Fibroma of the Gingiva: A Case Report of a 20 Year old Lesion Mohammed Nazish Alam, 1 S.C Chandrasekaran, 2 Mohan Valiathan 3 The 10 Most Common Soft Tissue Oral Lesions 7 Entity Percentage of all oral lesions Leukoplakia 18.2 Palatal or mandibular torus 17.2 Inflammation or irritation 10.8 Irritation fibroma 7.4 Fordyce's granules 5.9 Hemangioma 3.4 Inflammatory ulcer 3.2 Papilloma 2.9 Epulis fissurata 2.6 Varicosities 2.1 General characteristics: 1. From acute or repeated trauma (poor healing; exuberant scar tissue) – May develop from pyogenic granuloma – Most common soft tissue mass; 3rd most common mucosal lesion in adults – Prevalence: 12 lesions/1,000 adults 2. Gender Age Location : – None (but 2x females for biopsied cases) – 4th-6th decades – Buccal, lip, tongue, gingiva 3. Smooth-surfaced, pink (normal color), painless nodule – May be pigmented (racial pigment of surface epithelium) – May have surface frictional keratosis or traumatic ulcer – Usually sessile, may be pedunculated 4. Micro: dense, avascular fibrous stroma – No capsule – Epithelium often atrophic – Small numbers of lymphocytes in fibrous stroma 5. Usually grows to <1 cm. within 6 months; minimal increase after that – May become 3-4 cm. – Does not go away – No malignant transformation Introduction Fibroma is a common submucosal response to trauma from teeth or dental prostheses and was first reported in 1846 1,2 as fibrous polyp and polypus. It is universally understood that the use of the term "fibroma" is not intended in this case to convey neoplastic origin, as is the usual intent of its use for fibrous tumors in other anatomic sites. Found in 1.2% of adults, this inflammatory hyperplasia is the most common oral mucosal mass submitted for biopsy and is usually composed of Types I and III collagen. Gingival lesions are also common, although at that location they probably result from chronic infection rather than trauma. Its most common clinical aspect is the growth of well delimited tissue, of a smooth surface, usually with normal colored mucosa, sessile or pedunculated base, of hard consistence 3 , and smaller than 1.5 cm at its largest diameter 4 , though there have been reports of a 4-6 cm injury 5 . Its occurance is reported to the anterior maxillary, more precisely in the interdental papilla 6 . In this case report the benign lesion is posteriorly positioned at the distal aspect of maxillary molar. Fibroma is a common benign tumor. It can occur at any age from almost any soft tissue site the tongue, gingiva, and buccal mucosa being the most common. Females are twice as likely to develop this benign tumor than male. Typically the lesion is a rounded, well- demarcated, variably sized mass attached to tissue by a stalk. The surface is smooth, and the color is slightly paler than the adjacent healthy tissue. It is usually characterized by a slow, painless growth accumulated over a period of months or years. Treatment usually requires total excision and recurrence is rare. Key words: fibroma, soft tissue, benign tumor. ABSTRACT IJCD • DECEMBER, 2010 • 1(3) © 2010 Int. Journal of Contemporary Dentistry 107 CASE REPORT