Peripheral Giant Cell Granuloma

Peripheral Giant Cell Granuloma

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The peripheral giant cell granuloma has an unknown etiology, with some dispute as to whether this lesion represents a reactive or neoplastic process. However, most authorities believe peripheral giant cell granuloma is a reactive lesion. [1] See the image below.

The cause of peripheral giant cell granuloma is unknown, although local irritation due to dental plaque or calculus, periodontal disease, poor dental restorations, ill-fitting dental appliances, or dental extractions has been suggested to contribute to the development of the lesion.

Reports have described the development of the peripheral giant cell granuloma in association with dental implants. This appears to represent an uncommon complication of implant placement, developing from a few months to several years after placement of the dental implant. [2, 3, 4, 5]

Peripheral giant cell granuloma is uncommon but not rare. Precise estimates of its incidence and prevalence in the general population have not been definitively determined.

No known racial predilection is associated with peripheral giant cell granuloma.

One large recent study showed essentially no sex predilection (52% female vs. 48% male).

A wide age range of patients can be affected, although most patients are in the fifth to seventh decades of life at the time of diagnosis of this lesion. One institutional biopsy service reported the mean age of 235 patients with peripheral giant cell granuloma to be 46 years, with a range from 6-88 years.

Peripheral giant cell granuloma has an excellent prognosis. A recurrence rate of 10-20% has been reported in most series; however, recurrences are typically managed easily with additional surgery.  Some investigators have suggested that peripheral giant cell granulomas that develop in association with dental implants seem to have a higher risk for recurrence. [6]

Chrcanovic BR, Gomes CC, Gomez RS. Peripheral giant cell granuloma: An updated analysis of 2824 cases reported in the literature. J Oral Pathol Med. 2018 Mar 22. [Medline].

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

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

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].

Etoz OA, Demirbas AE, Bulbul M, Akay E. The peripheral giant cell granuloma in edentulous patients: report of three unique cases. Eur J Dent. 2010 Jul. 4(3):329-33. [Medline]. [Full Text].

Lester SR, Cordell KG, Rosebush MS, Palaiologou AA, Maney P. Peripheral giant cell granulomas: a series of 279 cases. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014 Oct. 118 (4):475-82. [Medline].

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

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. 2005 Winter. 30(2):161-4. [Medline].

Dereci Ö, Akgün Ş, Celasun B, Öztürk A, Günhan Ö. Histological evaluation of the possible transformation of peripheral giant cell granuloma and peripheral ossifying fibroma: A preliminary study. Indian J Pathol Microbiol. 2017 Jan-Mar. 60 (1):15-20. [Medline].

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. 2008 May. 66(5):1063-6. [Medline].

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

Banthia R, Maheshwari S, Banthia P, Mantri K. Peripheral giant cell granuloma: a case report. Gen Dent. 2013 Jan-Feb. 61(1):e12-4. [Medline].

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

Said Ahmed W. Efficacy of Ethanolamine Oleate Sclerotherapy in Treatment of Peripheral Giant Cell Granuloma. J Oral Maxillofac Surg. 2016 Nov. 74 (11):2200-2206. [Medline].

Carl M Allen, DDS, MSD Professor Emeritus, Division of Oral and Maxillofacial Pathology and Radiology, Ohio State University College of Dentistry; Staff Oral Pathologist, Central Ohio Skin and Cancer, Inc

Carl M Allen, DDS, MSD is a member of the following medical societies: American Academy of Oral and Maxillofacial Pathology, American Dental Association, Columbus Dental Society, International Association of Oral Pathologists, Ohio Dental Association

Disclosure: Nothing to disclose.

David F Butler, MD Former Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Society for MOHS Surgery, Association of Military Dermatologists, Phi Beta Kappa

Disclosure: Nothing to disclose.

Drore Eisen, MD, DDS Consulting Staff, Dermatology of Southwest Ohio

Drore Eisen, MD, DDS is a member of the following medical societies: American Academy of Dermatology, American Academy of Oral Medicine, American Dental Association

Disclosure: Nothing to disclose.

Jeff Burgess, DDS, MSD (Retired) Clinical Assistant Professor, Department of Oral Medicine, University of Washington School of Dental Medicine; (Retired) Attending in Pain Center, University of Washington Medical Center; (Retired) Private Practice in Hawaii and Washington; Director, Oral Care Research Associates

Disclosure: Nothing to disclose.

Peripheral Giant Cell Granuloma

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