Giant cell fibroma

Author: Dr Delwyn Dyall-Smith FACD, Dermatologist, 2010.

What is a giant cell fibroma?

Giant cell fibroma is a benign lesion of the mouth, usually seen in teenagers and young adults. It is believed to be the oral equivalent of fibrous papule of the nose/face.

Who gets giant cell fibroma?

Giant cell fibroma most commonly affects the age group 10-30 years. Both sexes are affected equally.

Clinical features

Giant cell fibroma is a small (usually less than 5mm diameter) firm lump in the mouth, often with a folded or pebbly surface. It may be on a small stalk (pedunculated) or dome-shaped like a limpet.

It most commonly occurs on the gums, more commonly on the lower than upper. Other sites include the tongue, palate or inside the cheeks.

It does not cause any symptoms.

How is the diagnosis made?

Clinically it is most often mistaken for an oral papilloma or oral irritation fibroma. Histology on biopsy or excision is diagnostic. The epithelium is folded with long thin rete ridges. Dense fibrous connective tissue is seen in the dermis with large, sometimes multinucleated fibroblasts (‘giant cells’) near the edge under the epithelium.

Treatment of giant cell fibroma

Simple surgical excision is curative. The fibroma rarely recurs.

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