Laboratory Studies
Laboratory studies are generally not necessary, although a serum calcium level or a parathyroid hormone assay may be indicated to rule out the rare possibility of brown tumor for lesions that are particularly large, recurrent despite adequate surgery, multiple, or associated with systemic signs suggestive of hyperparathyroidism.
Imaging Studies
Periapical radiographs typically demonstrate a cupping out or saucerization of the alveolar bone that underlies a peripheral giant cell granuloma.
Histologic Findings
Intact or ulcerated surface epithelium covers peripheral giant cell granulomas. The underlying connective tissue contains a benign proliferation of granulationlike tissue that supports numerous benign multinucleated giant cells. Abundant extravasated blood is typically noted, and deposits of hemosiderin are seen at the periphery of the lesional tissue. Spicules of woven or lamellar bone may be observed in approximately 35% of peripheral giant cell granulomas. [11]
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A 10-year-old boy developed this painless purple papule of the maxillary facial alveolar process over a 3-month period. Biopsy helped confirm the diagnosis of peripheral giant cell granuloma.
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This peripheral giant cell granuloma involved the maxillary gingiva associated with an erupting central incisor of a 6-year-old girl. The referring doctor had suggested a diagnosis of eruption cyst; however, an eruption cyst would immediately collapse once the tooth had disrupted its roof.
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This asymptomatic bluish-purple nodule developed on the edentulous mandibular alveolar ridge of a 76-year-old man.
