We present a case of mitotically active cellular fibroma of the. Fibromas have no or very few thecal cells and no or minimal estrogen activity. Tumor cells present in lacunae in myxoid areas, stellate in myxoid areas with long delicate cell. Apr 10, 20 fibroma and giantcell tumor of tendon sheath. American journal of pharmacology and pharmacotherapeutics. Mcqs on benign and malignant tumors of oral cavity. Fibroma of tendon sheath is a circumscribed, often multinodular, tumor that occurs in the extremities and most often affects the hands, fingers and wrists. Central giant cell granuloma cgcg is a locally destructive but. Well circumscribed, hypocellular lobules of poorly formed hyaline cartilage composed of chondroblasts with abundant pink cytoplasm and myxoid tissue with fibrous septae containing spindle cells and osteoclasts. Cut surface of cellular fibromas may appear fleshy cancer 1981. Central odontogenic fibroma associated with central giant cell granuloma cgcg in some cases, the cof and cgcg histologic components were not intimately admixed. The name giant cell fibroma has been assigned due to the presence of large stellate and multinucleated fibroblasts which are mainly in the lamina propria near the epithelium 14. Central giant cell granuloma cgcg is a locally destructive but benign lesion of.
It affects all ages of patients but is most commonly reported in adults. Giant cell fibroma is a type of fibrous tumour of the oral mucosa which rarely affects children under the age of 10. Dermis and subcutis contains hyperchromatic spindle or stellate shaped cells in a collagenous or myxoid matrix with scattered hyperchromatic, multinucleated, floretlike giant cells with prominent nucleoli, similar to those in pleomorphic lipomas. Gingival enlargement and gingival overgrowth are common features of gingival diseases. A series of nine cases of fibroma of tendon sheath is described including details of the ultrastructural features of two cases. The cause of oral giant cell fibroma is unknown and so are the risk factors. Giant cell fibroma is a type of fibrous tumour of the oral mucosa which rarely affects children under the age of. Giant cell fibroma is a type of fibroma not associated with trauma or irritation. Fibroma article about fibroma by the free dictionary.
It most commonly occurs on the gums, more commonly on the lower than upper. Pathology outlines peripheral giant cell granuloma. Histopathological examination confirmed the diagnosis of giant cell fibroma. Analyze the presence of myofibroblasts mfbs in oral fibrous lesions and investigate tgf. The myxofibroma fibroma myxomatodes is produced by liquefaction of the underlying soft tissue. It was named for its characteristically large, stellateshaped, mononuclear and multinucleated giant. It presents as a localized reactive proliferation of fibrous tissue, which resembles irritation fibroma rather than a neoplastic proliferation. Fibrosarcomas usually exhibit moderatetosevere nuclear atypia and mitotic counts of 4 or more per 10 highpower. Eversole and rovin compared 279 fibrous hyperplastic lesions that were categorized into four types, namely pyogenic granuloma, peripheral gingival fibroma, peripheral giant cell granuloma, and peripheral ossifying fibroma. It may be on a small stalk pedunculated or domeshaped like a limpet. This finding may have been the result of considering reactive lesions such as ossifying fibroma as a neoplasm in that study and also, due to. Giantcell fibroma is a type of fibroma not associated with trauma or irritation. Giant cell fibroma gcf is considered a distinct variant among the fibrotic soft tissue lesions. Giant cell fibroma gcf is a rare case with unique histopathology.
Therefore, we suggest that the ovarian fibrous tumors should be further classified, especially in the cases with mitotic counts. Peripheral ossifying fibroma 24 peripheral giant cell proliferation 25 traumatic eosinophilic granuloma 27 frey syndrome 29 benign masseteric hypertrophy 31 traumatic myositis ossificans 32 myositis ossificans progressiva 35 gorhamstout disease idiopathic osteolysis 37 2 inflammatory and reactive diseases of the oral and maxillofacial region 17. The giant cell fibroma, fibrous hyperplasia and fibroma are the most frequent fibrous oral lesions, sharing clinical and. Unlike peripheral ossifying fibroma, however, it may occur on the alveolar mucosa of edentulous areas. Phenotypic characterisation of stellate and giant cells in.
