Peripheral Giant Cell Granuloma: Case Report with Atypical Location and Dimensions

Abstract

Introduction: Peripheral giant cell granuloma (PGCG) is a benign reactive lesion, most frequently affecting the gingiva and alveolar ridge. Although relatively common, its clinical presentation may vary, and cases with atypical dimensions or unusual locations are rarely reported. Objective: To report a case of PGCG in a young patient, located in the hard and soft palate and maxillary alveolar ridge, with uncommon clinical and radiographic features. Case Report: A 32-year-old male presented with a vegetative, ulcerated, erythematous, and hemorrhagic nodule measuring approximately 5 cm, located in the hard/soft palate and left alveolar ridge, associated with bone resorption and dental displacement. Incisional biopsy revealed aggregates of multinucleated giant cells in a spindle-cell stroma with hemorrhagic areas, confirming the diagnosis of PGCG. Laboratory tests ruled out hyperparathyroidism. The lesion was surgically removed under general anesthesia in a hospital setting. Discussion: This case is remarkable due to the lesion’s large size, palatal location, and exuberant hemorrhagic behavior, uncommon features that complicate the differential diagnosis with central giant cell granulomas and bone neoplasms. Recent reports corroborate the rarity of palatal PGCG and emphasize the need for clinical, radiographic, and histopathological correlation for accurate diagnosis. Conclusion: Although benign, PGCG can exhibit locally aggressive behavior, requiring careful therapeutic planning. Cases with atypical dimensions and unusual location should be documented to broaden the clinical spectrum and guide management of this lesion.