Giant Cell Fibroma Clinically Mimicking Malignancy: A Case Report

Giant Cell Fibroma (GCF) is a benign rare fibrous lesion that predominantly occurs on the mandibular gingiva. Clinically, it is presented as a sessile or pedunculated mass that frequently occurs in the third decade with a slight female predilection. The lesion is usually characterized by stellate and multinucleated fibroblasts located in the lamina propria near the overlying epithelium and radiographically treated as a benign lesion. A 20-year-old female was referred to the Oral and Maxillofacial Medicine Department of Semnan Dental School, with the chief complaint of tooth displacement and gingivitis. Clinical examination revealed maxillary protrusion, mouth breathing, localized gingivitis in the interdental areas of the papilla of the lateral and canine teeth; also alveolar bone with pus discharge in the right mandibular premolar area. Radiographically, the lesion leads to the bone resorption and linguistic movement of the teeth in the right side of Mandible. There were no root resorption and no bone expansion. Gentle scaling and root planning, biopsy, and second premolar extraction were performed. The presence of the giant fibroblasts in superficial connective tissue confirmed the diagnosis of Giant Cell Fibroma. At the follow-up session, tissue repair was accomplished, and the first premolar was immobile and was no longer loose. Nevertheless, further studies are required to investigate the precise nature of the mono or multinucleated cells, i.e., atypical fibroblasts that illustrate degenerative and functional changes. Moreover, a high index of suspicion and appropriate analytical examination is required for distinct lesions to achieve a proper diagnosis and suggest an appropriate treatment.