Giant cell fibroma gcf is one such interesting lesion that may clinically mimic a fibroma or a papilloma that. Understanding the nature of an unusual histopathological entity wanjarighatesonalika, 1 anshutasahu, 2 suryakantc. The cystic fibroma fibroma cysticum has central softening or dilated lymphatic vessels. Case report giant cell fibroma in a twoyearold child annacarolinavolpimellomoura, 1,2 anamariaantunessantos, 3. Giant cell fibroma gcf is a distinct type of fibroma with characteristic large, stellate mononuclear or multinucleated giant fibroblasts. They considered gcf as a fibrous tumor with distinct diagnostic clinicopathological features. Hybrid peripheral giant cell granuloma and peripheral.
Usually these are solid tumors, sometimes with small areas of cystic degeneration. Giant cell fibroma definition of giant cell fibroma by. This article reports a case of giant cell fibroma in a 2yearold girl, which is an uncommon age for this lesion. Giant cell fibroma, first described by weathers and callihan in 1947, is a benign, sessile or pedunculated lesion of oral mucosa, seen predominately in the third decades of life with a slight female predilection. The giant cell lesions of oral cavity have been classified on the basis of etiopathogenesis, the presence of which at times being pathognomic like in hodgkins disease, peripheral giant cell granuloma and giant cell fibroma. Different forms of fibrous hyperplasia share a similar clinical features, age. It may affect a wide spectrum of ages, but it is most commonly found in young people and can be alarming due to rapid enlargement and ulceration. The most common site for occurrence of giant cell fibroma is gingiva followed by tongue, buccal mucosa, palate, lip and floor of mouth. The topic giant cell fibroma of mouth you are seeking is a synonym, or alternative name, or is closely related to the medical condition oral giant cell fibroma. It occurs in the first three decades of life in the mandibular gingiva, predominantly, showing predilection for females. Orofacial pathologic lesions in children and adolescents. Giant cell fibromas gcfs are a separate category under fibromas, that was first discovered by weathers and callihan in 1974.
Ovarian fibroma is the commonest benign tumor of the ovarian stroma. The giant cell fibroma is a nonneoplastic lesion with distinctive clinicpathologic features. Weathers and callihan were the first to describe giant cell fibroma gcf as a separate entity among fibrous soft tissue lesions of the oral cavity, in the early 1970s. Oral giant cell fibroma or oral gcf is a common, benign, slowgrowing tumor of the mouth. While the terminology implies a benign neoplasm, most if not all fibromas represent reactive focal fibrous hyperplasia due to trauma or local irritation. Oral giant cell fibroma is usually present as a mass in the mouth. The giant cell fibroma usually occurs at young age, and it is more common in the second and. Giantcell fibroma is a localized, benign fibrous mucosal mass, which clinically mimics any other fibroepithelial growth, and its distinction from other lesions is on. Oct 15, 2014 combined with a 66 month tumor free followup, the benign clinicopathologic characteristics in this case indicates a diagnosis of mitotically active cellular fibroma more suitable.
Pdf giant cell fibroma gcf is considered a distinct variant among the fibrotic soft tissue lesions. In a majority of cases, there may be no signs and symptoms of oral giant cell fibroma. Juvenile ossifying fibroma, which can be further categorized into juvenile trabecular ossifying fibroma jtof and juvenile psammomatoid. Ffh and the palatal lesion as a giant cell fibroma gcf. Only its peculiar histopathological features help us to distinguish it from them. Nonossifying fibroma 2 cm fibrous cortical defect feb 22, 20 fibroma 1. Giant cell fibroma is a benign oral fibrous tumor and it is typically an. A case report of a 20 y ear ol d lesion mohammed nazish al am, 1 s. The degree of mitotic activity is the main parameter for differentiating cellular fibroma from fibrosarcoma.
It occurs in the first three decades of life in the mandibular gingiva, predominantly. It makes up less than 5% of odontogenic tumors and is more commonly seen in females. It is a localized reactive proliferation of fibrous connective tissue giantcell fibroma gcf is a benign nonneoplastic lesion first described by weathers and. The commonest location was the gingiva, followed by the tongue and the buccal mucosa. Giant cell fibroma a variant of oral fibroma, is a rare reactive fibrous connective tissue tumour of the oral cavity.
