Peripheral Giant Cell Granuloma : Giant Cell Epulis
Microscopic Features of Peripheral Giant Cell Granuloma (Giant Cell Epulis): The lesion is separated from the mucosal surface by a zone of fibrosis. It shows a proliferation of multinucleated giant cells in a background of stroma of plump ovoid or spindle cells. The nuclei of giant cells may be large and vesicular or small and pyknotic. Evidence of recent and remote hemorrhage (hemosiderin-laden macrophages) is common. The stromal spindle cells are mitotically active. Scattered acute and chronic inflammatory cells may be seen. Reactive bone formation and dystrophic calcification may be present.
Treatment: Peripheral giant cell granuloma is treated by excising the lesion down to the underlying bone. The adjacent teeth may need to be scaled to remove any possible source of irritation and minimize recurrence risk. About 10% to 20% of lesions recur and are treated by reexcision.