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

§ 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:

References

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

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