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Peripheral gigant cell granuloma (giant cell epulis) associated with metabolic diseases: case report and literature review.

Peripheral giant cell granuloma (PGCG) is a relatively frequent benign lesion of the oral cavity, originating from the periosteum following local irritation or metabolic diseases. PGCG is a soft tissue lesion that can affect the underlying bone, which can develop at any age, and manifests as a red-purple nodule located in the region of the gums or edentulous alveolar margins. After complete clinical removal of PGCG recurrence occurs in about 10% of cases, which may result in an esthetic and functional soft tissue defect. In this paper, we report a case of PGCG of about 1 cm, sessile with a painful and bloody appearance with vegetating. The case has bad oral hygiene with a diffused gin-givits and affection chronic renal failure stage IV, arterial hypertension with diabetic retinopathy caused by diabetes mellitus type I and dialysis therapy waiting for renal transplantation. The lesion was removed in its entirety with root planing and gingival repositioning and it has been relpased after one year. According to our study and review of the literature, we can assume that among the various causes of etiological PGCG in addition to those already known as trauma and poor oral hygiene, there are also some metabolic disorders such as chronic renal failure, which are often the cause of relapses of PGCG once removed as in this case. Our study illustrates how chronic kidney failure is one of cofactors in the etiology of PGCG, and also causes of recurrence.