Peripheral giant cell granuloma - Oral Mucosal Lesion
It tends to occur in older individuals in the fifth and sixth decades with a slight female predilection. The mandibular gingiva is more often involved than the maxillary. It is usually non-painful. Biting on it may induce bleeding since it is contains many blood vessels. It often occurs in the edentulous ridge. The lesion may lie in a cup-shaped depression in the underlying bone. Sometimes it may be difficult to tell if this is a purely extra-osseous process that has cupped the bone or whether it is an intra-osseous central giant cell granuloma that has broken through the bone and now has an extra-osseous or "peripheral" presentation. Unlike the central giant cell granulomas, these are not usually associated with hyperparathyroidism.
K13.4 – Granuloma and granuloma-like lesions of oral mucosa
89722009 – Giant cell peripheral granuloma
Differential Diagnosis & Pitfalls
- Lobular capillary hemangioma (pyogenic granuloma) may appear identical although they tend to occur in younger individuals (some who are pregnant) and tends to be brighter red.
- Peripheral ossifying fibroma may appear similar if inflamed.
- The gingival fibroma is firm, fibrous looking and may be located on the attached rather than marginal gingiva.
- Some odontogenic cysts and tumors may occur on the gingiva but they are generally not located on the marginal gingiva. However, they may be seen on the attached or non-attached gingiva.
- The parulis (dental sinus tract) is usually located near the apices of teeth.
- Metastatic tumors do occur as gingival nodules but these are generally rapidly growing and tend to occur in older individuals with a history of such a tumor.
- Granulomatosis with polyangiitis