What are the other Names for this Condition? (Also known as/Synonyms)

• Giant Cell Reparative Granuloma
• Myeloid Epulis
• Peripheral Giant Cell Granuloma

What is Giant Cell Epulis? (Definition/Background Information)

• Giant Cell Epulis is a benign tumor that arises from the periodontal ligament, which is the anchoring ligament lying between the root of the tooth and the alveolar bone cavity that holds the tooth. It is also known as Peripheral Giant Cell Granuloma and is believed to develop as a reactive mass to local trauma
• Even though it is typically a benign condition, large-sized tumors may present pain, discomfort, and can result in a loss of tooth/teeth. A simple surgical excision may be curative, however Giant Cell Epulis is known to frequently recur following treatment

Who gets Giant Cell Epulis? (Age and Sex Distribution)

• Giant Cell Epulis is generally observed in adults in the 30 to 60 years age group. Rarely, they are noted in children and individuals of other age groups too
• Both males and females are affected, but for some reason more women than men are affected
• Worldwide, there is no racial or ethnic preference observed

What are the Risk Factors for Giant Cell Epulis? (Predisposing Factors)

• The risk factors for Giant Cell Epulis are currently not well specified

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Giant Cell Epulis? (Etiology)

• Giant Cell Epulis is a benign tumor that is observed to arise only from the periodontal ligament that encases the root of a tooth
• The cause of formation of this tumor is not well-understood, but is believed to occur in response to local injury at the site

What are the Signs and Symptoms of Giant Cell Epulis?

The signs and symptoms of Giant Cell Epulis may include:

• Appearance of a firm fibrous mass at the base of the teeth, typically between two teeth (arising from the gums)
• The tumor is known to arise abruptly and progress rapidly in size
• Most tumors average about 1.5-2 cm, but some grow to over 4 cm in size
• The tumors may present pain, chronic inflammation and may also ulcerate and bleed
• The irregular-shaped tumor may dislodge the teeth, and even erode the alveolar bone
• Large-sized tumors may cause eating difficulties and oral discomfort

How is Giant Cell Epulis Diagnosed?

A diagnosis of Giant Cell Epulis may involve the following exams and procedures:

• Physical examination of the individual and medical history evaluation
• Oral cavity examination
• Tissue biopsy: A tissue biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

A differential diagnosis is important to exclude other conditions presenting similar signs and symptoms may be needed. These include:

• Brown tumors of hyperparathyroidism
• Giant cell granuloma of the upper or lower jaw
• Osteoblastic osteosarcoma

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Giant Cell Epulis?

The possible complications due to Giant Cell Epulis include:

• Emotional stress and severe discomfort
• Superimposed bacterial and fungal skin infections
• Eating difficulties from large-sized tumors
• Loss of teeth
• Recurrence of the condition

How is Giant Cell Epulis Treated?

The healthcare provider may recommend the following treatment measures for Giant Cell Epulis:

• Minor surgery to remove the tumor
• Tooth/teeth extraction, if necessary
• If the underlying jaw bone is affected, then surgical restoration of the same
• Antibiotic or antifungal therapy for secondary infections, if necessary

Regular follow up visits with the healthcare provider is important and recommended.

How can Giant Cell Epulis be Prevented?

• Presently, there are no preventative guidelines available for Giant Cell Epulis
• Undertaking periodic and regular visits to a dental professional is important

What is the Prognosis of Giant Cell Epulis? (Outcomes/Resolutions)

The prognosis of Giant Cell Epulis is generally good with early recognition and appropriate treatment of the condition. However, a recurrence rate of over 10% is reported, which may necessitate repeat surgeries.

Additional and Relevant Useful Information for Giant Cell Epulis:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/healthy-living/dental-health/