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Pediatric Surgery

Pathology

OMS and Other Dental Specialists

Residents

Session: Pediatrics and Pathology Track: Hot-off-the-Press and Abstract Session

GP2b - Long-Term Success of Intralesional Denosumab for Management of Giant Cell Lesions of Jaws

Thursday, October 1, 2026
10:45 AM - 10:55 AM PDT
Location: Fineran Ballroom 3, Seattle Convention Center Summit
Abstract: Problem statement: Giant cell lesions (GCLs) of jawbones are benign and locally aggressive lesions having high tendency towards recurrence. Traditionally these have been managed with surgery. Recently to reduce surgical morbidity medical management has been reported in the literature. Systemic denosumab, a RANKL inhibitor, has been used successfully in managing GCLs but with many unwanted side effects such as marble-like radiographic appearance of skeleton due to large dose.1,2 The objective of this paper was to report the long-term outcome of a new protocol in the form of intralesional use of denosumab for managing GCLs.

Material and method: The 10 patients with giant GCLs, who were treated with intralesional 60 or 120 mg denosumab as per protocol (from January 2020 to March 2023) and had completed 3 years follow-up after last injection, were evaluated for long-term success.1

Results: All the patients treated with intralesional injection of denosumab responded well to the therapy. There was remodeling and reduction in size of lesion. No adverse effects were observed. All the patients responded well to intralesional therapy with denosumab. The patients had no disease at the time of evaluation and no relapse was seen after 3 years of last intralesional injection. In 4 patients, recontouring of the expanded bone was done to improve facial appearance. There were no adverse effects and other skeletal bones in all the patients had normal radiographic appearance.

Conclusion: Intralesional denosumab was effective in curing the giant cell lesions of jaws. There was no case of relapse after stoppage of the drug over a period of 3 years. Intralesional Denosumab was effective in curing the giant cell lesions of jaws.

References:

1. Jolly SS, Rattan V, Jha V, S Bhadada. Treatment of central giant cell granuloma of the jaws with intralesional denosumab: initial report ;International Journal of Oral and Maxillofacial Surgery, 2026 April ; 55(4) :417-424

2. Hassing GJ, Verkouteren DRC, Breimer GE, van Es RJJ. Novel approach to central giant cell granuloma of the Jaw: Low-dose intralesional denosumab treatment in a case series of nine patients. J Craniomaxillofac Surg. 2025 Sep;53(9):1350-1355.
Initial appearance of Cone beam CT of Giant cell granuloma in a 5 year child treated with four intralesional injections of 60 mg denosumab at interval of 3 months.
Appearance of Cone beam CT of giant cell lesion at completion of four intralesional injections of denosumab. There is gross reduction in size and bone has remodelled..
Five year follow up after last intralesional injection of the same child . All the teeth have erupted and there is normal bone appearance and contour.