Tumerlike Mass of the Gums

Giant Cell Epulis (peripheral giant cell granuloma)
Short Summary

86-year-old female presented to the clinic due to rapid growing T-formation on the mandible body in the frontal section, covering the body supra- and sub-mandibular, and was referred to a surgical biopsy procedure. Soft tissue was removed surgically by cutting out, and this Tumor over growth of gingiva and mandible bone was diagnosed as Giant Cell Tumor of Soft tissues.

Patient's Questions

The patient asks for information about her condition and about the possible treatment options.

Medical Background

Age 86.

This is an 86 years old female who suffers from Thyreotoxicosis with toxic polycystic Struma. Osteoporosis. Chronic Bronchitis – in remission. Presenting a Tumor formation with diameter up to 5-6 cm, livid color, on the mandible body in the frontal section, covering the body supra- and sub-mandibular, tightly adhered, immobile from the mandible. The patient has an history of mastectomy of the right breast and endo- prosthesis of the left pelvic joint, heart arrhythmias, broken hip above the left knee. In full consciousness.

The patient presented to the clinic due to rapid growing T-formation of mandible and was referred to a surgical biopsy procedure. Clinically, Tumor formation with diameter up to 5-6 cm, livid color, on the mandible body in the frontal section, covering the body supra- and sub-mandibular, tightly adhered, immobile from the mandible. Lymph nodes – not palpated

Soft tissue was removed surgically by cutting out and this Tumor over growth of gingiva and mandible bone was diagnosed as Giant Cell Tumor of Soft tissues.

 

Expert's Opinion

Giant cell epulis (peripheral giant cell granuloma) is a tumor like condition of the gingiva found predominantly in elderly women. On radiography, an osteolytic lesion will be presented, the tumor is of a benign nature with osteolytic behaviour.

Recommendation: Surgical removal of the epulis with thorough curettage of the jaw bone must be performed as the mandibular integrity is in danger.

This tumor is aggressive and if not removed may grow, cause severe inconvenience and obstruct the airway and cause problems which may not be possible to solve. According to the medical status of the patient presented, she can undergo the procedure although being in risk. Her personal good mental condition is another good reason to perform this procedure. As the biopsy was performed with no significant complications, the diagnosis is clear (dd – Mucoepidermoid or residual cyst , x-ray is needed) surgery has to be performed. Curettage is essential as the recurrences are frequent with possible undesirable damage to the jaw bone. The issue of injection of corticosteroids in the lesion or subcutaneous administration of calcitonin or interferon alpha may be discussed as palliative treatment.
 

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