A 38-year-old white woman presented with facial pain and pain in September 2000.
He had a progressive growth tumor of left hemimaxillary of 9 months of evolution.
Facial examination revealed increased volume in the left infraorbital region, slightly raising 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.
Oral examination revealed tooth decay 23 and fillings in teeth 21, 22, 24, 26 and 27 and absence of tooth 25.
A large mass of diffuse limits, covered by healthy, erythematous mucosa, deformed the left upper latero vestibule.
The apex beat, the lesion presented crepitant zones and other soft tissues, was asymptomatic and presented net limits.
The mass extended towards the palatine bone slightly deforming the alveolar ridge and the palatal vault.
Anterior rhinoscopy showed no alterations in the floor or nasal walls.
1.
Waters X-ray showed a homogeneous unilocular radiolucent mass of 5 cm in diameter larger, occupying the entire left maxilla, displacing the maxillary sinus and reaching the infraorbital rim, but not cortical.
Computed tomography showed a spherical mass extending from the canine or anterior pillar to the pterygoid process, which expanded and tuned the cortical areas.
There was destruction of the intersinuso-nasal septum and involvement of the inferior turbinate.
It was a radiolucent image with radiopaque elements inside, thinking of trabeculations.
1.
The previously described protocol for the treatment of GCL was implemented.
Regional anesthesia was performed by blocking the left maxillary nerve through the posterior palatine hole according to the Carrea.19 technique.
Two series of intralesional corticosteroids were performed.
The first series started in September 2000 and culminated in October 2000.
Then, in mid-December 2000, the second series was performed 2 months after the completion of the first.
In this second series there was an interval of 2 weeks in which the patient did not receive treatment because she missed appointments and decided to perform treatment at home.
In March 2001, after two months of completion of the second series and after considering that the lesion would not further reduce its size, it was decided to perform enucleation under general anesthesia using a superior buccal approach through the vestibule.
Macroscopically, the lesion corresponded to an encapsulated, non-friable, non-bleeding fibrous lesion that was easily enucleated from the bone cavity.
1.
Histological diagnosis was GCL.
In the description of the lesion, it was emphasized that it was predominantly fusocellular with collagenized sectors and it was also observed the presence of trabeculae and osteoid pathological anatomy guided by bone lesions.
In summary, the patient received corticosteroids in 2 series and then the lesion was enucleated.
From the clinical and radiographic point of view, at 22 months of follow-up there is no evidence of residual lesion or recurrence.
The patient had no adverse effects on corticoid treatment.
