1
|
Yousefian M, Aghakouchakzadeh A, Torki S. Peripheral giant cell granuloma as a sign of hyperparathyroidism in a patient under hemodialysis: A case report and review of literature. Clin Case Rep 2023; 11:e7823. [PMID: 37614292 PMCID: PMC10442469 DOI: 10.1002/ccr3.7823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 07/28/2023] [Accepted: 07/28/2023] [Indexed: 08/25/2023] Open
Abstract
Peripheral giant cell granuloma (PGCG) is a benign reactive exophytic oral lesion that originates from the periosteum or the periodontal ligament. It exclusively develops on the gingiva or alveolar mucosa. Hyperparathyroidism (HPT) is a possible etiology for its development. HPT is an endocrine disorder characterized by increased secretion of the parathyroid hormone (PTH). This case report describes a case of recurring PGCG in a patient diagnosed with secondary HPT after paraclinical assessment.
Collapse
Affiliation(s)
- Marzieh Yousefian
- Department of Oral and Maxillofacial Medicine, School of DentistryAlborz University of Medical SciencesKarajIran
| | - Arezoo Aghakouchakzadeh
- Department of Oral and Maxillofacial Pathology, School of DentistryAlborz University of Medical SciencesKarajIran
| | - Sajad Torki
- School of DentistryAlborz University of Medical SciencesKarajIran
| |
Collapse
|
2
|
Cahuana-Bartra P, Brunet-Llobet L, Suñol-Capella M, Miranda-Rius J. Expansive Oral Giant Cell Granuloma in a Pediatric Patient. Int J Clin Pediatr Dent 2023; 16:405-408. [PMID: 37519988 PMCID: PMC10373768 DOI: 10.5005/jp-journals-10005-2572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023] Open
Abstract
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.
Collapse
Affiliation(s)
- Pau Cahuana-Bartra
- Department of Paediatric Dentistry, Sant Joan de Déu Hospital, University of Barcelona, Barcelona, Spain; Department of Odontostomatology, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain; Hospital Dentistry, Clinical Orthodontics and Periodontal Medicine Research Group (HDCORPEMrg), Institut de Recerca Sant Joan de Déu (IRSJD), Barcelona, Spain
| | - Lluís Brunet-Llobet
- Department of Paediatric Dentistry, Sant Joan de Déu Hospital, University of Barcelona, Barcelona, Spain; Department of Odontostomatology, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain; Hospital Dentistry, Clinical Orthodontics and Periodontal Medicine Research Group (HDCORPEMrg), Institut de Recerca Sant Joan de Déu (IRSJD), Barcelona, Spain
| | - Mariona Suñol-Capella
- 3 Department of Pathology, Sant Joan de Déu Hospital, University of Barcelona, Barcelona, Spain
| | - Jaume Miranda-Rius
- Department of Paediatric Dentistry, Sant Joan de Déu Hospital, University of Barcelona, Barcelona, Spain; Department of Odontostomatology, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain; Hospital Dentistry, Clinical Orthodontics and Periodontal Medicine Research Group (HDCORPEMrg), Institut de Recerca Sant Joan de Déu (IRSJD), Barcelona, Spain
| |
Collapse
|
3
|
Bawazir M, Islam MN, Cohen DM, Fitzpatrick S, Bhattacharyya I. Gingival Fibroma: An Emerging Distinct Gingival Lesion with Well-Defined Histopathology. Head Neck Pathol 2021; 15:917-922. [PMID: 33686583 PMCID: PMC8384971 DOI: 10.1007/s12105-021-01315-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 02/22/2021] [Indexed: 11/29/2022]
Abstract
Gingival growths, barring a few are mostly reactive and seldom exhibit significant true neoplastic potential. The common etiology is local irritation from dental plaque/calculus, trauma as well as medication-related overgrowth. Such lesions are easily distinguishable and categorized into diagnoses such as pyogenic granuloma, peripheral ossifying fibroma, etc. We present a previously undescribed, but commonly encountered, reactive gingival growth with unique histologic features and suggest the diagnostic term "gingival fibroma." An IRB approved retrospective review of the University of Florida Oral Pathology Biopsy Service encompassing years 2010-2019, was performed to select cases. Demographics, clinical data, and microscopic diagnoses were recorded and analyzed. Four board-certified oral and maxillofacial pathologists agreed upon and established the diagnostic criteria. These are: a prominent fibromyxoid stroma, variable cellularity, a whorled or storiform pattern of arrangement of the cellular elements, lack of significant inflammation or vascularity, and complete absence of calcification, and/or odontogenic islands. A total of 60 cases met all criteria and were included in the study. Age range in years was 14-87 with the mean at 45.11 years. A striking female predilection (90%) was noted. Approximately 62% of cases were reported on the maxillary gingiva, followed by 38.3% in the mandibular gingiva. Majority, 66.7% were in the anterior incisor region followed by 11.7% in the canine/first premolar areas. All lesions were submitted as excisional biopsy, and 4 cases recurred within 2-3 years of excision. In all cases, lesional tissue appeared to extend to the surgical base of the specimen. We present 60 cases of a histologically unique entity occurring exclusively on the gingiva and introduce the diagnostic term "Gingival Fibroma" for these lesions. Further studies with adequate clinical follow-up may help understand the exact clinical behavior of these lesions.
