Giant-cell lesions of the facial skeleton.

Differentiation of brown tumors of primary or secondary hyperparathyroidism, giant-cell reparative granulomas, and the "true" giant-cell tumors requires consideration of the clinical presentation, anatomic location, roentgenographic features, and results of metabolic studies. These lesions are indistinguishable by histologic appearance alone. Of the 32 giant-cell lesions of bone that were treated at UCLA during the preceding 20 years, seven were from the head and neck region. Four giant-cell reparative granulomas were easily accessible and were treated by local excision. The three "true" giant-cell tumors were found to be in inaccessible locations and thus were treated with full course irradiation. This resulted in tumor shrinkage, but it is probably not curative. Tumor type, location, and clinical setting are important in planning treatment of these lesions.