Onkoderma-Clinic for Dermatology, Venereology and Dermatologic Surgery, General Skobelev 26, 1606, Sofia, Bulgaria.
Wien Med Wochenschr. 2023 Sep;173(11-12):249-250. doi: 10.1007/s10354-021-00894-y. Epub 2021 Nov 4.
Giant cell epulis (peripheral giant cell granuloma) typically appears as a reactive benign lesion in the oral cavity in areas following local irritation or chronic trauma. Here we describe the case of a 45-year-old male patient who presented with the chief complaint of a large gingival mass in the anterolateral maxilla. There had been progressive growth within the past few months, with increased painless discomfort during mastication. The patient also reported bleeding during interdental cleaning. A full physical work-up led to the suspicion of giant cell epulis alongside other differentials including mucosal hemangioma and squamous cell carcinoma, with unremarkable laboratory values. Imaging including computed tomography showed signs of previous insertion of metal implants on either side of the lesion alongside mucosal hyperplasia. A confirmatory biopsy was taken and showed multiple giant cells on a reactive bed of stroma, in line with the diagnosis of giant cell epulis. Oral inflammatory conditions such as giant cell epulis have greater chances of local recurrence and, therefore, careful investigation with timely and accurate diagnosis is imperative for appropriate early treatment. Complete surgical excision should then be employed to prevent relapses, as incomplete removal can lead to further recurrence. Identification and eradication of potential sources of irritation should also be considered when treating the patient, to avoid further recurrence.
巨细胞龈瘤(外周性巨细胞肉芽肿)通常表现为口腔内局部刺激或慢性创伤后区域的反应性良性病变。在此,我们描述了一名 45 岁男性患者的病例,其主要症状是在前上颌的前外侧有一个大的牙龈肿块。在过去的几个月里,肿块逐渐增大,咀嚼时无痛不适感增加。患者还报告在牙间隙清洁时出血。全面的身体检查提示除了其他鉴别诊断(包括黏膜血管瘤和鳞状细胞癌)外,还可能患有巨细胞龈瘤,实验室检查值无明显异常。包括计算机断层扫描在内的影像学检查显示,病变两侧有金属植入物插入的迹象,同时伴有黏膜增生。进行了确认性活检,显示在反应性基质床上有多个巨细胞,符合巨细胞龈瘤的诊断。口腔炎症性疾病(如巨细胞龈瘤)更有可能出现局部复发,因此,仔细检查并及时准确诊断对于适当的早期治疗至关重要。然后应采用完全手术切除以防止复发,因为不完全切除可能会导致进一步复发。在治疗患者时,还应考虑识别和消除潜在的刺激源,以避免进一步复发。