Peripheral giant cell granuloma

Expansive Oral Giant Cell Granuloma in a Pediatric Patient

Aim

This article describes a peripheral oral giant cell granuloma (POGCG) in a pediatric patient and its surgical management and histological characteristics.

Background

Peripheral oral giant cell granuloma (POGCG) is a hyperplastic reactive lesion formed by a proliferation of mononuclear cells and osteoclast-type giant cells in vascular tissue, occasionally with bone formation. Generally found in women and adults, POGCG has rarely been described in children.

Case description

An 8-year-old girl was consulted for an exophytic lesion in the anterior area of the upper jaw, which had increased in volume in the preceding weeks. An excisional biopsy of the tumor was performed with an electrosurgical pencil. The pathological diagnosis was POGCG.

Conclusion

Excision followed by additional therapy, such as scaling and curettage, should be the first option in the treatment of POGCG.

Clinical significance

Early detection of these lesions involving the periodontium is important in order to reduce bone loss and avoid pathological dental migration.

How to cite this article

Cahuana-Bartra P, Brunet-Llobet L, Suñol-Capella M, et al. Expansive Oral Giant cell Granuloma in a Pediatric Patient. Int J Clin Pediatr Dent 2023;16(2):405-408.

Coexistence of hyperparathyroidism and peripheral giant cell granuloma of the jaw: A rare case report

Peripheral giant cell granuloma (PGCG) known as “giant cell epulis” is a benign, reactive exophytic gingival lesion that accounts for less than 10% of all gingival lesions. PGCG affects females more than males with middle age predilection. Till now the etiology of PGCG remains unclear but various factors that can cause PGCG include poor oral hygiene, food impaction, following an extraction, dry mouth, hormonal disturbance, and hyperparathyroidism. The reported recurrence rate of the lesion is 5.0%–70.6%. The present case report describes the rare case of PGCG with primary hyperparathyroidism in a male patient with a history of swelling in the mandibular anterior region.

Relative frequency of oral focal reactive overgrowths: An institutional retrospective study

Context:

Focal fibrous hyperplasia, peripheral ossifying fibroma, pyogenic granuloma, peripheral giant cell granuloma, giant cell fibroma and focal reactive overgrowth (FROGs) are one of the foremost numerous benign soft-tissue growths in the oral cavity. Chronic irritation or trauma is with identified as the causative aspect. It may develop up to few centimeters in diameter, pedunculated or sessile and may arise on the gingiva or buccal mucosa. Treatment involves surgical excision, and recurrences are infrequent.

Aims:

The aim of this study was to assess the prevalence of FROGs of oral mucosa in an institutional setup.

Subjects and Methods:

All the histopathologically diagnosed cases of FROGs within a period of 10 years (January 2008–December 2017) were retrieved from the archives of the Department of Oral Pathology. The information such as age, sex, site, anatomical side and its prevalence were recorded on customized case history performa.

Statistical Analysis Used:

The significance of difference was assessed using the Chi-square test and Fisher's exact test.

Results:

A total of 2849 cases were identified, of which 449 (15%) were FROGs. The most prevalent lesion amid them were focal fibrous hyperplasia (277, 62%), followed by pyogenic granuloma (92, 20%), whereas the least common was giant cell fibroma with 2 (0.5%) cases. All the FROGs were distributed among 21–40 years of age showing female predominance. The commonly affected site was the right buccal mucosa.

Conclusions:

Nevertheless, information of the frequency and distribution of these lesions is favorable when establishing a diagnosis and treatment plan in clinical practice.

Recurrent Peripheral Giant Cell Granuloma: A Case Report

Objective:

This article describes a case of a Peripheral Giant Cell Granuloma (PGCG) in a girl.

Introduction:

PGCG is a relatively infrequent benign reactive lesion of the gingiva or alveolar ridge that develops in response to local irritation. Clinical appearance consists of a firm or soft smooth surface nodule in dissimilar colors of varying size with sessile or pedunculated implantation base. Radiographic features are generally nonspecific, thereby definitive diagnosis depends on microscopic examination to confirm the entity of PGCG.

Case Report:

A 6-year-old female patient was referred to the outpatient clinic of an Oral & Maxillofacial Surgery Department with the chief complaint of an intraoral swelling. The intraoral examination showed a painless sessile mass with exophytic growth similar to a tumorous lesion located on the mandibular alveolar ridge extending from distal aspect of right mandibular primary canine to mesial aspect of first permanent molar of the same side.

Conclusion:

Peripheral giant cell granuloma is a relatively uncommon lesion in children and potential for collaboration with the treatment in young patients should be considered for a successful therapeutic approach.

