A potential endodontic misdiagnosis: periapical central giant cell granuloma
Abstract
Objectives: The purpose of this case study was to report a periapical central giant cell granuloma post-endodontic treatment.Case Report: A 32-year-old female patient presented to the Dental Radiology Unit of Dental Hospital Universitas Padjadjaran with a CBCT referral letter, diagnosed clinically with periapical abscess of tooth 22 post-endodontic treatment. The patient had a history of coming to the emergency room with a fair general condition and complained of pain and swelling of the left upper lip. The CBCT result demonstrated a large radiolucent lesion at the periapical of tooth 22 with a well-defined border that extended to the apical area of tooth 21. There was a cortical destruction on the palatal and labial alveolar bone. Density analysis revealed an average density of 145.2 Grayscale.
Conclusion: Lesions might be analysed using both qualitative and quantitative methods with CBCT 3D. These methods lead to the suspicion of periapical central giant cell granuloma in this case's lesion.
Keywords: Periapical central giant cell granuloma, endodontic lesion, CBCT 3D
References
1. Candeiro GT de M, de Souza CVT, Chaves RSA, Ley AM, Feijão CP, Costa FWG, et al. Central giant cell granuloma mimicking a periapical lesion of endodontic origin: A case report. Australian Endodontic Journal. 2020 Dec 1;46(3):381–6.
2. White SC, Pharoah MJ. Oral Radiology Principles and Interpretation. 2014.
3. El-Khatib SH, Scott DB, Sigurdsson A. Unusual presentation of Aggressive Giant cell Granuloma with non-vital tooth Case report: The importance of using CBCT in diagnosis of the non-odonto-genic lesions [Internet]. 2020. Available from: www.jrmds.in
4. MacDonald D. Oral and Maxillofacial Radiology : A Diagnostic Approach. 2020.
5. de Arruda JAA, Martins AFL, Abreu LG, Mesquita RA, von Zeidler SV, Estrela C, et al. Central giant cell granuloma of the maxilla: Long-term follow-up of a patient treated with an adjuvant corticosteroid. Special Care in Dentistry. 2021 May 1;41(3):399–407.
6. Butel A, Di Bernardo G, Louvet B. Central giant cell granuloma: A case report. Vol. 24, Journal of Oral Medicine and Oral Surgery. EDP Sciences; 2018. p. 24–8.
7. Koong Bernard. Atlas of Oral and Maxillofacial Radiology. John Wiley & Sons, Incorporated; 2017. 371 p.
8. Dahlkemper P, Wolcott JF, Pringle GA, Hicks ML. Periapical central giant cell granuloma: A potential endodontic misdiagnosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;90(6):739–45.
9. Tahmasbi-Arashlow M, Patel PB, Nair MK, Liang H, Cheng YSL. Cone-beam computed tomographic imaging of central giant cell granuloma: A comprehensive review. Imaging Sci Dent. 2022 Jun 1;52(2):123–31.
10. Andersen L, Fejerskov O, Riilipsen HP. ORAL GIANT CELL GRANULOMAS A Clinical and Histological Study of 129 New Cases. Vol. 81, Acta path. microbiol. scand. Section A. 1973.
11. Waldron CA. THE CENTRAL GIANT CELL REPARATIVE GRANULOMA OF THE JAWS [Internet]. Vol. 45, JOURNAL OP CLINICAL PATHOLOGY. Available from: http://ajcp.oxfordjournals.org/
12. Lombardi T, Bischof M, Nedir R, Vergain D, Galgano C, Samson J, et al. Periapical central giant cell granuloma misdiagnosed as odontogenic cyst. Int Endod J. 2006 Jun;39(6):510–5.
13. Kumar R, Khambete N. Endodontic misdiagnosis of periapical central giant cell granuloma: Report of case with 2 years of follow-up. Saudi Endodontic Journal. 2012;2(2):95.
14. Waldron CA. THE CENTRAL GIANT CELL REPARATIVE GRANULOMA OF THE JAWS [Internet]. Vol. 45, JOURNAL OP CLINICAL PATHOLOGY. 2024. Available from: http://ajcp.oxfordjournals.org/
15. Tahmasbi-Arashlow M, Patel PB, Nair MK, Liang H, Cheng YSL. Cone-beam computed tomographic imaging of central giant cell granuloma: A comprehensive review. Imaging Sci Dent. 2022 Jun 1;52(2):123–31.