Collapse
Affiliation(s)
- M. Bawazir
- Department of Oral and Maxillofacial Diagnostic Services, University of Florida College of Dentistry, 1395 Center Dr, Gainesville, FL 32610-0414 USA ,Department of Oral and Maxillofacial Diagnostic Services, University of Florida College of Dentistry, Gainesville, USA
| | - M. N. Islam
- Department of Oral and Maxillofacial Diagnostic Services, University of Florida College of Dentistry, 1395 Center Dr, Gainesville, FL 32610-0414 USA
| | - D. M. Cohen
- Department of Oral and Maxillofacial Diagnostic Services, University of Florida College of Dentistry, 1395 Center Dr, Gainesville, FL 32610-0414 USA
| | - S. Fitzpatrick
- Department of Oral and Maxillofacial Diagnostic Services, University of Florida College of Dentistry, 1395 Center Dr, Gainesville, FL 32610-0414 USA
| | - I. Bhattacharyya
- Department of Oral and Maxillofacial Diagnostic Services, University of Florida College of Dentistry, 1395 Center Dr, Gainesville, FL 32610-0414 USA
| |
Collapse
|
4
|
Said Ahmed WM, Haggag MA. HAS Carnoy's solution a role in the management of recurrent peripheral giant cell granuloma? JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 123:37-43. [PMID: 33412339 DOI: 10.1016/j.jormas.2020.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 12/21/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE this study aimed to evaluate the efficacy of local application of Carnoy's solution following the surgical excision of recurrent PGCG. PATIENTS AND METHODS 40 patients who sought treatment for recurrent PGCG were included in this study. According to the type of treatment the patients were classified randomly into two equal groups. The lesions in all patients were excised down to the alveolar bone followed by aggressive curettage. Then only in group II, Carnoy's solution was applied for 5 min. Clinical follow-up was done for 1 year to evaluate the tissue healing. RESULTS patients were 23 females and 17 males, with an average of 35.9years. Recurrent PGCGs occurred most commonly in fifth decade of life (25 %). Maxilla (57.5 %) was involved more than the mandible. The lesions were found posteriorly in 27cases and anteriorly in 13cases. The average size of the lesions was 2.9 cm. Histologically, foci of calcifications occurred in 12cases. Recurrence occurred in 5 cases: 4 in group I and 1 in group II. Bone healing was appropriate in all patients without sequestration. CONCLUSION the use of Carnoy's solution following surgical removal of recurrent PGCG decreases their recurrence rates. The technique is safe, and conservative with low tissue morbidity.
Collapse
Affiliation(s)
| | - Mai Ahmed Haggag
- Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Egypt.
| |
Collapse
|
5
|
Limongelli L, Tempesta A, Lauritano D, Maiorano E, Ingravallo G, Favia G, Capodiferro S. Peripheral Giant Cell Granuloma of the Jaws as First Sign of Primary Hyperparathyroidism: A Case Series. J Clin Med 2020; 9:jcm9124042. [PMID: 33327593 PMCID: PMC7765060 DOI: 10.3390/jcm9124042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/09/2020] [Accepted: 12/11/2020] [Indexed: 01/14/2023] Open
Abstract
Peripheral giant cell granulomas (PGCG) associated with hyperparathyroidism (HPT) are rare clinical entities. The aim of this study is to report on 21 PGCGs of the oral cavity as the first clinical sign of unknown primary HPT (PHPT) referred to the Complex Operating Unit of Odontostomatology of Aldo Moro University of Bari from 2009 to 2019. Surgical treatment consisted in conservative enucleation of the lesion, if possible, with contextual bone rim osteoplasty with piezosurgical tools and following histological examination. After histological diagnosis of PGCG, PHPT screening was performed dosing parathyroid hormone and serum calcium. In all the patients haematological investigation demonstrated elevated values of parathyroid hormone and serum calcium ruling out an unknown PHPT. Specifically, after endocrinological evaluation, patients showed PHPT related to: parathyroid adenoma (13), parathyroid hyperplasia (two, one of which occurred in a intra-thyroidal parathyroid), and parathyroid carcinoma (1) and were scheduled for surgical treatment. Considering that PGCGs could represent the first clinical sign of an undiagnosed PHPT and the screening of PHPT is a non-invasive and cheap exam, in case of histological diagnosis of a giant cell lesion, both central and peripheral, especially in patients with synchronous or history of methacronous giant cell lesions, parathyroidal screening should be mandatory.
Collapse
Affiliation(s)
- Luisa Limongelli
- Department of Interdisciplinary Medicine, “Aldo Moro” University of Bari, 70124 Bari, Italy; (A.T.); (G.F.); (S.C.)
- Correspondence: ; Tel.: +39-339-879-0106
| | - Angela Tempesta
- Department of Interdisciplinary Medicine, “Aldo Moro” University of Bari, 70124 Bari, Italy; (A.T.); (G.F.); (S.C.)
| | - Dorina Lauritano
- Centre of Neuroscience of Milan, Department of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy;
| | - Eugenio Maiorano
- Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, 70124 Bari, Italy; (E.M.); (G.I.)
| | - Giuseppe Ingravallo
- Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, 70124 Bari, Italy; (E.M.); (G.I.)
| | - Gianfranco Favia
- Department of Interdisciplinary Medicine, “Aldo Moro” University of Bari, 70124 Bari, Italy; (A.T.); (G.F.); (S.C.)
| | - Saverio Capodiferro
- Department of Interdisciplinary Medicine, “Aldo Moro” University of Bari, 70124 Bari, Italy; (A.T.); (G.F.); (S.C.)
| |
Collapse
|
6
|
Pattnaik N, Rajguru JP, Pattanaik SJ, Bardhan D, Nayak B, Islam MMF. Coexistence of hyperparathyroidism and peripheral giant cell granuloma of the jaw: A rare case report. J Family Med Prim Care 2020; 9:3142-3146. [PMID: 32984187 PMCID: PMC7491829 DOI: 10.4103/jfmpc.jfmpc_479_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 04/25/2020] [Accepted: 05/11/2020] [Indexed: 02/06/2023] Open
Abstract
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.
Collapse
Affiliation(s)
- Naina Pattnaik
- Department of Periodontology, Hi-Tech Dental College and Hospital, Bhubaneswar, Odisha, India
| | - Jagadish P Rajguru
- Department of Oral and Maxillofacial Pathology, Hi-Tech Dental College and Hospital, Bhubaneswar, Odisha, India
| | - Samarjeet J Pattanaik
- Department of Periodontology, Hi-Tech Dental College and Hospital, Bhubaneswar, Odisha, India
| | - Debajyoti Bardhan
- Oral Medicine and Radiology, Hi-Tech Dental College and Hospital, Bhubaneswar, Odisha, India
| | - Bikash Nayak
- Oral Medicine and Radiology, Hi-Tech Dental College and Hospital, Bhubaneswar, Odisha, India
| | | |
Collapse
|
7
|
Bodhankar K, Bansal S, Jashnani K, Desai RS. Immunohistochemical expression of stem cell markers OCT-4 and SOX-2 in giant cell tumor, central giant cell granuloma, and peripheral giant cell granuloma. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130:78-84. [PMID: 32493681 DOI: 10.1016/j.oooo.2020.03.052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 02/25/2020] [Accepted: 03/31/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES This study aimed to evaluate and compare the immunohistochemical expression of OCT-4 and SOX-2 and to determine their use in differentiating giant cell tumor (GCT) from central giant cell granuloma (CGCG) and peripheral giant cell granuloma (PGCG). STUDY DESIGN Formalin-fixed, paraffin-embedded tissue blocks of 10 histopathologically diagnosed cases of GCT, CGCG, or PGCG were examined for anti-OCT-4 and anti-SOX-2 antibodies. Nuclear staining of stromal mononuclear cells and multinucleated giant cells was considered positive for OCT-4 and SOX-2 expression. RESULTS Nuclear immunoexpression of OCT-4 in stromal mononuclear cells was observed in 80% (8 of 10) of GCT cases, whereas none of the CGCG and PGCG cases showed OCT-4 immunoreactivity. SOX-2 immunoreactivity was negative in GCT, CGCG, and PGCG. CONCLUSIONS OCT-4 immunopositivity in GCT can be used as a cancer stem cell marker to differentiate GCT from CGCG and PGCG. The presence of OCT-4 in GCT versus its complete absence in CGCG and PGCG suggests that these three conditions are separate entities. The absence of stem cell marker OCT-4 and SOX-2 raises questions regarding their role in the pathogenesis of CGCG and PGCG.
Collapse
Affiliation(s)
- Kshitija Bodhankar
- Post-graduate Student, Department of Oral Pathology and Microbiology, Nair Hospital Dental College, Mumbai, India
| | - Shivani Bansal
- Professor (Additional), Department of Oral Pathology and Microbiology, Nair Hospital Dental College, Mumbai, India.
| | - Kusum Jashnani
- Professor and Head, Department of Pathology, BYL Nair Charitable Hospital and T.N Medical College, Mumbai, India
| | - Rajiv S Desai
- Professor and Head, Department of Oral Pathology and Microbiology, Nair Hospital Dental College, Mumbai, India
| |
Collapse
|
8
|
Mixed density mandibular mass in a patient with pain and paresthesia. J Am Dent Assoc 2020; 151:204-209. [DOI: 10.1016/j.adaj.2019.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 01/03/2019] [Accepted: 02/06/2019] [Indexed: 11/23/2022]
|
9
|
Coşgun A, Altan HA, Altan A. Peripheral Giant Cell Granuloma at an Early Age: 2 Year Case Follow-Up. CUMHURIYET DENTAL JOURNAL 2019. [DOI: 10.7126/cumudj.492238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
10
|
Barros de Alencar CR, Porto DE, Cavalcanti AFC, Cavalcanti AL. Recurrent Peripheral Giant Cell Granuloma: A Case Report. Open Dent J 2018. [DOI: 10.2174/1874210601812011043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
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.
