Giant cell granuloma is an uncommon bone lesion, which has slightly different histopathologic characteristics and a more benign clinical course than giant-cell tumors. The Brown tumor of hyperparathyroidism is histologically identical to this lesion; therefore, patients with giant-cell granuloma should be evaluated for parathyroid disease. We present a renal transplant recipient, who had developed eroding intranasal and generalized masses of giant cell granuloma eight years following transplant. A 46-year-old women developed intranasal lesion eight years following renal transplant. The MR imaging study showed lobulated high signal mass at the right nasal cavity with extension upward and invasion into the right ethmoid bone and marked contrast enhancement. An eroding, contrast-enhanced lesion was also found at odontoid. Four years later, her chest CT scan showed multiple expansive bony lesions with sclerotic margin in the ribs and right clavicle. The histopathologic studies of intranasal and right clavicle lesions were identical and compatible with giant cell granuloma. Markedly elevated parathyroid hormone led us to the diagnosis of brown tumor of hyperparathyroidism. To the best of our knowledge, the present case is the first report of brown tumor in a renal transplant recipient who presented with intranasal lesion. We suggest that clinicians should consider brown tumor of hyperparathyroidism as a potential cause of giant cell lesion in renal transplant recipients.