eMedicine Specialties > Dermatology > Diseases of the Oral Mucosa

Peripheral Giant Cell Granuloma: Differential Diagnoses & Workup

Author: Carl Allen, DDS, Director, Oral and Maxillofacial Pathology, Professor, Department of Oral and Maxillofacial Surgery and Pathology, Ohio State University College of Dentistry; Professor, Department of Pathology, Ohio State University College of Medicine
Contributor Information and Disclosures

Updated: Jan 20, 2009

Differential Diagnoses

Kaposi Sarcoma
Metastatic Neoplasms to the Oral Cavity
Oral Malignant Melanoma
Oral Pyogenic Granuloma

Other Problems to Be Considered

Peripheral ossifying fibroma
Peripheral odontogenic neoplasms
Gingival cyst of the adult
Brown tumor of hyperparathyroidism5

Workup

Laboratory Studies

Laboratory studies are generally not necessary, although a serum calcium level or a parathyroid hormone assay may be indicated to rule out the rare possibility of brown tumor for lesions that are particularly large, recurrent despite adequate surgery, multiple, or associated with systemic signs suggestive of hyperparathyroidism.

Imaging Studies

Periapical radiographs typically demonstrate a cupping out or saucerization of the alveolar bone that underlies a peripheral giant cell granuloma.

Histologic Findings

Intact or ulcerated surface epithelium covers peripheral giant cell granulomas. The underlying connective tissue contains a benign proliferation of granulationlike tissue that supports numerous benign multinucleated giant cells. Abundant extravasated blood is typically noted, and deposits of hemosiderin are seen at the periphery of the lesional tissue. Spicules of woven or lamellar bone may be observed in approximately 35% of peripheral giant cell granulomas.6

More on Peripheral Giant Cell Granuloma

Overview: Peripheral Giant Cell Granuloma
Differential Diagnoses & Workup: Peripheral Giant Cell Granuloma
Treatment & Medication: Peripheral Giant Cell Granuloma
Follow-up: Peripheral Giant Cell Granuloma
Multimedia: Peripheral Giant Cell Granuloma
References
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References

  1. Bodner L, Peist M, Gatot A, Fliss DM. Growth potential of peripheral giant cell granuloma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. May 1997;83(5):548-51. [Medline].

  2. Bischof M, Nedir R, Lombardi T. Peripheral giant cell granuloma associated with a dental implant. Int J Oral Maxillofac Implants. Mar-Apr 2004;19(2):295-9. [Medline].

  3. Hirshberg A, Kozlovsky A, Schwartz-Arad D, Mardinger O, Kaplan I. Peripheral giant cell granuloma associated with dental implants. J Periodontol. Sep 2003;74(9):1381-4. [Medline].

  4. Cloutier M, Charles M, Carmichael RP, Sandor GK. An analysis of peripheral giant cell granuloma associated with dental implant treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;103:618-622. [Medline].

  5. Choi C, Terzian E, Schneider R, Trochesset DA. Peripheral giant cell granuloma associated with hyperparathyroidism secondary to end-stage renal disease: a case report. J Oral Maxillofac Surg. May 2008;66(5):1063-6. [Medline].

  6. Dayan D, Buchner A, Spirer S. Bone formation in peripheral giant cell granuloma. J Periodontol. Jul 1990;61(7):444-6. [Medline].

  7. Sahingur SE, Cohen RE, Aguirre A. Esthetic management of peripheral giant cell granuloma. J Periodontol. Mar 2004;75(3):487-92. [Medline].

  8. Grand E, Burgener E, Samson J, Lombardi T. Post-traumatic development of a peripheral giant cell granuloma in a child. Dent Traumatol. Feb 2008;24(1):124-6. [Medline].

  9. Martins MD, Pires F, Daleck F, Myaki SI, Friggi MN, Martins MA. Peripheral giant cell granuloma in anterior maxilla: case report in a child. J Clin Pediatr Dent. Winter 2005;30(2):161-4. [Medline].

  10. Pandolfi PJ, Felefli S, Flaitz CM, Johnson JV. An aggressive peripheral giant cell granuloma in a child. J Clin Pediatr Dent. Summer 1999;23(4):353-5. [Medline].

  11. Warrington RD, Reese DJ, Allen G. The peripheral giant cell granuloma. Gen Dent. Nov-Dec 1997;45(6):577-9. [Medline].

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Further Reading

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Keywords

peripheral giant cell epulis, peripheral giant cell reparative granuloma

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Contributor Information and Disclosures

Author

Carl Allen, DDS, Director, Oral and Maxillofacial Pathology, Professor, Department of Oral and Maxillofacial Surgery and Pathology, Ohio State University College of Dentistry; Professor, Department of Pathology, Ohio State University College of Medicine
Carl Allen, DDS is a member of the following medical societies: American Academy of Oral and Maxillofacial Pathology, American Dental Association, American Society for Microbiology, International Association for Dental Research, and International Association of Oral Pathologists
Disclosure: Nothing to disclose.

Medical Editor

Terry L Barrett, MD, Clinical Professor of Dermatology and Pathology, University of Texas Southwestern School of Medicine; Director, ProPath Dermatopathology, Dallas, Texas
Terry L Barrett, MD is a member of the following medical societies: American Academy of Dermatology, American Dermatological Association, American Medical Association, American Society of Dermatopathology, College of American Pathologists, and United States and Canadian Academy of Pathology
Disclosure: Nothing to disclose.

Pharmacy Editor

David F Butler, MD, Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic
David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa
Disclosure: 3M Pharmaceutical Grant/research funds Other; Graceway Pharmaceuticals Grant/research funds Other

Managing Editor

Drore Eisen, MD, DDS, Consulting Staff, Department of Dermatology, Dermatology Research Associates of Cincinnati
Drore Eisen, MD, DDS is a member of the following medical societies: American Academy of Dermatology, American Academy of Oral Medicine, and American Dental Association
Disclosure: Nothing to disclose.

CME Editor

Glen H Crawford, MD, Assistant Clinical Professor, Department of Dermatology, University of Pennsylvania School of Medicine; Chief, Division of Dermatology, The Pennsylvania Hospital
Glen H Crawford, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Phi Beta Kappa, and Society of USAF Flight Surgeons
Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

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