Giant Cell Granuloma: Two Expressions in Pediatric Population

A granuloma is a collection of epithelioid histiocytes that is often associated with multinucleated giant cells, and is considered widely to be a non-neoplastic lesion, although some lesions demonstrate aggressive behavior similar to that of a neoplasm. The diagnosis of giant cell granulomas (central and peripheral) is confirmed by histopathologic examination. Early detection and excision are important to minimize potential dentoalveolar complications. The following article consists of case reports of central and peripheral giant cell granuloma (PGCG), and discussion about the diagnosis and management of such lesions. How to cite this article: Mukherjee CG, Mukherjee U, Bansal A, Mukhopadhyay M. Giant Cell Granuloma: Two Expressions in Pediatric Population. Int J Clin Pediatr Dent 2018;11(1):46-49.

Reactive lesions of oral cavity: A retrospective study of 659 cases

OBJECTIVE

This study reviews, analyzes, and compares the demographic data, histopathological features and discusses the treatment and prognosis of reactive lesions (RLs).

MATERIALS AND METHODS

Retrospective study was performed on the departmental archives from July 2006 to July 2016 (total 5000 cases) comprising of 659 cases of RLs of the oral cavity. The recorded data included age, gender, size, site, duration, habits, etiology, histopathological diagnosis, treatment, and prognosis.

RESULTS

The most common lesion was found to be inflammatory fibrous hyperplasia (47%) followed by pyogenic granuloma (PG) (27.16%) and the least cases were of peripheral giant cell granuloma (1.6%). The mean age for the occurrence was 4th-5th decade in all the RL's exceptperipheral ossifying fibroma (POF) which presented in the third decade. Female predominance was noted in all lesions except irritational FIB. The sizes of majority of the lesions were approximately 0.5-1 cm. The common sites were anterior maxilla followed by posterior mandible and least in tongue with no associated habits (82.2%). The duration of all the lesions was seen to be <1 year. Majority of them presented with poor oral hygiene status (87.2%). Recurrences were present in 13.5% of surgically excised lesions.

CONCLUSION

The RLs present commonly in oral cavity secondary to injury and local factors which can mimic benign to rarely malignant lesions. The clinical and histopathological examination helps to categorize the type of lesions. The complete removal of local irritants with follow-up and maintenance of oral hygiene helps to prevent the recurrences of such lesions.

Peripheral and Central Giant Cell Lesions in Children: Institutional Experience at Subharti Dental College and Hospital

Introduction:

Giant cell lesions (GCG) are a group of varied lesions that contain a multitude of multinucleated, osteoclast like giant cells within connective tissue stroma. These include giant cell granulomas which may be central (CGCG), if they lie within the jaw bone, or, peripheral (PGCG) if they lie within the soft tissue. Giant cell granulomas comprised 9.29% of all oral lesions. This case series comprises of 5 giant cell lesions in children between the ages of 4 to 12 years.

Materials and Methods:

A retrospective analysis was conducted of all patients who were diagnosed with giant cell lesions and treated over a period of 10 years (from August 2004 to August 2014) at Subharti Dental College and Hospital, Meerut, India.

Results:

A total of 5 giant cell lesions were identified in this case series, of which 2 cases were diagnosed as PGCG and 3 cases as CGCG. Surgical excision and curettage was performed for 2 peripheral lesions under local anesthesia while 1 central lesion was excised under general anesthesia. Two central lesions were treated with a non-surgical approach using intralesional corticosteroid.

Conclusion:

Our experience suggests that a correct diagnosis and complete surgical excision with curettage is effective in complete management of oral giant cell lesions in the pediatric age group.

CTCFL (BORIS) mRNA Expression in a Peripheral Giant Cell Granuloma of the Oral Cavity

Peripheral giant cell granuloma (PGCG) is a relatively common benign reactive lesion of the oral cavity which can occur at any age. CTCFL/BORIS (CTCF like/Brother of the Regulator of Imprinted Sites) and CTCF (CCCTC-binding factor) are paralogous genes with an important role in the regulation of gene expression, genomic imprinting, and nuclear chromatin insulators regulation. BORIS expression promotes cell immortalization and growth while CTCF has tumor suppressor activity; the expression pattern may reflect the reverse transcription silencing of BORIS. The aim of this work was to describe a histopathological and molecular approach of an 8-year-old pediatric male patient with PGCG diagnosis. It was observed that the PGCG under study expressed CTCF as well as BORIS mRNAs alongside with the housekeeping gene GAPDH, which may be related to possible genetic and epigenetic changes in normal cells of oral cavity.