Peripheral Giant Cell Granuloma, Diode Laser Surgical Treatment: A Case Report

Background: Peripheral giant cell granuloma is a tumour-like lesion arising on the mucosa of the adherent vestibular or lingual gingiva, or edentulous alveolar ridge mucosa. This lesion is often misdiagnosed because it is clinically mistaken for a pyogenic granuloma. This work aims to present a case of peripheral giant cell granuloma and its surgical laser excision. Methods: A 62-year-old female patient of Dominican origin came to the Oral Medicine of our institution for clinical evaluation of oral conditions. Physical examination revealed an exophytic lesion of the gingival mucosa with dimensions of 10 x 14 mm in 2.1-2.2 vestibular gingival area. The primary clinical diagnosis was gingival hypertrophy associated with gingival epulis. The patient underwent laser-assisted excisional biopsy and subsequent histopathological analysis. A radiological check-up with orthopantomography and Cone Beam CT was required to evaluate the surgical site and to assess any residual of the lesion. Results: The histopathological examination described mucosa fragments with chorion, containing spindle and rounded fibrous cells, and giant multinucleated cells, associated with aspecific chronic inflammation and focally covered by normal-appearing squamous epithelium. The morphologial features were compatible with peripheral giant cell granuloma of the oral cavity. No laser sample damage was observed. Subsequent diagnostic images showed no evidence of residual or recurrence of the lesion. Conclusions: Laser-assisted biopsy is effective in excising the lesion, does not prevent the histopathological analysis of the taken sample and can allow a complete excision. Strict collaboration with the anatomic pathologist is suggested to get a correct diagnosis.