Fibro-Osseous Lesion Associated with Central Giant Cell Granuloma: A Rare Hybrid Lesion of the Anterior Mandible
DOI:
https://doi.org/10.15517/pbprpe28Keywords:
Giant cell granuloma; Juvenile ossifying fibroma; Ossifying fibroma; Fibro-osseous lesion; Hybrid tumor; Collision tumor.Abstract
Hybrid lesions have been reported in literature as lesions consisting of a combination of characteristics from different pathologies. In this article we document a case where a collision tumor of central giant cell granuloma and juvenile trabecular ossifying fibroma co-existed in the mandible. Only a few cases of similar conditions were documented in literature. An 18-year-old female presented with an unusually painful swelling in the symphysis and parasymphysis region bilaterally. Although the two-dimensional imaging suggested an enlarged cystic lesion, the CBCT revealed a well-defined multi-locular hypodense lesion with hyperdense foci, buccal cortical expansion, and lingual cortical perforation suggesting a more aggressive pathology. Curettage, peripheral ostectomy and apicectomy to the associated teeth were the treatment modalities performed. Six months postoperatively, tooth mobility had resolved, and trabecular bone formation was evident in the parasymphysis region. The co-existence of central giant cell granuloma and juvenile trabecular ossifying fibroma is to be considered on observing the clinical and radiographic pictures of both in the same case.
References
Ari I., Adiloglu S., Aktas A,. Yasan G.T., Usman E., Aksoy S. Incidence, treatment method and recurrence rate in giant cell granulomas: Retrospective study. Journal of Cranio-Maxillofacial Surgery. 2024; 52 (6). DOI: https://doi.org/10.1016/j.jcms.2024.03.011
Triantafillidou K., Venetis G., Karakinaris G., Iordanidis F. Central giant cell granuloma of the jaws: A clinical study of 17 cases and a review of the literature. Annals of Otology, Rhinology and Laryngology. 2011; 120 (3). DOI: https://doi.org/10.1177/000348941112000305
Crusoé-Rebello I., Torres M.G.G., Burgos V., Oliveira C., Dos Santos J.N., Azevedo R.A., et al. Hybrid lesion: Central giant cell granuloma and benign fibroosseous lesion. Dentomaxillofacial Radiology. 2009; 38 (6). DOI: https://doi.org/10.1259/dmfr/44753298
How Y.B., Telang A., Telang L., Tilakaratne W.M. An unusual case of Central Giant Cell Granuloma. J Oral Maxillofac Surg Med Pathol. 2024; 37 (1): 239. doi:10.1016/j.ajoms.2024.04.018 DOI: https://doi.org/10.1016/j.ajoms.2024.04.018
Choudhari S.K., Gadbail A.R. Hybrid Odontogenic Tumors: A Controversy. Vol. 21, Pathology and Oncology Research. 2015. DOI: https://doi.org/10.1007/s12253-014-9844-0
Rai A., Ahmad S.A., Saleem M., Faisal M. Hybrid central giant cell granuloma and central ossifying fibroma: Case report and literature review. J Oral Maxillofac Surg Med Pathol. 2019; 31 (4). DOI: https://doi.org/10.1016/j.ajoms.2019.02.007
De Souza G.M., Da Silva Monteiro M., Miranda Á.M.M.A., De Andrade B.A.B., Romañach M.J., Abrahão A.C., et al. Central Giant Cell Granuloma Associated with Central Ossifying Fibroma: Report of an Unusual Case. Oral Surg Oral Med Oral Pathol Oral Radiol. 2022; 134 (3). DOI: https://doi.org/10.1016/j.oooo.2022.01.255
Saadaat R., Adelyar M.A., Haidary A.M., Faizi F.R., Abdul-Ghafar J. Combined lesion of central giant cell granuloma and ossifying fibroma: A case report of a rare event in oral cavity. Int J Surg Case Rep. 2022; 94. DOI: https://doi.org/10.1016/j.ijscr.2022.107082
Farzaneh A.H., Pardis P.M. Central giant cell granuloma and fibrous dysplasia occurring in the same jaw. Med Oral Patol Oral Cir Bucal. 2005; 10 Suppl 2.