Collapse
|
11
|
Volpato LER, Leite CA, Anhesini BH, Aguilera JMGDS, Borges ÁH. Peripheral Giant Cell Granuloma in a Child Associated with Ectopic Eruption and Traumatic Habit with Control of Four Years. Case Rep Dent 2016; 2016:6725913. [PMID: 27999690 PMCID: PMC5143708 DOI: 10.1155/2016/6725913] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 10/07/2016] [Accepted: 11/15/2016] [Indexed: 11/18/2022] Open
Abstract
Peripheral giant cell granuloma (PGCG) is a nonneoplastic lesion that may affect any region of the gingiva or alveolar mucosa of edentulous and toothed areas, preferentially in the mandible and rarely occurring in children. This report describes the clinical and histopathological findings of a PGCG diagnosed in the maxilla of a 9-year-old boy associated with a tooth erupting improperly and a traumatic habit. The patient did not present anything noteworthy on extraoral physical examination or medical history, but the habit of picking his teeth and "poking" the gingiva. The oral lesion consisted of an asymptomatic, rounded, pink colored, smooth surface, soft tissue injury with fibrous consistency and approximated size of 1.5 cm located in the attached gingiva between the upper left permanent lateral incisor and the primary canine of the same side. Excisional biopsy was performed through curettage and removal of the periosteum, periodontal ligament, and curettage of the involved teeth with vestibular access. The histopathological analysis led to the diagnosis of PGCG. The prompt diagnosis and treatment of the PGCG resulted in a more conservative surgery and a reduced risk for tooth and bone loss and recurrence of the lesion. After four years of control, patient had no relapse of the lesion and good gingival and osseous health.
Collapse
Affiliation(s)
| | | | - Brunna Haddad Anhesini
- Master's Program in Restorative Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | | | - Álvaro Henrique Borges
- Master's Program in Integrated Dental Sciences, University of Cuiabá, Cuiabá, MT, Brazil
| |
Collapse
|
12
|
Efficacy of Ethanolamine Oleate Sclerotherapy in Treatment of Peripheral Giant Cell Granuloma. J Oral Maxillofac Surg 2016; 74:2200-2206. [DOI: 10.1016/j.joms.2016.04.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 04/19/2016] [Accepted: 04/19/2016] [Indexed: 11/20/2022]
|
13
|
A Review and Report of Peripheral Giant Cell Granuloma in a 4-Year-Old Child. Case Rep Dent 2016; 2016:7536304. [PMID: 27403351 PMCID: PMC4925949 DOI: 10.1155/2016/7536304] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 05/26/2016] [Indexed: 12/04/2022] Open
Abstract
Peripheral giant cell granuloma is a common benign and reactive gingival epulis in oral cavity. It is often difficult to make a clinical diagnosis; thereby definitive diagnosis depends on histopathologic features. We report a case of a 4-year-old Caucasian boy presenting with a five-month history a 20 × 15 × 12 mm pedunculated, lobular soft tissue mass of the left anterior maxilla gingiva which was misdiagnosed and maltreated before his referral. An excisional biopsy of the lesion followed by histopathologic examination of the biopsy specimen revealed distinctive features of peripheral giant cell granuloma. Early detection and excision of this hyperplastic nodule especially in children are important to minimize potential dentoalveolar complications.
Collapse
|
14
|
Clinical Management of a Peri-Implant Giant Cell Granuloma. Case Rep Dent 2015; 2015:976756. [PMID: 26788379 PMCID: PMC4691601 DOI: 10.1155/2015/976756] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 11/29/2015] [Accepted: 11/30/2015] [Indexed: 11/17/2022] Open
Abstract
Purpose. Implant therapy plays an important role in contemporary dentistry with high rates of long-term success. However, in recent years, the incidence of peri-implantitis and implant failures has significantly increased. The peripheral giant cell granuloma (PGCG) rarely occurs in peri-implant tissues and it is clinically comparable to the lesions associated with natural teeth. Therefore, the study of possible diseases associated with dental implants plays an important role in order to be able to diagnose and treat these conditions. Materials and Methods. This report described a 60-year-old Caucasian male who presented a reddish-purple pedunculated mass, of about 2 cm in diameter, associated with a dental implant and the adjacent natural tooth. Results. An excisional biopsy was performed and the dental implant was not removed. Histological examination provided the diagnosis of PGCG. After 19-month follow-up, there were no signs of recurrence of peri-implantitis around the implant. Conclusion. The correct diagnosis and appropriate surgical treatment of peri-implant giant cell granuloma are very important for a proper management of the lesion in order to preserve the implant prosthetic rehabilitation and prevent recurrences.