Pofs comprises of, one or more mineralized tissues, including bone, cementum like material or dystrophic calcification, within a matrix of cellular fibroblastic tissue 2. Ultrastructural examination suggested that the multinucleated giant cells in the lesion were unusual fibroblasts. Discussion v, we believe that the giant cell fibroma is a distinctive lesion whose charac teristic location, age distribution, sex incidence, and histologie features clearly separate it from the usual fibroma or fibrous tumors of the oral mucosa. These tumors are not associated with any known congenital syndrome what are the signs and symptoms of oral giant cell fibroma. Fibromas are generally asymptomatic and are often detected at palpation during a routine gynecologic examination. Clinicopathologic study of a series of giant cell fibroma. Case report giant cell fibroma in a paediatric patient. The most common oral locations are on the gingiva of the mandible, tongue, and palate. It was named for its characteristically large, stellateshaped, mononuclear and multinucleated giant cells. In about 60% of the cases the lesion is diagnosed within the first three decades of life and is slightly more in women. There are no significant complications due to the tumor. Hybrid central odontogenic fibroma with giant cell granuloma. A rare case report veerakishorekumarreddy, 1 naveenkumar, 1 prashantbattepati, 2.
The purpose of this paper was to contribute two clinically and histologically documented cases of giant cell fibroma in the free gingiva of a 7 and 6 year old boys. Since 1992, hybrid lesions containing a similar component to the giant cell granuloma gcg mainly associated with the central odontogenic fibroma cof,,, and more rarely with the central ossifying fibroma cosf,, trabecular variant of the. Clinicopathological study of oral giant cell fibromas. Also called giant cell epulis, giant cell reparative granuloma, osteoclastoma, myeloid epulis epidemiology. Giant cell fibroma is a form of fibrous tumour affecting the oral mucosa. Case report giant cell fibroma in a twoyearold child. The giant cell fibroma is a fibrous tumour with distinct clinicopathologic features which sets it apart from the conventional fibroma. Microscopically, the tumors were characterized by the presence of large stellate or angular cells, which occasionally contained several. Its occurrence is relatively rare in paediatric patients. Giant cell fibroma gcf is an unusual fibrous mucosal mass with several unique features separating it from other oral fibrous hyperplasias. It can occur at any age and on a mucous membrane surface. The gcf was first described as a separate entity among fibrous hyperplastic soft tissue lesions by weathers and callihan in 1974.
The giant cell fibroma is a benign, fibrous tumor with multiple large fibroblasts, not associated with trauma or chronic irritation. A dermatofibroma is a common overgrowth of the fibrous tissue situated in the dermis also known as. Design twenty giant cell fibromas gcfs, 20 fibromas fibs, and 20 fibrous hyperplasias fhs were selected. The cellular fibroma is a tumor of uncertain malignant potential that may recur or be associated with peritoneal implants. The condition responded to surgical excision and appears to have limited growth potential. The aim of this study was to evaluate the staining properties of collagen fibers in gcf and to correlate. The giant cell fibroma is an interesting nonneoplastic lesion of the oral mucosa. Jan 09, 2014 giant cell fibroma gcf is a rare case with unique histopathology.
Here we are presenting a case where a sevenyearold male patient reported with a painless nodular growth in. If associated with ovarian torsion, fibromas will often exhibit hemorrhage and necrosis. The most common site of involvement was the hand including fingers and the mean greater diameter was 19 mm. The multinucleated giant cells had similar morphology and occasionally resembled langhans giant cells. Immunohistochemical markers are required to diagnose gcf. Clinicopathological study on giant cell fibroma of oral mucosa. Peripheral giant cell granuloma, like the peripheral ossifying fibroma, is a lesion unique to the oral cavity, occurring only on the gingiva. Cellular fibroma of the ovary with multiloculated macroscopic. The patient was brought for treatment at the research and clinical center of. It usually occurs in young people without any gender predilection. Peripheral ossifying fibroma pof is a reactive gingival overgrowth which is relatively uncommon in nature. First reported by weathers and callihan in 1974, gcf is found predominantly in caucasians in first three decades of life with slight female predilection. The purpose of this paper was to contribute two clinically and histologically documented cases of giant cell fibroma in the free gingiva of a 7 and 6 year.