Kurra S., Sreenatha Reddy D., Gunupati S., Srikanth K., Srinath Reddy M. Fibrous dysplasia and central giant cell granuloma: A report of hybrid lesion with its review and hypotheticated pathogenesis. Journal of Clinical and Diagnostic Research. 2013; 7 (5). DOI: https://doi.org/10.7860/JCDR/2013/5533.2987
Jawanda M., Narula R., Shankari M., Gupta S. Hybrid lesions comprising central giant cell granuloma and fibrous dysplasia: A diagnostic challenge for pathologist. Journal of Oral and Maxillofacial Pathology. 2015; 19 (3). DOI: https://doi.org/10.4103/0973-029X.174631
Geetha N., Pattathan R.K., Shivakumar H., Upasi A. Fibro-osseous lesions vs. central giant cell granuloma: A hybrid lesion. Ann Maxillofac Surg. 2011; 1 (1). DOI: https://doi.org/10.4103/2231-0746.83162
Saad H.R., Kamal N.M., Amer H.W. Case report: Rare hybrid lesion of a central giant cell granuloma within a juvenile ossifying fibroma. F1000Res. 2019; 8. DOI: https://doi.org/10.12688/f1000research.19891.1
Krishna R., Kumar P., Mohanty S., Urs A.B. Juvenile trabecular ossifying fibroma associated with central giant cell granuloma and aneurysmal bone cyst like changes-A triple hybrid tumour? or a pathologic sequelae? Journal of Oral and Maxillofacial Pathology. 2024; 28 (2): 337-42. DOI: https://doi.org/10.4103/jomfp.jomfp_554_23
M. Mallya S., W.N. Lam E. White and Pharoah’s Oral Radiology Principles and Interpretation 8th ed. Missouri: Elsevier. 2020.
MacDonald D. Oral and maxillofacial radiology: A diagnostic approach, second edition. In: David MacDonald BDS, BSc (Hons.), LLB (Hons.), et al., eds. Oral and Maxillofacial Radiology: A Diagnostic Approach. Second. John Wiley & Sons; 2019: 159-272. doi:10.1002/9781119218739 DOI: https://doi.org/10.1002/9781119218739.ch9
Neville B., Damm D., Allen C., Chi A. Neville Oral and Maxillofacial Pathology, 4ed. Vol. 4, Elsevier. 2016.
Neville B.W., Damm, D.D., Allen, C.M., Chi, AC. Oral and Maxillofacial Pathology. Fifth. United States: ElSevier; 2023.
Penfold C.N., McCullagh P., Eveson J.W., Ramsay A. Giant cell lesions complicating fibro-osseous conditions of the jaws. Int J Oral Maxillofac Surg. 1993; 22 (3). DOI: https://doi.org/10.1016/S0901-5027(05)80242-5
Shetty K., Giannini P., Leigh J. A hybrid giant cell granuloma and fibro-osseous lesion of the mandible. Oral Oncology Extra. 2004; 40 (6-7). DOI: https://doi.org/10.1016/j.ooe.2004.05.001
Wu P.F., Tang J.Y., Li K.H. RANK pathway in giant cell tumor of bone: pathogenesis and therapeutic aspects. Vol. 36, Tumor Biology. 2015. DOI: https://doi.org/10.1007/s13277-015-3094-y
Published
Issue
Section
License
Copyright (c) 2025 Esraa Ahmed Eid, Mona Mahmoud Abo El Fotouh, Hossam El-Dien Hany, Basma Abdelrahman Ahmed, Mariam Magdy Mostafa, Iman Mohamed Helmy.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
ODOVTOS - Int. J. Dent. Sc. endorses CC BY-NC-SA
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator. If you remix, adapt, or build upon the material, you must license the modified material under identical terms. CC BY-NC-SA includes the following elements:
BY: credit must be given to the creator.
NC: Only noncommercial uses of the work are permitted.
SA: Adaptations must be shared under the same terms.