Collapse
|
15
|
Epulis: a study of 92 cases with special emphasis on histopathological diagnosis and associated clinical data. Clin Oral Investig 2015; 20:1757-64. [DOI: 10.1007/s00784-015-1665-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 11/11/2015] [Indexed: 10/22/2022]
|
16
|
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; 118:475-82. [DOI: 10.1016/j.oooo.2014.06.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 06/05/2014] [Accepted: 06/15/2014] [Indexed: 10/25/2022]
|
17
|
Abu Gharbyah AZ, Assaf M. Management of a Peripheral Giant Cell Granuloma in the esthetic area of upper jaw: A case report. Int J Surg Case Rep 2014; 5:779-82. [PMID: 25290380 PMCID: PMC4245672 DOI: 10.1016/j.ijscr.2014.09.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Accepted: 09/09/2014] [Indexed: 11/21/2022] Open
Abstract
Peripheral Giant Cell Granuloma not responding to non-surgical treatment. Peripheral Giant Cell Granuloma surgical excision reversed the tooth migration caused by the lesion. Connective tissue grafting to prevent esthetic complications.
INTRODUCTION Peripheral Giant Cell Granuloma (PGCG) is the most common giant cell lesion found in the jaws; it originates from the connective tissue of the periosteum or from the periodontal ligament in response to local chronic irritation. Early and accurate diagnosis of these lesions allows for conservative management without compromising adjacent teeth or tissues. PRESENTATION OF CASE This paper presents a case of PGCG in the esthetic zone of the upper jaw in a 23-year-old female patient. The treatment offered consisted of an excisional biopsy with immediate soft tissue grafting to prevent esthetic complications. The growing lesion has caused an interproximal spacing between the central and lateral incisors. The spacing spontaneously closed during the next six weeks after excision and no relapse occurred during postoperative follow-up. DISCUSSION Proper management of a PGCG lesion requires excluding other pathologies prior to planning for surgery. Correct diagnosis of such lesions is essential to optimize the treatment and prevent recurrence. Clinical examination alone may not give a correct picture, thereby requiring histopathological confirmation. CONCLUSION Immediate soft tissue augmentation using a connective tissue graft has been suggested as a surgical solution after removal of PGCG to minimize patient discomfort and the loss of precious tissues.
Collapse
Affiliation(s)
- Alaa' Z Abu Gharbyah
- Alpha Clinic, Private Practice Limited to Periodontology and Dental Implants, Ramallah, Palestine
| | - Mohammad Assaf
- Department of Periodontology and Preventive Dentistry, Al-Quds University, Jerusalem, Palestine.
| |
Collapse
|
18
|
Kaplan I, Hirshberg A, Shlomi B, Platner O, Kozlovsky A, Ofec R, Schwartz-Arad D. The Importance of Histopathological Diagnosis in the Management of Lesions Presenting as Peri-Implantitis. Clin Implant Dent Relat Res 2013; 17 Suppl 1:e126-33. [DOI: 10.1111/cid.12137] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Ilana Kaplan
- Tel-Aviv Sourasky Medical Center; Tel-Aviv
- Department of Pathology; Sackler School of Medicine; Tel-Aviv University; Ramat-Aviv Israel
| | - Avraham Hirshberg
- Department of Oral Pathology and Oral Medicine; The Maurice and Gabriela Goldschleger School of Dental Medicine; Tel Aviv University; Tel Aviv Israel
| | - Benjamin Shlomi
- Tel-Aviv Sourasky Medical Center; Tel-Aviv and Goldschleger School of Dental Medicine; Tel Aviv University; Tel Aviv Israel
| | - Ori Platner
- Department of Periodontology; Goldschleger School of Dental Medicine; Tel-Aviv University; Ramat-Aviv Israel
| | - Avital Kozlovsky
- Department of Periodontology; Goldschleger School of Dental Medicine; Tel-Aviv University; Ramat-Aviv Israel
| | - Ronen Ofec
- private dental practice and Biostatistics; Tel-Aviv Israel
| | | |
Collapse
|
19
|
Risoluzione chirurgica di un granuloma periferico a cellule giganti del mascellare superiore mediante laser a diodi. DENTAL CADMOS 2012. [DOI: 10.1016/j.cadmos.2012.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
20
|
Damasceno LS, Gonçalves FDS, Silva ECE, Zenóbio EG, Souza PEA, Horta MCR. Stromal myofibroblasts in focal reactive overgrowths of the gingiva. Braz Oral Res 2012; 26:373-7. [DOI: 10.1590/s1806-83242012005000012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Accepted: 04/25/2012] [Indexed: 01/21/2023] Open
|
21
|
Peñarrocha-Diago MA, Cervera-Ballester J, Maestre-Ferrín L, Peñarrocha-Oltra D. Peripheral giant cell granuloma associated with dental implants: clinical case and literature review. J ORAL IMPLANTOL 2012; 38 Spec No:527-32. [PMID: 22712772 DOI: 10.1563/aaid-joi-d-11-00143] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Peripheral giant cell granuloma (PGCG) associated to dental implants is a very infrequent peri-implant soft-tissue complication, with only 11 cases recorded in the literature to date. The present study describes a 54-year-old woman presenting a swelling of the alveolar margin in the fourth quadrant in relation to a fixed prosthesis cemented over implants. Treatment consisted of complete resection of the lesion with implantoplasty of the exposed implant threads. The diagnosis of PGCG was confirmed by histological study, and no relapse has been recorded after 12 months of follow-up.
