The peripheral giant cell granuloma, also known as giant cell epulis, PGCL or giant cell hyperplasia, is the most common giant cell lesion in the oral cavity. It does not constitute a true neoplasm, but rather a reactive lesion caused by local irritation or trauma. Moreover, its etiology is still contentious. Previously, the lesion was called peripheral giant cell reparative granuloma. However, its reparative effect has not been proved yet, hence osteoclast activity seems doubtful. This paper presents a unique case of peripheral giant cell granuloma in an 11 year old boy who was referred for evaluation of a gingival mass approximately 2 cm × 1.5 cm in size extending from distal aspect of canine to mesial aspect of first permanent molar and covering the crowns of first premolar and primary second molar. It extended from the free gingival margin on the labial side of the first premolar and primary second molar to the attached gingiva on the lingual surface. Thus, management of such case presents a challenge to the practitioner to carefully excise the lesion and on the same hand protecting the underlying erupting permanent tooth.
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