Peripheral Giant Cell Granuloma — MFDS Part 1 MCQ

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ModerateOral PathologyPeripheral Giant Cell GranulomaMFDS Part 1

A patient has a painless red-purple oral soft-tissue nodule. Histopathological examination shows numerous osteoclast-like multinucleated giant cells within a haemorrhagic, vascular connective-tissue stroma, and imaging shows no primary intraosseous lesion. At which site does this lesion most characteristically arise?

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Correct answer: A — Gingiva and edentulous alveolar ridge

Explanation lettering: D = shown as B · B = shown as C · E = shown as D · C = shown as E

A is correct. Peripheral giant cell granuloma is a reactive peripheral giant-cell lesion that characteristically presents as a red-purple mass on the gingiva or alveolar mucosa, including an edentulous ridge or extraction socket. The absence of a primary intraosseous lesion supports the peripheral form rather than central giant cell granuloma, although superficial saucerisation of underlying bone can occur. Buccal mucosa, the floor of the mouth and the tongue are not characteristic sites. Rare atypical palatal presentations have been reported, so describing the lesion as occurring “exclusively” on the gingiva or alveolar ridge is unnecessarily absolute; the gingivoalveolar region nevertheless remains the single best answer.

Reference: Fligelstone S, Ashworth D. Peripheral giant cell granuloma: a case series and brief review. Annals of the Royal College of Surgeons of England. 2024;106:649–651. https://pubmed.ncbi.nlm.nih.gov/37365927/