Collapse
|
22
|
Woo SB. Diseases of the oral mucosa. MCKEE'S PATHOLOGY OF THE SKIN 2012:362-436. [DOI: 10.1016/b978-1-4160-5649-2.00011-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
|
23
|
Mannem S, Chava VK. Management of an unusual peripheral giant cell granuloma: A diagnostic dilemma. Contemp Clin Dent 2012; 3:93-6. [PMID: 22557907 PMCID: PMC3341770 DOI: 10.4103/0976-237x.94556] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The peripheral giant cell granuloma (PGCG) is a reactive exophytic lesion of the gingiva and alveolar ridge that usually occurs as a result of local irritating factors such as plaque, calculus, chronic infections, chronic irritation, tooth extraction, improperly finished fillings, unstable dental prosthesis, and impacted food which originates from the periosteum or periodontal ligament. This article presents management of an unusual PGCG located on the partially edentulous mandible.
Collapse
Affiliation(s)
- Satheesh Mannem
- Department of Periodontics, Vishnu Dental College and Hospital, Bhimavaram, Andhra Pradesh, India
| | - Vijay K. Chava
- Department of Periodontics, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| |
Collapse
|
24
|
Abstract
Gingival enlargements are a common clinical finding and most represent a reactive hyperplasia as a direct result of plaque related inflammatory gingival disease. These generally respond to conservative tissue management and attention to plaque control. However, a small group are distinct from these and whilst they also represent a reactive tissue response, this occurs at the level of the superficial fibres of the periodontal ligament. These epulides grow from under the free gingival margin and not as a result of a primary inflammatory gingival enlargement. This distinct aetiopathogenesis separates this group of lesions both in terms of their specific clinical presentation and behaviour and their propensity for recurrence if managed inadequately.
Collapse
Affiliation(s)
- N W Savage
- School of Dentistry, The University of Queensland, Brisbane.
| | | |
Collapse
|
25
|
Houpis CH, Tosios KI, Papavasileiou D, Christopoulos PG, Koutlas IG, Sklavounou A, Alexandridis C. Parathyroid hormone-related peptide (PTHrP), parathyroid hormone/parathyroid hormone-related peptide receptor 1 (PTHR1), and MSX1 protein are expressed in central and peripheral giant cell granulomas of the jaws. ACTA ACUST UNITED AC 2010; 109:415-24. [PMID: 20060342 DOI: 10.1016/j.tripleo.2009.09.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2009] [Revised: 09/08/2009] [Accepted: 09/18/2009] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Parathyroid hormone-related peptide (PTHrP) binds to the parathyroid hormone receptor type 1 (PTHR1), which results in the activation of pathways in osteoblasts that promote osteoclastogenesis through the RANK/RANKL system. RANK/RANKL expression has been shown in central giant cell granuloma of the jaws but PTHrP/PTHR1 has not. MSX1 protein is a classical transcription regulator which promotes cell proliferation and inhibits cell differentiation by inhibiting master genes in tissues such as bone and muscle. It has been implicated in the pathogenesis of cherubism, and its expression has been reported in a single central giant cell granuloma (CGCG) case. We aimed, therefore, to study the expression of those proteins by the different cellular populations of central and peripheral giant cell granulomas (PGCGs) of the jaws. STUDY DESIGN Twenty cases of CGCG and 20 cases of PGCG of the jaws were retrospectively examined by immunohistochemistry for the percentage of positively staining cells to antibodies for PTHrP, PTHR1, and MSX1, using a semiquantitative method. RESULTS In both CGCG and PGCG of the jaws, PTHrP and PTHR1 were abundantly expressed by type I multinucleated giant cells (MGC) and mononucleated stromal cells (MSC) with vesicular nuclei, whereas type II MGC and MSC with pyknotic nuclei expressed those proteins to a lesser extent. In both CGCG and PGCG of the jaws, MSX1 was abundantly expressed by type I MGC and MSC but type II MGC did not express it. A statistically significant difference (P < .05) was observed between CGCG and PGCG in the expression of PTHrP in type II MGC and MSC with pyknotic nuclei and in the expression of PTHR1 in type II MGC. CONCLUSIONS We suggest that in CGCG and PGCG of the jaws, PTHrP-positive immature osteoblasts activate PTHR1-positive mature osteoblasts to produce RANKL which interacts with RANK on the PTHrP/PTHR1-positive osteoclast-precursor cells found in abundance in the stroma of giant cell lesions and induces osteoclastogenesis through the classic pathway. Cells of the jawbones, the periodontal ligament, or the dental follicle, originating from the neural crest, may be involved in the pathogenesis of giant cell lesions of the jaws. Further study is required for these suggestions to be proved.
