A healthy 24-year-old woman presented with gingival bleeding in the upper right teeth during the last 6 months.
The patient also reported mild pain episodes and gradual tooth deviation.
There were no signs of fever or pus.
A general systemic examination of the patient revealed no abnormalities.
Local examination revealed diffuse swelling of 1 x 3 cm in the alveoli corresponding to the right upper molars.
Swelling was more prominent on the vestibular side.
The surface was rough and erythematous.
There were no visible pulsations in the lesion.
The mentioned teeth were diverted to the palate.
At fixation, the swelling showed a hard consistency.
The three affected teeth did not respond to heat, cold or electric stimuli of the pulp.
Orthopantomography was inconclusive.
Contrast-enhanced computed tomography (CT) showed a soft tissue mass in the right maxillary alveolar bone, without bone erosion.
Routine radiological examinations and laboratory tests, including coagulation tests, revealed no abnormalities.
1.
Comparing clinical findings and CT findings, a provisional diagnosis of giant cell lesion was made, and an incisional biopsy of the vestibular gingiva was performed.
The marginal increase in intraoperative bleeding was evident, but was attributed to inflammation.
The pathological report of the sample revealed fibrovascular connective tissue with aggregates of numerous capillaries and endothelial venules suggestive of AVM.
After consultation with an interventional radiologist, it was decided and performed the resection of the lesion under general anesthesia.
The only sample included buccal and palatal gingiva, alveoli, and affected teeth.
Hemostasis was achieved and the defect was closed by first intention through the advancement of the palate and oral mucosa.
The perioperative period and recovery were uneventful and comfortable for the patient.
The anatomopathological analysis of the sample was very similar to that of the incisional biopsy and revealed numerous arterioles and venules intercalated between the bony trabeculae, extending to the gingiva, suggesting adhesion.
1.
The patient was followed for a period of 1 year without recurrence.