16. Koong Bernard. Atlas of oral and maxillofacial radiology. John Wiley & Sons Inc., Credo Reference; 2019.
2. White SC, Pharoah MJ. Oral Radiology Principles and Interpretation. 2014.
3. El-Khatib SH, Scott DB, Sigurdsson A. Unusual presentation of Aggressive Giant cell Granuloma with non-vital tooth Case report: The importance of using CBCT in diagnosis of the non-odonto-genic lesions [Internet]. 2020. Available from: www.jrmds.in
4. MacDonald D. Oral and Maxillofacial Radiology : A Diagnostic Approach. 2020.
5. de Arruda JAA, Martins AFL, Abreu LG, Mesquita RA, von Zeidler SV, Estrela C, et al. Central giant cell granuloma of the maxilla: Long-term follow-up of a patient treated with an adjuvant corticosteroid. Special Care in Dentistry. 2021 May 1;41(3):399–407.
6. Butel A, Di Bernardo G, Louvet B. Central giant cell granuloma: A case report. Vol. 24, Journal of Oral Medicine and Oral Surgery. EDP Sciences; 2018. p. 24–8.
7. Koong Bernard. Atlas of Oral and Maxillofacial Radiology. John Wiley & Sons, Incorporated; 2017. 371 p.
8. Dahlkemper P, Wolcott JF, Pringle GA, Hicks ML. Periapical central giant cell granuloma: A potential endodontic misdiagnosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;90(6):739–45.
9. Tahmasbi-Arashlow M, Patel PB, Nair MK, Liang H, Cheng YSL. Cone-beam computed tomographic imaging of central giant cell granuloma: A comprehensive review. Imaging Sci Dent. 2022 Jun 1;52(2):123–31.
10. Andersen L, Fejerskov O, Riilipsen HP. ORAL GIANT CELL GRANULOMAS A Clinical and Histological Study of 129 New Cases. Vol. 81, Acta path. microbiol. scand. Section A. 1973.
11. Waldron CA. THE CENTRAL GIANT CELL REPARATIVE GRANULOMA OF THE JAWS [Internet]. Vol. 45, JOURNAL OP CLINICAL PATHOLOGY. Available from: http://ajcp.oxfordjournals.org/
12. Lombardi T, Bischof M, Nedir R, Vergain D, Galgano C, Samson J, et al. Periapical central giant cell granuloma misdiagnosed as odontogenic cyst. Int Endod J. 2006 Jun;39(6):510–5.
13. Kumar R, Khambete N. Endodontic misdiagnosis of periapical central giant cell granuloma: Report of case with 2 years of follow-up. Saudi Endodontic Journal. 2012;2(2):95.
14. Waldron CA. THE CENTRAL GIANT CELL REPARATIVE GRANULOMA OF THE JAWS [Internet]. Vol. 45, JOURNAL OP CLINICAL PATHOLOGY. 2024. Available from: http://ajcp.oxfordjournals.org/
15. Tahmasbi-Arashlow M, Patel PB, Nair MK, Liang H, Cheng YSL. Cone-beam computed tomographic imaging of central giant cell granuloma: A comprehensive review. Imaging Sci Dent. 2022 Jun 1;52(2):123–31.
16. Koong Bernard. Atlas of oral and maxillofacial radiology. John Wiley & Sons Inc., Credo Reference; 2019.
Published
2025-08-31
How to Cite
CAHYARENI, Firlana et al.
A potential endodontic misdiagnosis: periapical central giant cell granuloma.
Jurnal Radiologi Dentomaksilofasial Indonesia (JRDI), [S.l.], v. 9, n. 2, p. 99-104, aug. 2025.
ISSN 2686-1321.
Available at: <http://jurnal.pdgi.or.id/index.php/jrdi/article/view/1295>. Date accessed: 29 nov. 2025.
doi: https://doi.org/10.32793/jrdi.v9i2.1295.
Section
Case Report
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
