Case report 52 Archives of Dental and Medical Research Vol 2 Issue 2 AODMR Peripheral Giant Cell Granuloma: Case Report and Review Richa Khurana, Sangita Agarwal 1 , Richa Jain 2 , Mayank Vermani 3 , Shweta Aggarwal 4 , Arun Garg 4 Senior Lecturer, Department of Periodontology, JCD Dental College, Sirsa Haryana, India; 1 Reader, Department of Periodontology, People's Dental Academy, Bhopal, India; 2 Senior Lecturer, Department of Periodontology, Rishiraj College of Dental Sciences, Bhopal, India; 3 Senior Lecturer, Department of Oral Surgery, JCD Dental College , Sirsa Haryana; 4 Reader, Department of Oral and Maxillofacial Surgery, JCD Dental College, Sirsa Haryana, India. Address for Correspondence: Dr. Richa Khurana, Assistant Professor, Department of Periodontology, JCD Dental College, Sirsa Haryana, India. ABSTRACT: Peripheral giant cell granuloma or “giant cell epulis’’ is a benign hyperplastic lesion caused by local trauma or chronic irritation. It arises from the periodontal ligament or mucoperiosteum. This article reports the diagnosis and successful treatment of peripheral giant cell granuloma in a 16 year old male patient. Keywords: Giant cell granuloma, Hyperplasia, Neoplasm INTRODUCTION An oral inflammatory hyperplasic lesion is a common entity and may be defined as an increase in the size of an organ or tissue due to an increase in the number of its constituent cells as a local response of tissue to injury. 1 Traumatic irritants include calculi, overhanging restoration, foreign bodies, caries, chronic biting and sharp bony spicules and appliances with overextended borders. 2 The peripheral giant cell granuloma (PGCG) is an inflammatory hyperplastic type of lesion that probably involves a reactive response in the periosteum, periodontal ligament and gingiva. 1 It is set apart from other inflammatory hyperplastic lesions by the presence of multinucleated giant cells whose origin is yet undetermined. The etiology of PGCG has not been defined precisely. Giant cell lesions of the gingiva in the past have been referred to as “peripheral reparative giant cell tumors”. Lesions are not neoplasm but tissue response to local injury. Therefore now referred to as“peripheral giant cell granulomas”. In 1962, Gottsegen 3 suggested the development of peripheral giant cell granuloma often after periodontal surgery. Recently, Choi et al 4 reported the association of peripheral giant cell granuloma with hyperparathyroidism secondary to renal failure. The lesions appear centrally in bone typically associated with hyperparathyroidism referred to as brown tumors. 5 It has also been reported with dental implants. 6 The peripheral giant cell granuloma occurs exclusively on the gingiva or edentulous alveolar ridge, presenting as pink to deep red or purplish blue mass. The PGCG bears a close microscopic resemblance to the central giant cell granuloma. Thus, prefix peripheral is needed to differentiate them and it may represent a soft tissue counterpart of the central bony lesion 7 as believed by many pathologists . CASE REPORT A 16 years old male patient reported to department of periodontology with chief complaint of swollen gums in right lower back tooth region for last one month. History revealed that swelling started as a pea nut size which increased over a period of 1 month to present size. He went to local doctor where he was prescribed some medication for three days