Collapse
Affiliation(s)
- Constantinos H Houpis
- Department of Oral Pathology and Surgery, Dental School, National and Kapodestrian University of Athens, Athens, Greece.
| | | | | | | | | | | | | |
Collapse
|
26
|
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; 66:1063-6. [PMID: 18423303 DOI: 10.1016/j.joms.2007.11.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2007] [Revised: 10/08/2007] [Accepted: 11/11/2007] [Indexed: 11/19/2022]
Affiliation(s)
- Christopher Choi
- Division of Oral and Maxillofacial Surgery, Long Island Jewish Medical Center, New Hyde Park, NY, USA
| | | | | | | |
Collapse
|
27
|
Prado JD, Andrade RG, Silva-Sousa YTC, Andrade MF, Soares FA, Perez DEC. Nerve Sheath Myxoma of the Gingiva: Report of a Rare Case and Review of the Literature. J Periodontol 2007; 78:1639-43. [PMID: 17668985 DOI: 10.1902/jop.2007.060425] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Nerve sheath myxoma (NSM) is an extremely rare benign neoplasm in the oral cavity. This paper describes the first case, to our knowledge, of NSM in the gingival mucosa of an 84-year-old female patient. METHODS Intraoral examination revealed a painless and well-defined nodule in the lingual gingival mucosa of the right mandibular lateral incisor, which measured approximately 1.0 cm in diameter. The lesion was fully excised under local anesthesia, without intercurrences. Hematoxylin and eosin staining was performed in 5-microm sections for histopathologic analysis. Immunohistochemical reactions against vimentin and S-100 protein were carried out in 3-microm histologic sections in accordance with manufacturers' instructions. RESULTS The patient's medical history and an extraoral exam did not reveal other abnormalities. The patient wore a removable partial denture in the affected area. A trauma-induced gingival hyperplasia was the main diagnostic hypothesis. Microscopically, the lesion was composed of an abundant myxoid matrix and stellated and spindle-shaped cells arranged in lobules separated by fine fibrous septa. The cells presented strong positivity for vimentin and S-100 protein. According to the histopathologic and immunohistochemical features, the diagnosis of NSM was established. After 9 months of treatment, no signs or symptoms of recurrences have been observed. CONCLUSION Although NSM is an extremely rare oral tumor, it should be considered in the clinical differential diagnosis of gingival nodules.
Collapse
Affiliation(s)
- José D Prado
- Department of Stomatology, A.C. Camargo Cancer Hospital, São Paulo, SP, Brazil
| | | | | | | | | | | |
Collapse
|
28
|
Motamedi MHK, Eshghyar N, Jafari SM, Lassemi E, Navi F, Abbas FM, Khalifeh S, Eshkevari PS. Peripheral and central giant cell granulomas of the jaws: A demographic study. ACTA ACUST UNITED AC 2007; 103:e39-43. [PMID: 17428697 DOI: 10.1016/j.tripleo.2006.12.022] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2006] [Revised: 12/13/2006] [Accepted: 12/21/2006] [Indexed: 12/01/2022]
Abstract
OBJECTIVE This study aimed to assess the demographic characteristics of peripheral giant cell granulomas (PGCGs) and central giant cell granulomas (CGCGs) in patients treated at our centers. STUDY DESIGN This 12-year retrospective study was based on existing data. Files of patients from 1993-2004 with a definite diagnosis of PGCGs and CGCGs from the oral pathology departments of our universities were assessed. Information regarding age distribution, gender, the jaw involved, the presenting area of the lesion, surgical treatment, and recurrence was documented. RESULTS During the study period, 204 patients with CGCGs were treated. The patients with CGCGs varied in age from 5 to 72 years, and the mean age patients was 23.72 years. Among these, 127 cases (62.87%) occurred in the second and third decades of life. One hundred thirty cases (63.75%) occurred in females and 74 (36.25%) in males. Ninety cases (44.1%) presented in posterior parts of the jaws. One hundred forty-four cases (70.58%) appeared in the mandible. Peripheral GCGs presented in 575 patients, who varied in age from 2 to 85 years with a mean age of 31.02 years. Among these, 297 cases (51.65%) occurred in females and 278 (48.34%) in males. Four hundred sixty-seven cases (81.2%) occurred in the first five decades of life, and 352 cases (61.21%) appeared in the mandible. CONCLUSIONS Giant cell granulomas comprised 9.29% of oral lesions. Peripheral GCG lesions occurred more than 2 times more frequently than CGCGs. Central GCGs occurred about 2 times more frequently in females, whereas PGCGs had an equal prevalence in both genders (P < .05). The mean age for patients with CGCGs was less than patients with PGCGs (P < .05). Central GCGs involved the mandible approximately 2 times more frequently than the maxilla (P < .05). However, when presenting in the maxilla, CGCGs most frequently presented in the area anterior to the canines (P < .05). Peripheral GCGs involved the mandible approximately 1.5 times more frequently than the maxilla (P < .05). Thorough curettage was the main treatment modality used. There were 9 cases (4.41%) of recurrence of CGCGs and 8 cases (1.39%) of recurrence of PGCGs documented during the follow-up period (ranging from 1-12 years).
