JL, a 46-year-old white woman presented with facial palsy in February 2000, and difficulty in using her lower prosthesis.
It occurred with an increase of left parasymphyseal volume of 1 year of evolution, of slow growth and that in the last months it had stabilized, and did not remember traumatic antecedents in the area.
Oral examination revealed a complete upper and lower edentulous patient.
In the left anterior mandibular zone a mass was observed that expanded the buccal and lingual cortical bone, covered by healthy mucosa in which telangectasias were observed.
At fixation, the limits were net, there was crepitation of the buccal cortical and lingual perforation.
Objective and subjective neurological examination confirmed that there was no involvement of the inferior alveolar nerve, Vincent's sign (-).
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On imaging examination, a radiolucent lesion with radiopaque areas inside, unilocular of approximately 6 cm in its largest diameter, with defined and non-corticalized limits, was observed.
The lesion extended from approximately the left premolar area to the right incisor area crossing the midline.
He deformed and thinned the mandibular basal bone and displaced the inferior alveolar canal.
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The previously described protocol for the treatment of GCL was implemented.
Two series of intralesional corticosteroids were performed.
The first series was conducted between March and April 2000 and the second series began in September 2000, 5 months after the end of the first series.
Fifteen months after the beginning of treatment, in May 2001, due to the fact that it did not decide that the cortical bones did not pass through the needle to try a new series of surgical enucleation, it was decided to perform the lesion.
Under general anesthesia, the lesion was treated with an oral approach.
Contrary to what was expected, no bleeding lesion was found, friable corresponding to the macroscopic characteristics of the GCL, but an increase in bone volume without clear limits with normal bone structure was found.
Surgical removal of the lesion was performed.
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Currently, the patient is in clinical cure 39 months after the beginning of treatment and 24 months after the start of surgical closure, without deviation of the facial midline and with an inferior alveolar ridge suitable for use.
