Quiz 11: What is your diagnosis?

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Diagnosis: Quiz 11

Quiz 11

Answer: Oral fibroma

Criteria for diagnosis histopathologically:  A papule made up of fibrous tissue with an increased number of fibrocytes in foci is consonant with an oral fibroma.

Differential diagnosis histopathologically: There is none.

Criteria for diagnosis clinically: A dome-shaped, well-demarcated papule with a smooth surface on the lateral aspect of the tongue is characteristic of oral fibroma.

Differential diagnosis clinically: There is none.

Clinicopathologic correlation: The papule results from the proliferation of fibrous tissue. The surface of the papule is smooth because the mucous membrane is not affected.

Options for therapy predicated on knowledge of histopathologic findings: The oral fibroma developed in response to repeated bite trauma. Once it has developed, surgical removal is the therapy of choice.

1) Oral fibroma is common and usually develops on sites of bite trauma within the oral cavity (tongue, buccal mucosa). It is not a neoplasm, but a reactive proliferation of fibrous tissue.

2) Giant-cell fibroma has been described as a variant of oral fibroma in which the number of giant cells dominates over single stellate fibroblasts. Other variants include fibromas containing significant amounts of fat (fibrolipomas) and fibromas with myxoid changes. Chronic mechanical trauma is the common causative factor. Some authors regard all lesions as a single reactive fibrotic process with different morphologic patterns, each with its own histopathologic characteristic but overlapping in the clinical presentation. In sum, all types of fibrous lesions of the oral cavity are merely different histologic responses to a common etiologic factor.

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