BACKGROUND: Giant cell reparative granuloma is a condition commonly found in the facial bones. It has been reported in the skull bones, predominantly the bones comprising the skull base. Giant cell reparative granuloma of the cranial vault is exceedingly rare. Its distinction from a neoplastic lesion is difficult clinically and radiologically. CASE DESCRIPTION: Only the third case of a GCRG of the skull vault, the first in an adult, is described. Its pathophysiology and differential diagnoses influencing management are discussed. CONCLUSION: It is not possible to diagnose this condition definitively on a clinical or radiologic basis, and given its differential diagnoses, an excision biopsy should be offered.
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