This is the first reported case of oral giant cell fibroma in a japanese patient. Hybrid central odontogenic fibroma with giant cell. It is a localized reactive proliferation of fibrous connective tissue. Giant cell fibromas gcf of the oral cavity are found predominantly in caucasians and rarely in other races. The fibroma cavernosum or angiofibroma, consists of many often dilated vessels, it is a vasoactive tumor occurring almost exclusively in adolescent males. Giant cell fibroma may mimic fibroma of the gingiva, but have distinctive histopathological difference.
It is often mistaken with fibroma and papilloma due to its clinical resemblance. Download fulltext pdf download fulltext pdf traumatic fibroma article pdf available in pan african medical journal 21 october 2015 with 924 reads. Giant cell fibroma gcf is a benign oral fibrous tumor that was described initially by w eathers and callihan. B, spindle cells show strong positivity for vimentin. Giant cell fibroma is a small usually less than 5mm diameter firm lump in the mouth, often with a folded or pebbly surface. Central odontogenic fibroma cof is an uncommon intraosseous neoplasm of the gnathic bones which is composed of fibrous connective tissue, with or without calcifications, and variable amounts of inactive odontogenic epithelium. Mitotically active cellular fibroma of ovary should be. As always, continue to listen to your patients and always ask good questions. It belongs to the broad category of fibrous hyperplastic lesions of the oral cavity. A 53yearold man presented in 2009 with a tumor over the dorsum of his hand and wrist. Peripheral odontogenic fibroma is an uncommon neoplasm that is believed to arise from. Pdf benign gingival overgrowths are not uncommon in the oral cavity. Usually women, 30s to 50s, although may involve children or elderly patients without teeth. Reactive and benign lesions of fibroblastic and histiocytic origin irritation fibroma giant cell fibroma inflammatory fibrous hyperplasia inflammatory papillary hyperplasia fibrous histiocytoma fibromatosis and myofibromatosis oral focal mucinosis pyogenic granuloma peripheral giant cell granuloma peripheral ossifying fibroma.
The origin of the giant cell is still controversial. The picrosirus red polarizing microscopy technique is used to characterize the collagen fibers. C chand rasekaran, 2 mohan v aliathan 3 the 10 most common soft tiss ue oral lesions 7. The giant cell fibroma is a benign nonneoplastic fibrous tumor of the oral mucosa.
Sixteen giant cell fibromas were stained immunocytochemically for keratin mnf 116, vimentin, s. No recurrence was observed a er a period of months of monitoring. Desmoplastic fibromas are extremely rare bone tumors that do not metastasize but may be locally aggressive. Immunohistochemical expression of myofibroblasts, tgf. Compared to traumatic fibroma, giant traumatic fibroma or irritation fibroma cell fibroma occurs at a younger age. They are considered to be a bony counterpart of soft tissue desmoid tumors and are histologically identical. Giant cell fibroma in a twoyearold child europe pmc.
The origin of the stromal, stellate and multinucleate cells in oral giant cell fibroma is unclear. It presents as a sessile or pedunculated nodule, usually less than 1 cm in diameter with a flat or papillary surface. This article reports a series of 103 cases of giant cell fibromas occurring in the oral mucosa. May 31, 2018 the fibroma, also referred to as irritation fibroma, is by far the most common of the oral fibrous tumorlike growths. Etiology the cause of oral giant cell fibroma is unknown, in most of the cases. Nonossifying fibroma commonly involves metaphysis of long bones and consists of 40% in distal femur, 40% in tibia with 10% in fibula. The etiology for gcf remains unknown and does not appear to be associated with. Giant cell brom a is a form of b rous tumour a ecting the oral muc osa. The tumor site could include the tongue, palate, or gums.
If you cannot find any books here in the list below, you can search. A hybrid lesion consists of the association of characteristic features from different pathologies into one single lesion. The tumor belongs to the same histopathologic spectrum as an ovarian thecoma ovarian fibrothecoma. The cellular subtype accounts for around 10% of ovarian fibromatous tumors. The series was composed of lesions from six males and three females with a mean age of 38 yr. A complete surgical excision of oral giant cell fibroma usually results in a cure. Deogade, 3 pushkargupta, 3 dineshnaitam, 4 harshchansoria, 5 jatinagarwal, 6 andshivakatoch 7 department of oral pathology and microbiology, hitkarini dental college and hospital, jabalpur, madhya pradesh, india.
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