Abstract：
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.
摘要：
巨细胞上皮（外周巨细胞肉芽肿）通常表现为局部刺激或慢性创伤后口腔区域的反应性良性病变。在这里，我们描述了一名45岁的男性患者的情况，该患者主诉是上颌骨前外侧有大量牙龈肿块。在过去的几个月里一直在逐步增长，咀嚼期间无痛不适感增加。患者还报告在齿间清洁期间出血。全面的体格检查导致怀疑巨细胞上皮以及其他差异，包括粘膜血管瘤和鳞状细胞癌，具有不显著的实验室价值。包括计算机断层扫描在内的影像学检查显示，先前在病变的任一侧插入了金属植入物以及粘膜增生的迹象。进行了证实的活检，显示基质反应床上有多个巨细胞，符合巨细胞外皮的诊断.口腔炎症条件，如巨细胞上皮有更大的机会局部复发，因此,仔细调查，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导致进一步复发。在治疗患者时，还应考虑识别和根除潜在的刺激源，以避免进一步复发。