Collapse
|
29
|
Cloutier M, Charles M, Carmichael RP, Sándor GKB. An analysis of peripheral giant cell granuloma associated with dental implant treatment. ACTA ACUST UNITED AC 2006; 103:618-22. [PMID: 17141536 DOI: 10.1016/j.tripleo.2006.08.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2006] [Revised: 07/21/2006] [Accepted: 08/11/2006] [Indexed: 11/29/2022]
Abstract
This report discusses the management of a 21-year-old male who developed a peripheral giant cell granuloma (PGCG) associated with dental implant therapy, and reviews 4 previously reported cases of PGCGs developing in association with dental implant treatment. The patient described in this report was treated with multiple dental implants to manage severe oligodontia. Six years after implant placement, with the patient lost to follow-up, he presented to his dentist complaining of increasing swelling in the right mandibular vestibule. The patient was noted to have a large exophytic, ovoid-shaped, firm, smooth-surfaced, maroon-colored lesion. The lesion was found to be a PGCG associated with a dental implant. The lesion was treated successfully by explantation of the dental implant, complete excision of the lesion, and curettage of the underlying bony defect. No evidence of recurrence was seen over 12 months of follow-up.
Collapse
Affiliation(s)
- Martin Cloutier
- Oral and Maxillofacial Surgery and Anesthesia, University of Toronto, Toronto, Canada
| | | | | | | |
Collapse
|
30
|
Abstract
This article reviews some of the more common benign oral soft tissue masses with emphasis on their etiology, epidemiology, clinical presentation, histopathology, and treatment. These lesions include traumatic fibroma, mucocele, warts/papilloma, pyogenic granuloma, peripheral giant cell granuloma, generalized gingival hyperplasia, gingival fibromatosis, lateral periodontal cyst, lipoma, and denture-induced hyperplasia.
Collapse
Affiliation(s)
- Tara Esmeili
- Department of Stomatology, Division of Oral Medicine, Oral Pathology, Oral Radiology, School of Dentistry, University of California at San Francisco, 513 Parnassus Street, San Francisco, CA 94143, USA
| | | | | |
Collapse
|
31
|
Abstract
BACKGROUND Peripheral giant cell granuloma (PGCG) is a relatively rare hyperplastic lesion of the oral cavity. The lesion occurs in females more frequently than males and more often in the mandible than the maxilla. Although the precise etiology of PGCG is unknown, it might represent a local reaction to trauma or irritation. METHODS In general, treatment requires a wide excision of the lesion due to its possible recurrence. RESULTS This report describes the clinical and histopathological findings of PGCG diagnosed in the maxilla of a young male, as well as the successful treatment of a gingival defect that occurred following excision of the lesion, by placement of a subepithelial connective tissue graft concurrently with the biopsy procedure. CONCLUSIONS This report emphasizes the importance of having histopathological data to confirm the clinical diagnosis, and the importance of an adequate excision to prevent recurrence even in less extensive cases.
Collapse
Affiliation(s)
- Sinem Esra Sahingur
- Department of Periodontics and Endodontics, School of Dental Medicine, University at Buffalo, Buffalo, NY, USA.
| | | | | |
Collapse
|
32
|
Junquera LM, Lupi E, Lombardía E, Fresno MF. Multiple and synchronous peripheral giant cell granulomas of the gums. Ann Otol Rhinol Laryngol 2002; 111:751-3. [PMID: 12184600 DOI: 10.1177/000348940211100817] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The presence of multiple giant cell lesions in the maxillofacial region is suggestive of hyperparathyroidism or neurofibromatosis. A case of synchronous, multiple peripheral giant cell granulomas is reported, bilaterally affecting the mandibular gums and also the upper right maxillary gingival mucosa, without concomitant systemic disease. Only 2 cases of central giant cell granulomas, and no cases of peripheral giant cell granulomas exhibiting similar characteristics, have been reported in the literature to date.
Collapse
Affiliation(s)
- Luis M Junquera
- Department of Maxillofacial Surgery, University of Oviedo, Asturias Central Hospital, Spain
| | | | | | | |
Collapse
|