Pharmacological Management of Central Giant Cell Granuloma of Jaws - A Narrative Review

Abstract

Central giant cell granuloma (CGCG) of the jaws is a benign but potentially aggressive osteolytic lesion characterized by multinucleated giant cells and a proliferative stromal component. Conventional management has largely relied on surgical approaches; however, these may be associated with recurrence and significant functional and aesthetic morbidity, particularly in extensive lesions. In recent years, pharmacological therapies have gained attention as alternative or adjunctive treatment modalities. This narrative review aims to summarize the current evidence on the pharmacological management of CGCG, focusing on agents such as intralesional corticosteroids, calcitonin, interferon-α, and denosumab. These therapies target key pathogenic mechanisms, including osteoclastogenesis and angiogenesis, thereby promoting lesion stabilization or regression. Intralesional corticosteroids and calcitonin are commonly used for non-aggressive lesions, whereas interferon-α and denosumab are considered in aggressive or refractory cases. Although promising outcomes have been reported, the response to these treatments is variable, and long-term therapy is often required. Additionally, concerns regarding cost, adverse effects, and the limited availability of high-quality evidence persist. A multidisciplinary and individualized approach remains essential in selecting appropriate therapy. Further well-designed clinical studies are needed to establish standardized treatment protocols and optimize outcomes in the management of CGCG.