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 summar..
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.
