Tag Archives: Dimitrios Andreadis

Clinical Presentation and Management of Peripheral Giant Cell Granulomas in Children: 2 Cases Report

[btn url=”http://balkandentaljournal.com/wp-content/uploads/2016/04/Clinical-Presentation-and-Management-of-Peripheral-Giant-Cell-Granulomas-in-Children.pdf” text_color=”#ffffff” bg_color=”#81d742″ icon=”fa-file-pdf-o” icon_position=”start” size=”14″ id=”” target=”NewWindow”]Download Article[/btn]

Anna Lefkelidou1 / 2 / Elena-Lito Exarchou1 / Dimitrios Andreadis3 / Konstantinos Arapostathis1

1Aristotle University of Thessaloniki, Dental School Department of Paediatric Dentistry
2Aristotle University of Thessaloniki, Dental School Department of Oral Medicine and Oral Pathology Thessaloniki, 54124 Greece
3Aristotle University of Thessaloniki, Dental School Department of Oral Medicine and Oral Pathology Thessaloniki, Greece


Objective(s): Peripheral giant cell granuloma (PGCG) is a reactive, proliferative, exophytic lesion developing on the gingiva and alveolar ridge, originating from the periosteum or periodontal membrane. The lesion develops mostly in adults, commonly in the lower jaw, with slight female predilection although is uncommon in children.

Cases Report: Two boys, 11 and 8-years-old respectively, otherwise healthy, presented with gingival exophytic lesions in our clinic. In the first case the lesion was located in the right maxilla and appeared 4 months ago, whereas in the second case the fast growing lesion was located in the mandible and appeared 2 months ago. The lesions were red-blue enlargements, irregular and elliptical in shape respectively, soft to firm on palpation. Based on clinical examination, the initial diagnosis was assumed to be a type of reactive hyperplasia. OPG and CBCT showed no evidence of bone pathology. Blood, biochemical and hormonal investigations were within the normal values. Both lesions were surgically removed and histological examination established the diagnosis of PGCG. 4 consecutive follow ups have been done, with no evidence of recurrence.

Conclusion: This uncommon lesion in children should be included in the differential diagnosis of reactive hyperplasia. The treatment of PGCG comprises surgical resection, along with suppression of the underlying etiologic factors.

Keywords: Peripheral Giant Cell Granuloma; Dental Treatment; Giant Cell Epulis


  1. Chaparro-Avendano AV, Berini-Aytes L, Gay-Escoda C. Peripheral giant cell granuloma. A report of five cases and review of the literature. Med Oral Patol Oral Cir Bucal, 2005; 10:53-57.
  2. Bhat SS, Jayakrishnan A, Rao BH, Kudva S. Peripheral giant cell granuloma – a case report. J Indian Soc Pedod Prev Dent, 1999; 17:93-96.
  3. Katsikeris N, Kakarantza-Angelopoulou E, Angelopoulos A. Peripheral giant cell granuloma: clinico-pathologic study of 224 new cases and 956 reported cases. Int J Oral Maxillofac Surg, 1988; 17:94-99. [Crossref]
  4. Mighell AJ, Robinson PA, Hume WJ. Peripheral giant cell granuloma: a clinical study of 77 cases from 62 patients, and literature review. Oral Dis, 1995; 1:12-19.
  5. Wolfson L, Tal H. Peripheral giant cell granuloma during orthodontic treatment. Am J Orthod Dentofac Orthop, 1989; 96:519-23 [Crossref]
  6. Shadman N, Ebrahimi SF, Jafari S, Eslami M. Peripheral giant cell granuloma: a review of 123 cases. Dental Research Journal, 2009; 6:47-50.
  7. Flaitz CM. Peripheral giant cell granuloma: a potentially aggressive lesion in children. Pediatr Dent, 2000; 22:232-233.
  8. Kfir Y, Buchner A, Hansen L. Reactive lesions of the gingiva. A clinico-pathological study of 741 cases. J Periodontol, 1980; 51:655-661. [Crossref]
  9. Giansanti JS, Waldron CA. Peripheral giant cell granuloma: review of 720 cases. J Oral Surg, 1969; 27:787-791.
  10. Motamedi MH, Eshghyar N, Jafari SM, Lassemi E, Navi F, Abbas FM, et al. Peripheral and central giant cell granulomas of the jaws: a demographic study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2007; 103:e39-e43. [Web of Science] [Crossref]
  11. Buchner A, Shnaiderman-Shapiro A, Vered M. Pediatric Localized Reactive Gingival Lesions: A Retrospective Study from Israel. Pediatr Dent, 2010; 32:486-492.
  12. Sklavounou-Andrikopoulou A, Piperi E, Papanikolaou V, Karakoulakis I. Oral soft tissue lesions in Greek children and adolescents: A retrospective analysis over a 32-year period. J Clin Pediatr Dent, 2005; 29:175-178.
  13. Bodner L, Peist M, Gatot A, Fliss DM. Growth potential of peripheral giant cell granuloma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 1997; 83:548-551. [Crossref]
  14. Zhang W, Chen Y, An Z, Geng N, Bao D. Reactive gingival lesions: a retrospective study of 2,439 cases. Quintessence Int, 2007; 38:103-110.
  15. Zarei MR, Chamani G, Amanpoor S. Reactive hyperplasia of the oral cavity in Kerman province, Iran: a review of 172 cases. Br J Oral Maxillofac Surg, 2007; 45:288-292. [Web of Science]
  16. Salum FG, Yurgel LS, Cherubini K, De Figueiredo MA, Medeiros IC, Nicola FS. Pyogenic granuloma, peripheral giant cell granuloma and peripheral ossifying fibroma: retrospective analysis of 138 cases. Minerva Stomatol, 2008; 57:227-232.
  17. Bhaskar NS, Cutright DE, Beasley JD, Pérez B. Giant cell reparative granuloma (peripheral): report of 50 cases. J Oral Surg, 1971; 29:110-115.
  18. Lester R, Cordell K, Rosebush M, Palaiologou A, Maney P. Peripheral giant cell granulomas: a series of 279 cases. Oral Surg Oral Med Oral Pathol Oral Radiol, 2014; 118:475-482.
Citation Information: Balkan Journal of Dental Medicine. Volume 20, Issue 1, Pages 44–48, ISSN (Online) 2335-0245, DOI: https://doi.org/10.1515/bjdm-2016-0007, April 2016

