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

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Abstract

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. It makes up less than 5% of odontogenic tumors and is more commonly seen in females. Central giant cell granuloma (CGCG) is a locally destructive but benign lesion of the jaws containing osteoclast-like multinucleated giant cells in a fibrovascular stroma. CGCG makes up approximately 10% of all benign jaw tumors and typically occurs in females younger than 30 years of age. A hybrid lesion with histologic features of both COF and CGCG is very rare and was first described in 1992. To date, fewer than 50 cases of this lesion have been reported. In this study, we present three additional cases of COF developing in conjunction with giant cell granuloma-like lesion, as well as provide a comprehensive literature review. Two of the lesions presented in our study were located in the posterior mandible and one occurred in the anterior mandible. Buccal and/or lingual expansion was noted in two patients and no recurrence was reported. Histologically, all three lesions demonstrated a blend of odontogenic epithelial islands with numerous multinucleated giant cells in a highly cellular connective tissue stroma. Immunohistochemical staining with CK19 and CD68 highlighted the odontogenic epithelium and multinucleated giant cells respectively. The precise nature of these hybrid lesions remains obscure and additional molecular studies may be of help in understanding their pathogenesis.

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Acknowledgements

The authors are thankful to Dr. Michael McDermott, Midwest Oral & Maxillofacial Surgery, Omaha, NE, Dr. Andrew Norkin, Boca Raton Oral Facial and Implant Surgery, FL, and Dr. James Freeman, Oral Surgery South Burlington, VT for providing the treatment and followup information on the three cases presented in this study. We are grateful to Dr. Adalberto Mosqueda-Taylor, Dr. Molly Rosebush, Dr. Harvey Kessler, and Dr. Taiana Leite for providing additional information on their cases.

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No funding was required for completion of this study.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, 1395 Center Drive, Gainesville, FL, 32610, USA

    Jasbir D. Upadhyaya, Donald M. Cohen, Mohammed N. Islam & Indraneel Bhattacharyya

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  1. Jasbir D. Upadhyaya
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  2. Donald M. Cohen
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  3. Mohammed N. Islam
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  4. Indraneel Bhattacharyya
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Correspondence to Jasbir D. Upadhyaya.

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The authors declare no conflict of interest.

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All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Upadhyaya, J.D., Cohen, D.M., Islam, M.N. et al. Hybrid Central Odontogenic Fibroma with Giant Cell Granuloma like Lesion: A Report of Three Additional Cases and Review of the Literature. Head and Neck Pathol 12, 166–174 (2018). https://doi.org/10.1007/s12105-017-0845-7

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