Journal of the Formosan Medical Association
Volume 108, Issue 9 , Pages 725-729, September 2009

Clinicopathological Study of Oral Giant Cell Fibromas

  • Ru-Cheng Kuo

      Affiliations

    • Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
    • College of Medicine, Taipei, Taiwan
    • ,
  • Yi-Ping Wang

      Affiliations

    • Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
    • College of Medicine, Taipei, Taiwan
    • School of Dentistry, Taipei, Taiwan
    • Graduate Institute of Clinical Dentistry, Taipei, Taiwan
    • ,
  • Hsin-Ming Chen

      Affiliations

    • Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
    • College of Medicine, Taipei, Taiwan
    • School of Dentistry, Taipei, Taiwan
    • Graduate Institute of Oral Biology, National Taiwan University, Taipei, Taiwan
    • ,
  • Andy Sun

      Affiliations

    • Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
    • College of Medicine, Taipei, Taiwan
    • School of Dentistry, Taipei, Taiwan
    • ,
  • Bu-Yuan Liu

      Affiliations

    • Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
    • College of Medicine, Taipei, Taiwan
    • School of Dentistry, Taipei, Taiwan
    • Graduate Institute of Clinical Dentistry, Taipei, Taiwan
    • ,
  • Ying-Shiung Kuo

      Affiliations

    • Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
    • College of Medicine, Taipei, Taiwan
    • School of Dentistry, Taipei, Taiwan
    • Department of Dentistry, Far Eastern Memorial Hospital, Taipei, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Ying-Shiung Kuo, Department of Dentistry, Far Eastern Memorial Hospital, 21, Nan-Ya South Road, Section 2, Pan-Chiao, Taipei 220, Taiwan

Received 10 February 2009; received in revised form 5 March 2009; accepted 6 March 2009.

Article Outline

Background/Purpose

Oral giant cell fibromas (GCFs) are found predominantly in Caucasians and rarely in other races. This retrospective study evaluated the clinicopathological features of 24 GCFs in Taiwanese patients.

Methods

Twenty-four consecutive cases of oral GCF were investigated from 1987 to 2008. Clinical data and microscopic features were reviewed and analyzed.

Results

The mean age of patients at the time of diagnosis was 29 years. Oral GCF occurred more commonly in patients between 11 and 40 years of age. There were 12 male and 12 female patients. The lesions were found more frequently on the tongue (8 cases) and gingiva (7 cases). The mean size of the lesion was 5.5 mm (range, 2–10 mm) in greatest dimension. GCF is misdiagnosed frequently as fibroma (19 cases) or papilloma (5 cases). All tumors were treated by total surgical excision and no recurrence was found after treatment. Microscopically, the GCF was a sessile or pedunculated mass covered with a thin layer of parakeratinized or orthokeratinized stratified squamous epithelium. The tumor was composed mainly of loose or dense fibrous connective tissue with well-formed capillaries and no inflammation. The consistent and diagnostic feature was the presence of large stellate giant cells, usually with one or two nuclei. Multinucleated giant cells were seen occasionally. These giant cells were most numerous in the connective tissue just beneath the epithelium.

Conclusion

Oral GCFs show no significant sex predilection and occur in patients in the second to fourth decades of life. Usually, the lesions are < 1 cm in diameter and are found more frequently on the tongue and gingiva. GCF resembles fibroma or papilloma and is difficult to diagnose correctly at the first glance. All GCFs can be treated by conservative surgical excision without subsequent recurrence.

Key Words:  fibroma , giant cell tumors , histopathology

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Weathers DR , Callihan MD . Giant cell fibroma . Oral Surg Oral Med Oral Pathol . 1974;37:374–384
  2. Houston GD . The giant cell fibroma. A review of 464 cases . Oral Surg Oral Med Oral Pathol . 1982;53:582–587
  3. Bakos LH . The giant cell fibroma: a review of 116 cases . Ann Dent . 1992;51:32–35
  4. Magnusson BC , Rasmusson LG . The giant cell fibroma. A review of 103 cases with immunohistochemical findings . Acta Odontol Scand . 1995;53:293–296
  5. Wang Z , Levy B . Clinico-pathological study on giant cell fibroma of oral mucosa . Chin J Stomatol . 1995;30:332–333
  6. Weathers DR , Campbell WG . Ultrastructure of the giantcell fibroma of the oral mucosa . Oral Surg Oral Med Oral Pathol . 1974;38:550–561
  7. Takeda Y , Kaneko R , Suzuki A , et al.   Giant cell fibroma of the oral mucosa. Report of a case with ultrastructural study . Acta Pathol Jpn . 1986;36:1571–1576
  8. Mighell AJ , Robinson PA , Hume WJ . PCNA and Ki-67 immunoreactivity in multinucleated cells of giant cell fibroma and peripheral giant cell granuloma . J Oral Pathol Med . 1996;25:193–199
  9. Reibel J . Oral fibrous hyperplasias containing stellate and multinucleated cells . Scand J Dent Res . 1982;90:217–226
  10. Mighell AJ , Robinson PA , Hume WJ . Histochemical and immunohistochemical localisation of elastic system fibres in focal reactive overgrowths of oral mucosa . J Oral Pathol Med . 1997;26:153–158
  11. Odell EW , Lock C , Lombardi TL . Phenotypic characterisation of stellate and giant cells in giant cell fibroma by immunocytochemistry . J Oral Pathol Med . 1994;23:284–287
  12. Campos E , Gomez RS . Immunocytochemical study of giant cell fibroma . Braz Dent J . 1999;10:89–92
  13. Souza LB , Andrade ES , Miguel MC , et al.   Origin of stellate giant cells in oral fibrous lesions determined by immunohistochemical expression of vimentin, HHF-35, CD68 and factor XIIIa . Pathology . 2004;36:316–320

PII: S0929-6646(09)60396-X

doi:10.1016/S0929-6646(09)60396-X

Journal of the Formosan Medical Association
Volume 108, Issue 9 , Pages 725-729, September 2009

Article Tools