The Peripheral Giant Cell Granuloma in Edentulous Patients: Report of Three Unique Cases

Abstract

The peripheral giant cell granuloma (PGCG) is a rare reactive exophytic lesion taking place on the gingiva and alveolar ridge usually as a result of local irritating factors such as trauma, tooth extraction, badly finished fillings, unstable dental prosthesis, plaque, calculus, chronic infections, and impacted food. This article presents 3 cases of PGCG that presented at the same location of the edentulous mandible of patients that using complete denture for over ten years.

Management of an unusual peripheral giant cell granuloma: A diagnostic dilemma

“…Very few cases of 5 cm diameter PGCG were also reported in literature in which poor oral hygiene and food impaction are the major etiological factors in the lesion growth. [78] As of our knowledge, this is the first case report in which the lesion size (6 × 5 × 5 cm) exceeded 5 cm in diameter and confusing. Histopathologic characteristics of PGCG may be consistent with periodontal ligament or periosteum origin.…”

“…The distinctive feature of PGCG is distinctive mainly due to excess number of giant cells that are disseminated in the connective tissue stroma. [ 8 10 ] The exact basis of giant cells is uncertain. Many opinions have been identified in the literature as osteoblasts, phagocytes, endothelial cells, and spindle cells are thought to be responsible for giant cell proliferation.…”

“…[ 3 4 ] Even though there is no clear evident etiology, it is thought that it may be due to plaque, calculus, constant trauma, tooth extraction, overhanging restorations, unstable dental prosthesis, chronic infections, and food impaction. [ 5 – 8 ] Clinical appearance of PGCGs can present as polyploidy or nodular lesions, primarily bluish red with a smooth shiny or mamillated surface, stalky or sessile base, small and well demarcated. [ 9 10 ] Histological features of PGCG reveal a non-capsulated mass of tissue containing a large number of young connective tissue cells and multinucleated giant cells.…”

“…[ 1 11 ] PGCG is a soft tissue lesion that infrequently affects the underlying bone, although the latter may undergo superficial erosion. [ 8 12 ] The PGCG may cause underlying bone resorption and less commonly underlying teeth. These lesions are not painful unless they are traumatized.…”

A Case of Painless Excision

“…15 The theory states the capacity of PGCGs to enlarge to be 0.1 to 3 cm and 94% of such lesions are <1.5 cm. 16 The extent of these lesions rarely crosses 2 cm in diameter, although larger ones may be seen occasionally. 17 Their gradual growth, however, becomes a tumorous mass, which then counters normal oral function.…”