locally aggressive. To our knowledge, no spinal epidural GCRG case has been reported.
METHODS: A case of man aged 32 years who presented with upper right limb numbness and weakness. Computed tomography showed a round soft tissue mass in the spinal canal at the C7-T1 level. The mass showed isointensity on T1-weighted images, hypointensity on T2-weighted images, and significant enhancement on postcontrast T1-weighted images. The mass localized in the epidural space and was surgically resected. The histologic diagnosis was consistent with GCRG.
CONCLUSIONS: Spinal epidural GCRG is rare and is hardly considered in the differential diagnosis. Preoperative diagnosis of GCRG is challenging, and the definitive diagnosis could only be made by pathological examination. Surgical resection is probably an effective therapy for relief of symptoms.

OBJECTIVE: To report 3 cases of cherubism, one of whom underwent surgery for orbital manifestations, and to provide a literature review.
METHODS: Our patients were normal at birth and developed painless enlarging of the cheeks and jaws when they were 4-5 years old. Ophthalmologic examinations showed mild proptosis, superior globe displacement and inferior scleral show in all cases. Cases 2 and 3 had lower lid skin discoloration. Computed tomography (CT) scans demonstrated bilateral multicystic lesions in the maxilla and mandible with cortical thinning in all cases. In Case 3, left eye hyperglobus and anisometropic amblyopia was seen. In this case, the CT scan showed a round, well-defined and homogeneous mass, involving the anterior and superior walls of the maxillary sinus on the left side, extending into inferior orbit. Debulking of the mass was performed at the surgery. The pathologic findings were compatible with the diagnosis of giant cell reparative granuloma. He returned 1 year after surgery with recurrence of the mass.
CONCLUSIONS: A few cases were reported in the literature with histopathologically proven orbital cherubism. To our knowledge, lower lid skin discoloration in Cases 2 and 3 and anisometropic amblyopia in case 3 were not described elsewhere in cherubism cases. We recommend that all cases with cherubism must be examined by an ophthalmologist to diagnose and treat possible orbital manifestations.

BACKGROUND: Giant cell reparative granulomas (GCRGs) are rare lesions in the cranial bones. We present a case of this rare lesion emanating from the clivus and replacing the sphenoid sinus, a highly unusual location for this entity.
METHODS: The case and clinical course of a 29-year-old female who presented with a large sphenoid mass are described here. The patient presented with symptoms of severe headache and diplopia; imaging demonstrated a large sphenoid mass which was completely resected via an endoscopic endonasal approach. It was based on the clivus and was shown to be a GCRG.
CONCLUSIONS: GCRGs are benign granulomatous lesions which should be considered in the differential in the setting of a sphenoid mass.