AtlasSoft TissuePeripheral Giant Cell Granuloma

Soft Tissue Lesions

Peripheral Giant Cell Granuloma

aka PGCG · Giant Cell Epulis · Peripheral Giant Cell Lesion

Reactive exophytic gingival lesion containing multinucleated giant cells, arising only from attached gingiva or alveolar ridge.

Site
Gingiva / alveolar ridge
Histology
Giant cells + haemosiderin
Rx
Excision to periosteum

§ figuresFigures (2)

Fig. 1High magnification micrograph of a central giant cell granuloma, abbreviated CGCG. CGCGs are lesions of the mandible or maxilla. The soft tissue counterpart is peripheral giant cell granuloma. CGCG is also known as giant

“Central giant cell granuloma - high mag” · Nephron · CC BY-SA 3.0 · Wikimedia Commons

Fig. 2Intermediate magnification micrograph of a central giant cell granuloma, abbreviated CGCG. CGCGs are lesions of the mandible or maxilla. The soft tissue counterpart is peripheral giant cell granuloma. CGCG is also known

“Central giant cell granuloma - intermed mag” · Nephron · CC BY-SA 3.0 · Wikimedia Commons

Verified open-access images only, reproduced for education under their stated licences · no AI-generated or illustrative artwork · Peripheral Giant Cell Granuloma figures pending faculty review.

§ overviewOverview

Non-neoplastic reactive lesion of the gingiva/edentulous ridge characterised by multinucleated osteoclast-like giant cells.

§ icdICD Classification

K06.8

§ etiologyEtiology

  • 01Reactive to local irritation (calculus, trauma, extraction)
  • 02Possibly from periosteum or PDL

§ epidemiologyEpidemiology

Most common giant cell lesion of oral cavity. F > M. Peak 5th–6th decade.

§ pathogenesisPathogenesis

Local irritation → osteoclast precursor recruitment → granulomatous tissue with giant cells.

§ clinicalClinical Features

  • 01Dark red-purple nodule on gingiva/alveolar ridge
  • 02Sessile or pedunculated
  • 03May cause superficial bone resorption ('cupping')
  • 04Bleeds easily

§ differentialDifferential Diagnosis

  • 01Pyogenic granuloma
  • 02Peripheral ossifying fibroma
  • 03Central giant cell granuloma (central lesion)
  • 04Brown tumour of hyperparathyroidism

§ histopathHistopathology

  • 01Numerous multinucleated giant cells in vascular stroma
  • 02Haemosiderin pigment
  • 03No capsule

§ radiographicRadiographic Features

  • 01Superficial cupping of alveolar crest (peripheral cupping)
  • 02No central bony involvement

§ investigationsInvestigations

  • 01Excisional biopsy
  • 02Serum calcium/PTH if recurrent (to exclude hyperparathyroidism)

§ treatmentTreatment

  • 01Excision to periosteum
  • 02Remove local irritants
  • 03Curettage of underlying bone

§ complicationsComplications

  • 01Recurrence (~10%)
  • 02Superficial bone loss

§ prognosisPrognosis

Excellent; low recurrence with complete excision.

§ examKey Examination Points

  • 01ALWAYS on gingiva/ridge (not intra-osseous)
  • 02Rule out hyperparathyroidism if recurrent
  • 03Giant cells on histology

§ revisionQuick Revision Summary

  • 01Purple-red gingival nodule
  • 02Giant cells + haemosiderin
  • 03Excise to periosteum

§ vivaBDS Viva Questions

  • 01How do you differentiate PGCG from CGCG?
  • 02What systemic condition mimics PGCG?
  • 03Describe the histology.

§ mcqsMCQs — Assessment (3)

Question 1

PGCG arises from:

Question 2

Systemic condition to exclude with recurrent PGCG:

Question 3

Treatment of PGCG:

§ evidenceReferences & Evidence

Current Classification

WHO Classification of Tumours Online — Head and Neck

IARC / WHO · 2022

Continuously updated online edition of the WHO head and neck tumour classification.

View official source

Evidence summary

Highest level of evidence linked to this page: WHO / Official Classification.

  • L1 · Classification — 1
  • L6 · Textbook — 3

1 linked source was published from 2024 onwards. Where guidance is limited or contested, rely on the higher-level sources above rather than this summary. Educational use only — not a substitute for clinical judgement.

Content last reviewed

September 2026

Evidence last reviewed

September 2026

Next scheduled review

September 2027

Review status

EVIDENCE REVIEWED

Search latest PubMed evidence

Last literature search: 7 September 2026

Open PubMed

Current Classification

Reference #1L1 · ClassificationWHO / Classification Verified
WHO Classification of Tumours Online — Head and Neck

IARC / WHO. IARC · 2022

Continuously updated online edition of the WHO head and neck tumour classification.

DOI: Identifier not availablePMID: Identifier not available
View source

Histopathology References

Reference #4L6 · TextbookHistopathology References Unverified
Surgical Pathology of the Head and Neck3rd Edition

Barnes L. CRC Press · 2008

Detailed histopathological reference for head and neck diagnostic criteria.

DOI: Identifier not availablePMID: Identifier not available

Textbook References

Reference #2L6 · TextbookTextbooksRecent Verified
Oral and Maxillofacial Pathology5th Edition

Neville BW, Damm DD, Allen CM et al.. Elsevier · 2024

Standard reference textbook of oral and maxillofacial pathology used throughout this atlas.

DOI: Identifier not availablePMID: Identifier not available
View source
Reference #3L6 · TextbookTextbooks Unverified
Shafer's Textbook of Oral Pathology9th Edition

Rajendran R, Sivapathasundharam B. Elsevier · 2020

Undergraduate and postgraduate oral pathology textbook widely used in BDS and FCPS curricula.

DOI: Identifier not availablePMID: Identifier not available

Additional sources cited on this page

  1. Neville BW. Oral & Maxillofacial Pathology, 4e
  2. Katsikeris N. Int J Oral Maxillofac Surg 1988

Browse the full evidence library →

Draft — pending faculty review. Educational use only; verify against current guidelines and primary sources before clinical application.