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Case Report: rare hybrid lesion of a central giant cell granuloma within a juvenile ossifying fibroma
Poster Title: Case Report: rare hybrid lesion of a central giant cell granuloma within a juvenile ossifying fibroma
Submitted on 29 Feb 2020
Author(s): Hadeer Rizk Saad 1, Noura M. Kamal 2, Hatem W. Amer 2
Affiliations: 1 Department of Oral and Maxillofacial Pathology, Misr International University, Cairo, Egypt. 2 Department of Oral and Maxillofacial Pathology, Cairo University, Giza, Egypt
This poster was presented at The Annual Scientific Day of Oral and Maxillofacial Pathology, Faculty of Oral and Dental Medicine, Cairo University
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Abstract: Central giant cell granuloma (CGCG) is classified by the World Health Organization as a benign bone lesion. It is found anteriorly in the mandible, with most of the cases crossing the midline. In total, 70% of CGCGs are encountered in young females. Fibro-osseous lesions are a group of pathologies that encompass neoplastic, dysplastic and reactive entities. Juvenile ossifying fibroma, which can be further categorized into juvenile trabecular ossifying fibroma (JTOF) and juvenile psammomatoid ossifying fibroma, represents an aggressive neoplastic example of these fibro osseous lesions. JTOF occurs in children at almost equal ratios in both sexes, affecting the maxilla more than mandible. This study aims to report a peculiar case of a hybrid lesion comprising CGCG and JTOF in the mandible of a nine-year-old female patient. Clinical, radiographic and histopathological findings were assessed. Clinical examination revealed an intraoral swelling extending from the right impacted third molar area to the left first molar area. Computed tomography showed a well-defined multilocular radiolucency with diffuse flecks of radioopacities. Histopathologically, the lesion comprised fibrous connective tissue encompassing numerous multinucleated giant cells and other areas of cell-rich connective tissue stroma containing bands of osteoid matrix and anastomosing immature bone trabeculae intermixed with scattered clusters of multinucleated giant cells. We hereby report a case of a rare hybrid lesion comprising CGCG and JTOF.Summary: In our search of the literature no cases of similar hybrid lesions were reported, except for one reported by Geetha et al. To our knowledge, our case is the second to be documented as a hybrid lesion involving CGCG and JOF. Therefore, we believe that this report would significantly contribute to the understanding and clinical management of such a rare lesion. References: 1. Waldron CA, el-Mofty SK: A histopathologic study of 116 ameloblastomas withspecial reference to the desmoplastic variant. Oral Surg Oral Med Oral Pathol. 1987; 63(4): 441–451.
2. Geetha NT, Pattathan RK, Shivakumar HR, et al.: Fibro-osseous lesions vs. central giant cell granuloma: A hybrid lesion. Ann Maxillofac Surg. 2011; 1(1): 70–3.
3. De Corso E, Politi M, Marchese MR, et al.: Advanced giant cell reparative granuloma of the mandible: radiological features and surgical treatment. Acta Otorhinolaryngol Ital. 2006; 26(3): 168–172.
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