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

Abstract

The combination of central odontogenic fibroma and central giant cell granuloma is extremely rare and has been reported in only 46 cases worldwide in previous articles. The lesion is called a hybrid central odontogenic fibroma with central giant cell granuloma like lesion (HCOF-CGCG) due to a histopathological characteristics of multinucleated giant cell and odontogenic epithelium in fibro-cellular background. We report a case of HCOF-CGCG in a 27-year old Thai male patient who was identified as the first case in Thailand. Radiographic examination showed a well-defined radiolucency lesion at posterior mandibular area. Enucleation and curettage were done and microscopic study revealed a fibro-cellular proliferating tissue containing numerous strands, cord of odontogenic epithelium, and numerous multinucleated giant cells. This report also included a literature review of the previous 45 cases.

Fibrous epulis - case report

“…As suggested by Peralles et al, another possible etiology of this lesion is local tissue irritation by bacterial agents and cellular products that induce tissue hyperplasia [6]. Most previous studies have shown that the frontal region, as seen in our case, of the oral cavity was more affected by gingival hyperplasia, ranging from 57% to 71% of cases [7], and this can be explained by the fact that these regions are drier, less exposed to oral moisture and therefore less exposed to saliva with all its positive characteristics. Fibrous epulis in the current case appeared in 25-yearold female patient.…”