Oral cavity
Inflammatory (noninfectious) lesions
Peripheral giant cell granuloma

Author: Charu Thakral, M.D. (see Authors page)

Revised: 17 April 2018, last major update March 2013

Copyright: (c) 2002-2018, PathologyOutlines.com, Inc.

PubMed Search: Peripheral giant cell granuloma[TI] oral

Cite this page: Thakral, C. Peripheral giant cell granuloma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/oralcavityperipheralgiantcellgranuloma.html. Accessed August 17th, 2018.
Definition / general
  • Reactive gingival mass resembling pyogenic granuloma, which pushes teeth aside and may erode alveolar bone or involve periodontal membrane
  • Arises from periodontal ligament enclosing root of tooth
  • Central giant cell granuloma: similar to peripheral giant cell granuloma but multiloculated
Terminology
  • Also called giant cell epulis, giant cell reparative granuloma, osteoclastoma, myeloid epulis
Epidemiology
  • Usually women, 30s to 50s, although may involve children or elderly patients without teeth
Case reports

Central giant cell granuloma:
Treatment
  • Excision with curettage of base of lesion extending into adjacent periodontal membrane
  • Recurs if not completely excised or source of irritation not removed (10% recurrence rate)
Clinical images

Images hosted on other servers:


Hemorrhagic, ulcerated mass

Resembes pyogenic granuloma


22 year old woman:

Preoperative, excision, postoperative



53 year old man:

Pre and postoperative


57 year old woman:

Pre and postoperative


81 year old woman:

Pre and postoperative



Central giant cell granuloma:

Swelling

Extended to midline

Excisional biopsy

Gross description
  • Nodular, pedunculated, inflammatory lesion up to 1.5 cm that protrudes from gingiva at site of chronic inflammation
  • Covered by gingival mucosa or ulcerated
Gross images

Images hosted on other servers:

22 year old woman

Microscopic (histologic) description
  • Nonencapsulated aggregates of foreign body giant cells and fibroangiomatous stroma with hemorrhage, hemosiderin, acute and chronic inflammatory cells
  • Alveolar bone often expanded in edentulous patients, leading to superficial bone loss with peripheral cuffing
  • Variable mitotic activity
Microscopic (histologic) images

Images hosted on other servers:

22 year old woman

81 year old woman

53 year old man



Contributed by Dr. Tim Bracey, Derriford Hospital, Plymouth (UK):

Various images



Central giant cell granuloma:

Irregular giant cells