Three types of giant cell lesions occur in the facial skeleton; namely, giant cell reparative granuloma, Brown tumor of hyperparathyroidism, and true giant cell tumor -- osteoclastoma preferably called giant cell neoplasm. An appraisal of the clinical course biochemical laboratory data, radiographic appearance, and histological features are all necessary to distinguish between these varieties. Differentiation is a prerequisite to treatment because the management differs in each lesion. Three case reports illustrate these features. The important considerations of facial growth following surgery to the facial skeleton of a child are discussed. Long-term observation is imperative.

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