Giant cell reparative granuloma of the pediatric cranium: case report and review of the literature.
OBJECTIVE
Giant cell reparative granulomas are rare bone tumors. Although benign, these tumors are locally destructive and can be highly vascular. They seldom occur in the cranial vault. We describe a multidisciplinary approach to a case of giant cell reparative granuloma of the cranium in a 3-year-old patient.


METHODS
A 3-year-old girl female referred to the pediatric neurosurgery department for evaluation of a retro-auricular mass. She had a history of recurrent otitis media with two subsequent courses of antibiotics without resolution. CT imaging revealed an expansive lesion located in the right mastoid region. Open surgical biopsy revealed a hemorrhagic tumor consistent with a giant cell reparative granuloma. Angiography identified a hypervascular tumor blush that was supplied by the occipital artery. Preoperative transcatheter embolization was performed followed by a multidisciplinary surgical resection and reconstruction. Blood loss was minimal, and the patient recovered well after surgery.


CONCLUSIONS
Preoperative endovascular embolization and a multidisciplinary intraoperative approach with primary resection and cranial vault reconstruction is an effective approach to hypervascular giant cell reparative granulomas.
Departments of Neurosurgery, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA.
Adam
A
Conley
Brian H
BH
Cho
Gary W
GW
Tye
John
J
Reavey-Cantwell
Daniel
D
Coelho
Christine E
CE
Fuller
Jennifer L
JL
Rhodes
D001706:Biopsy; D002533:Cerebral Angiography; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004621:Embolization, Therapeutic; D005260:Female; D006101:Granuloma, Giant Cell / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D019635:Neurosurgical Procedures / Q000379:methods; D010347:Patient Care Planning; D010348:Patient Care Team; D011183:Postoperative Complications / Q000517:prevention & control; D040242:Risk Reduction Behavior; D012886:Skull / Q000601:surgery; D012888:Skull Neoplasms / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome