Hybrid central giant cell granuloma and central odontogenic fibroma‐like lesions of the jaws

Abstract

Ten lesions from eight cases are presented of a rare intra‐osseous jaw lesion with the combined histological features of giant cell granuloma and central odontogenic fibroma. Lesions arose over a wide age range and presented as monolocular or multilocular radiolucencies with cortical expansion and, in one case, perforation. Two lesions recurred after curettage, one being eradicated by a second curettage and one by conservative excision. Histologically, zones of typical giant cell granuloma lay in a fibrous stroma containing islands, strands and clusters of epithelial cells. Islands often contained duct‐like spaces or hyaline basement membrane globules. Trabeculae of osteoid were present in five lesions. Recurrent lesions showed features identical to the initial lesion, including recurrence of the prominent epithelial component. These features cannot be conclusively ascribed to a variant of either giant cell granuloma, central odontogenic fibroma or aneurysmal bone cyst, but the clinical features are slightly more suggestive of giant cell granuloma. Attention is drawn to the characteristic and potentially confusing histological appearances. The presence of giant cell granuloma‐like areas in central odontogenic fibroma‐like lesions is associated with an increased risk of recurrence following curettage.

So-called Hybrid Central Odontogenic Fibroma/Central Giant Cell Lesion of the Jaws. A Report on Seven Additional Cases, Including an Example in a Patient with Cherubism, and Hypotheses on the Pathogenesis

“…Similarly, one case reported by Allen et al recurred and featured again both components [7]. Our findings suggest that either component can be predominant and we are in agreement with the opinion of Odell et al [9].…”

“…None of the case reported so far presented calcified material resembling dysplastic dentin or cementum as seen in COF, although that is not imperative for such diagnosis. In their series, as in ours, the lesions exhibited osteoid or woven bone trabeculae which are frequently featured in CGCL [9]. The possibility of a local irritation factor is recognized in some patients (root-canal treatment, orthodontic treatment), but such factors have not been reportedly causative for either CGCL or COF [9].…”

So-called Hybrid Central Odontogenic Fibroma/Central Giant Cell Lesion of the Jaws. A Report on Seven Additional Cases, Including an Example in a Patient with Cherubism, and Hypotheses on the Pathogenesis

“…Similarly, one case reported by Allen et al recurred and featured again both components [7]. Our findings suggest that either component can be predominant and we are in agreement with the opinion of Odell et al [9].…”

“…None of the case reported so far presented calcified material resembling dysplastic dentin or cementum as seen in COF, although that is not imperative for such diagnosis. In their series, as in ours, the lesions exhibited osteoid or woven bone trabeculae which are frequently featured in CGCL [9]. The possibility of a local irritation factor is recognized in some patients (root-canal treatment, orthodontic treatment), but such factors have not been reportedly causative for either CGCL or COF [9].…”

Hybrid Central Odontogenic Fibroma with Central Giant Cell Granuloma Like Lesion ; A Case Report and Review of the Literature

“…The growth of collision tumor arose from the synchronous occurrence of COF in the same area as a CGCG. 9,21 This theory correlated with our case due to the presence of intrabony mixedup area of these two lesions. This case displayed three different areas including: odontogenic fibroma, giant cell granuloma and two merged lesions.…”

“…The areas have been revealed to merge independently with a variably plump to narrow spindle-shaped fibrocellular connective tissue containing multinucleated giant cells. 18,21,23 Similarly, in this reported case, features of HCOF-CGCG like components and the odontogenic epithelial nests in the mature fibrous connective tissue were seen histologically.…”

Hybrid Central Odontogenic Fibroma with Giant Cell Granuloma like Lesion: A Report of Three Additional Cases and Review of the Literature

“…Cytoplasmic vacuolization of cells, duct-like spaces and hyaline basement membrane globules in the odontogenic epithelium have been reported in previous published cases of hybrid COF with GCGL lesions. Osteoid deposits have been reported in many cases of this hybrid lesion [13][14][15]. In our study, in addition to these previously reported features, we also noticed vacuolization in few multinucleated giant cells as well as osteoid formation in one case (Fig.…”

So-called Hybrid Central Odontogenic Fibroma/Central Giant Cell Lesion of the Jaws. A Report on Seven Additional Cases, Including an Example in a Patient with Cherubism, and Hypotheses on the Pathogenesis

“…Similarly, one case reported by Allen et al recurred and featured again both components [7]. Our findings suggest that either component can be predominant and we are in agreement with the opinion of Odell et al [9].…”

“…None of the case reported so far presented calcified material resembling dysplastic dentin or cementum as seen in COF, although that is not imperative for such diagnosis. In their series, as in ours, the lesions exhibited osteoid or woven bone trabeculae which are frequently featured in CGCL [9]. The possibility of a local irritation factor is recognized in some patients (root-canal treatment, orthodontic treatment), but such factors have not been reportedly causative for either CGCL or COF [9].…”

Hybrid Central Odontogenic Fibroma with Central Giant Cell Granuloma Like Lesion ; A Case Report and Review of the Literature

“…The growth of collision tumor arose from the synchronous occurrence of COF in the same area as a CGCG. 9,21 This theory correlated with our case due to the presence of intrabony mixedup area of these two lesions. This case displayed three different areas including: odontogenic fibroma, giant cell granuloma and two merged lesions.…”

“…The areas have been revealed to merge independently with a variably plump to narrow spindle-shaped fibrocellular connective tissue containing multinucleated giant cells. 18,21,23 Similarly, in this reported case, features of HCOF-CGCG like components and the odontogenic epithelial nests in the mature fibrous connective tissue were seen histologically.…”

Hybrid Central Odontogenic Fibroma with Giant Cell Granuloma like Lesion: A Report of Three Additional Cases and Review of the Literature

“…Cytoplasmic vacuolization of cells, duct-like spaces and hyaline basement membrane globules in the odontogenic epithelium have been reported in previous published cases of hybrid COF with GCGL lesions. Osteoid deposits have been reported in many cases of this hybrid lesion [13][14][15]. In our study, in addition to these previously reported features, we also noticed vacuolization in few multinucleated giant cells as well as osteoid formation in one case (Fig.…”

So-called Hybrid Central Odontogenic Fibroma/Central Giant Cell Lesion of the Jaws. A Report on Seven Additional Cases, Including an Example in a Patient with Cherubism, and Hypotheses on the Pathogenesis

“…Similarly, one case reported by Allen et al recurred and featured again both components [7]. Our findings suggest that either component can be predominant and we are in agreement with the opinion of Odell et al [9].…”

“…None of the case reported so far presented calcified material resembling dysplastic dentin or cementum as seen in COF, although that is not imperative for such diagnosis. In their series, as in ours, the lesions exhibited osteoid or woven bone trabeculae which are frequently featured in CGCL [9]. The possibility of a local irritation factor is recognized in some patients (root-canal treatment, orthodontic treatment), but such factors have not been reportedly causative for either CGCL or COF [9].…”

Hybrid Central Odontogenic Fibroma with Central Giant Cell Granuloma Like Lesion ; A Case Report and Review of the Literature

“…The growth of collision tumor arose from the synchronous occurrence of COF in the same area as a CGCG. 9,21 This theory correlated with our case due to the presence of intrabony mixedup area of these two lesions. This case displayed three different areas including: odontogenic fibroma, giant cell granuloma and two merged lesions.…”

“…The areas have been revealed to merge independently with a variably plump to narrow spindle-shaped fibrocellular connective tissue containing multinucleated giant cells. 18,21,23 Similarly, in this reported case, features of HCOF-CGCG like components and the odontogenic epithelial nests in the mature fibrous connective tissue were seen histologically.…”

Hybrid Central Odontogenic Fibroma with Giant Cell Granuloma like Lesion: A Report of Three Additional Cases and Review of the Literature

“…Cytoplasmic vacuolization of cells, duct-like spaces and hyaline basement membrane globules in the odontogenic epithelium have been reported in previous published cases of hybrid COF with GCGL lesions. Osteoid deposits have been reported in many cases of this hybrid lesion [13][14][15]. In our study, in addition to these previously reported features, we also noticed vacuolization in few multinucleated giant cells as well as osteoid formation in one case (Fig.…”