--Introduction: Peri implantitis can be identified by classic clinical and radiographic signs. The aim of this case was to show an original exophytic lesion appeared 8 years after the implantation in the mandibular symphysis. Observations: The patient has been implanted on symphyseal site 8 years ago. The lesion was exophytic and located around mobile implant in right mandible. First curative surgical resection was performed under local anesthesia, combined with explantation of mobile implants. Histhopathological exam identified a giants cells granuloma. A second surgical removal was necessary under general anesthesia because of a severe recurrence. Discussion: The goal of this clinical case was to emphasize the possible correlation between inflammatory peri implantits context and giants cells granuloma. Others techniques could be used to manage this case.