AM, a 38-year-old white woman, consulted in September 2000 for facial asymmetry and pain. She presented with a tumour of progressive growth in the left hemimaxillary region of 9 months' evolution. On facial examination, an increase in volume was observed in the left infraorbital region, which slightly raised the lower eyelid. There was no deviation of the nasal pyramid, but there was subjective obstruction of the left nostril. The ocular examination showed no alterations. The oral examination showed caries in tooth 23 and fillings in tooth 21, 22, 24, 26 and 27 and absence of tooth 25. A large mass of diffuse limits, covered by healthy mucosa, and erythematous, deformed the left upper labial vestibule. On palpation, the lesion had crepitant and soft areas, was asymptomatic and had clear borders. The mass extended palatally, slightly deforming the alveolar ridge and the palatine vault. Anterior rhinoscopy showed no alterations of the nasal floor or walls.

Waters X-ray showed a unilocular homogeneous radiolucent mass of 5 cm in greatest diameter, occupying the entire left maxilla, displacing the maxillary sinus and reaching the infraorbital rim, with clear limits, but not corticalised.
Computerised axial tomography showed a spherical mass extending from the canine or anterior pillar to the pterygoid process, which expanded and thinned the cortices and in some areas perforated them. There was destruction of the intersinuso-nasal septum and involvement of the inferior turbinate. It was a radiolucent image with radiopaque elements inside, suggesting trabeculations.

The protocol described above for the treatment of LCG was implemented. Regional anaesthesia was performed by means of a left maxillary nerve block through the posterior palatine foramen according to the Carrea technique.19
Two series of intralesional corticosteroids were performed. The first series started in September 2000 and was completed in October 2000. Then, in mid-December 2000, the second series was performed 2 months after the completion of the first series. In this second series there was an interval of 2 weeks in which the patient did not receive treatment as she missed the scheduled appointments, so it was decided to perform the infiltrations at home.
In March 2001, 2 months after the end of the second series and after considering that the lesion was not going to reduce further in size, it was decided to perform the enucleation under general anaesthesia using a buccal approach through the upper vestibule. Macroscopically the lesion corresponded to a fibrous, encapsulated, non-friable, non-bleeding lesion that was easily enucleated from the bone cavity.

The histological diagnosis corresponded to a GCL. The description of the pathological anatomy highlighted that the lesion was predominantly fusocellular with collagenised sectors and also noted the presence of osteoid and bone trabeculae lined by osteoblasts.
In summary, the patient received 12 corticosteroid infiltrations in 2 series and then underwent enucleation of the lesion. Clinically and radiographically, at 22 months follow-up there is no evidence of residual lesion or recurrence.
The patient had no adverse effects to corticosteroid treatment.

