Ossifying Fibroma and Central Giant Cell Granuloma, a Hybrid Tumor in the Maxilla

Authors

Jason Phung, HCA HealthcareFollow
Robert Bender, HCA HealthcareFollow
Susana Ferra, HCA HealthcareFollow

Files

Division

East Florida

Hospital

HCA Florida Westside Hospital

Specialty

Transitional Year

Document Type

Poster

Publication Date

2024

Keywords

ossifying fibroma, giant cell granuloma, tumors, fibro-osseous lesion

Disciplines

Medicine and Health Sciences | Musculoskeletal Diseases | Neoplasms | Pathology

Abstract

Introduction: Ossifying fibromas (OF) and central giant cell granulomas (CGCG) are benign lesions of the jaw. The presence of a hybrid lesion consisting of OF and CGCG is exceedingly rare.

Case summary: A 28-year-old male presented with complaints of nasal congestion and loud snoring worsening over six months. CT scan revealed a 2.2 x 1.5 x 1.2 cm radiolucent lesion involving the right maxillary sinus. During endoscopic sinus excision, a friable light tan and hemorrhagic lesion was seen occupying the right maxillary sinus with underlying bone destruction. Intraoperative pathology evaluation revealed no malignancy.

Results: Histologic examination revealed a biphasic tumor with fibro-osseous component transitioning to a more cellular spindle component with multinucleated giant cells. The fibro-osseous lesion contained curvilinear woven bone spicules with osteoblasts rimming, supporting a diagnosis of ossifying fibroma. The giant cell granuloma consisted of numerous multinucleated giant cells in a fibrous stroma. Both components were equally represented, consistent with hybrid lesion.

Discussion: OF is a benign fibro-osseous lesion of odontogenic origin that presents as an asymptomatic slow-growing mass in the jaw. CGCG is osteoclastic in origin and can be divided into nonaggressive lesions which are slow-growing, and aggressive lesions which are rapidly expanding and characterized by pain, root resorption, and high recurrence rate. The presence of both on histology is indicative of a hybrid lesion.

Conclusion: Hybrid tumors are rare and pose a unique challenge. Diagnosis of hybrid tumors must be made through careful histopathologic evaluation along with radiological correlation.

Original Publisher

HCA Healthcare Graduate Medical Education

Recommended Citation

Phung, Jason; Bender, Robert; and Ferra, Susana, "Ossifying Fibroma and Central Giant Cell Granuloma, a Hybrid Tumor in the Maxilla" (2024). East Florida Division GME Research Day 2024. 31.
https://scholarlycommons.hcahealthcare.com/eastflorida2024/31