Description
Traumatic or irritational fibroma is a common benign exophytic and reactive oral lesion that develops secondary to injury.1 2 Fibroma is a result of a chronic repair process that includes granulation tissue and scar formation resulting in a fibrous submucosal mass. Recurrences are rare and may be caused by repetitive trauma at the same site. The lesion does not have a risk for malignancy.3
The most common sites of traumatic fibroma are the tongue, buccal mucosa and lower labial mucosa clinically, they appear as broad-based lesions, lighter in colour than the surrounding normal tissue, with the surface often appearing white because of hyperkeratosis or with surface ulceration caused by secondary trauma. Differential diagnosis of other lesions including benign tumours (neurofibroma, neurilemmoma, granular cell tumours and lipoma) and mucocele should be ruled out by biopsy.
A 44-year-old man reported to the Department of Periodontics, with chief complaint of growth on the tip of the tongue. It was 0.5 mm in diameter, normal coloured, fibrous, pedunculated and asymptomatic (figure 1). The patient was systemically healthy. He has chronic irritation from lower attrided anteriors.
Figure 1.
Irritational fibroma present on tip of tongue.
With diamond bur all sharp edges of attrided anteriors were smoothened out. Surgical excision was done from pedunculated area under local anaesthesia (lignocaine, 1:100 000) with Bard parker handle and 15 no. blade. The excised portion sent for histological examination.
Histologically, it shows normal to hyperplastic para to orthokeratinised epithelial cell with elongated connected rete ridges. Focal hyperplasia of fibroblasts and collagen fibers are present in underlying connective tissue, with little or no inflammatory cell infiltration (figure 2).
Figure 2.
Histological findings.
After 1 week, postoperative photograph (figure 3) shows satisfactory healing. No recurrence has occurred after 2-year follow-up.
Figure 3.
Postoperatively after 1 week.
Learning points.
Aetiology of irritational fibroma may be traumatic tooth or restoration or prosthesis, which should be corrected.
Surgical excision is the treatment of choice.
Histology will show typical dense fibrous tissue with relatively few cells.
Footnotes
Competing interests: None.
Patient consent: Obtained.
Provenance and peer review: Not commissioned; externally peer reviewed.
References
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