Excessive Tongue Amyloidosis as the Diagnostic Sign of Multiple Myeloma: a Case Report

[btn url=”http://balkandentaljournal.com/wp-content/uploads/2016/02/Excessive-tongue-amyloidosis-as-the-diagnostic-sign-of-multiple-myeloma-a-case-report.pdf” text_color=”#ffffff” bg_color=”#81d742″ icon=”fa-file-pdf-o” icon_position=”start” size=”14″ id=”” target=”NewWindow”]Download Article[/btn]

Stylianos Dalampiras1 / 2 / Ioannis Kostopoulos3 / Florentia Stylianou4 / Ioannis Papadiochos1 / Athanasios Poulopoulos2

1School of Dentistry, Department of Oral and Maxillofacial Surgery, Aristotle University, Thessaloniki, Greece
2School of Dentistry, Department of Oral Medicine and Pathology, Aristotle University, Thessaloniki, Greece
3School of Medicine, Department of Histopathology, Aristotle University, Thessaloniki, Greece
4School of Dentistry, student, Aristotle University, Thessaloniki, Greece
5“Evangelismos” General Hospital, School of Dentistry, Athens, Greece


Background: Deposition of amyloid in oral mucosa may be related to systemic disorders, including immune-related diseases and malignancies.

Clinical Presentation: We describe a case of 76-year-old patient with excessive, painless, multi-nodular tongue enlargement, and petechiae on the vermilion border and perioral skin that appeared 2 months ago. The biopsy detected subepithelial, Congo’s Red positive amyloid depositions. Consequent laboratory investigation and bone marrow biopsy confirmed the diagnosis of multiple myeloma stage 2 (International Prognostic Index – IPI).

Conclusion: Multi-nodular excessive tongue enlargement could be of high significance as initial sign of undiagnosed, underlying systemic disease including severe malignancy like multiple myeloma.

Keywords: Oral Amyloidosis; Macroglossia; Multiple Myeloma


  1. Petersson T, Konttinen YT. Amyloidosis-Recent Developments. Semin Arthritis Rheum, 2010; 39(5):356-358. [Crossref] [Web of Science]
  2. Robbins J. Diseases of immunity. In: Cortan RS, Kumar V, Collins T (eds). Pathologic basis of disease. 6th ed. Philadelphia: Saunders Co, 1999; pp 188-259.
  3. Stoopler ET, Sollecito TP, Chen SY. Amyloid deposition in the oral cavity: a retrospective study and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2003; 95(6):674-680. [Crossref]
  4. Eisen D, Lynch DP. Oral manifestations of systemic diseases. In: Eisen D, Lynch DP (eds). The mouth. Diagnosis and treatment. St Louis: Mosby, 1998; pp 212-236.
  5. Van der Waal RIF, van de Scheur MR, Huijgens PC, Starink TM, van der Waal I. Amyloidosis of the tongue as a paraneoplastic marker of plasma cell dyscrasia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2002; 94:444-447. [Crossref]
  6. Salisbury PL Jr, Jacoway JR. Oral amyloidosis: A late complication of multiple myeloma. Oral Surg, 1983; 56:48-50.
  7. Angiero F, Seramondi R, Magistro S, Crippa R, Benedicenti S, Rizzardi C, Cattoretti G. Amyloid Deposition in the Tongue: Clinical and Histopathological Profile. Anticancer Res, 2010; 30:3009-3014. [PubMed]
  8. Kyle RA, Greipp PR. Amyloidosis (AL) clinical and laboratory features in 229 cases. Mayo Clin Proc, 1983; 58:665.
  9. Khan MF, Falk RH. Amyloidosis. Postgrad Med J, 2001; 7:686-693. [Crossref]
  10. Cengiz MI, Wang HL, Yildiz L. Oral involvement in a case of AA amyloidosis: a case report. J Med Case Rep, 2010; 4:200. [Crossref]
  11. Durie BG, Kyle RA, Belch A, Bensinger W, Blade J, Boccadoro M, Child JA, Comenzo R, Djulbegovic B, Fantl D, Gahrton G, Harousseau JL, Hungria V, Joshua D, Ludwig H, Mehta J, Morales AR, Morgan G, Nouel A, Oken M, Powles R, Roodman D, San Miguel J, Shimizu K, Singhal S, Sirohi B, Sonneveld P, Tricot G, Van Ness B. Myeloma management guidelines. A consensus report from the scientific advisors of the International Myeloma Foundation.Hematol J, 2003; 4:279-298 [Crossref]
  12. Kyle RA, Gertz MA. Primary systemic amyloidosis: clinical and laboratory features in 474 cases. Semin Hematol, 1995; 32:45-59.
Citation Information: Balkan Journal of Dental Medicine. Volume 19, Issue 1, Pages 50–52, ISSN (Online) 2335-0245, DOI: https://doi.org/10.1515/bjdm-2015-0034, July 2015