Aggressive behavior of peripheral giant cell granuloma: A case report

Background: Peripheral Giant Cell Granuloma (PGCG) considered one of the commonest oral giant cell lesions and gingival epulis. It is probably a non neoplastic lesion but rather reactive in nature which originates from the periodontal membrane or the periosteum as a reaction to chronic trauma or local irritation. This article reports a case of PGCG in a 6 years old male patient complaining of massive gingival swelling associated with looseness of related teeth which is highly unlikely to occur with such lesions, that may lead to misdiagnosis. Material and method: Surgical excision followed by histopathological examination was performed and confirmed using CD34 and CD45 for detection and confirming the origin of multinucleated giant cells (MNGCs). Results: Immunopositivity for CD34 was demonstrated only as cytoplasmic reaction of endothelial cells lining blood vessels while negative reaction was observed in MNGCs or in stromal mononuclear cell. Moreover, cytoplasmic immunoreactivity for CD45 was revealed in MNGCs and few stromal cells. Conclusion: Correlating clinical, radiographic and histopathologic examination reaching definite and early diagnosis is mandatory for management of such lesions thus eliminating potential risk of damaging to adjacent hard tissue structures.