MANDIBULAR HYBRID CGCG-COF: REPORT OF A RARE ENTITY

Abstract

<h3>BACKGROUND</h3> The hybrid central giant cell granuloma/central odontogenic fibroma-like (hCGCG/COF) lesion was first described in 1992 and has been reported fewer than 50 times thereafter. Separately, central giant cell granulomas (CGCG) and central odontogenic fibromas (COF) account for approximately 5% and 10% of all benign jaw tumors, respectively. Published literature reveals that the clinical, radiologic, and histologic features of hCGCG/COF lesions share similar characteristics with both entities in varying degrees; however, the precise nature of the lesions remains unclear. <h3>CASE REPORT</h3> A 20-year-old female patient was referred to our clinic by the Head and Neck Oncology Department for comprehensive dental care. Her clinical history began when she presented with complaints of a slowly growing mass in the left posterior mandible with increased bleeding upon toothbrushing over a 3-month period. Clinical exam revealed an expansile mass spanning from the second premolar to the retromolar pad with obliteration of the gingivobuccal sulcus, lingual cortical expansion, and tooth mobility. Neurologic deficits were difficult to ascertain. Panoramic radiography and cone beam computed tomography revealed a unilateral, well-defined, multilocular, partially corticated radiolucent entity with multiple mixed internal radiopacities spanning from the retromolar pad to the second premolar and from the alveolar crest to the inferior border; expansion and thinning of lingual cortical plate; fractured inferior border of mandible; and displacement of the second molar. She was recommended for surgical intervention and subsequently underwent a left segmental mandibulectomy with fibular free flap reconstruction and modified neck dissection. Final pathology showed hybrid CGCG/COF-like lesion; the giant cell granuloma component predominated. The patient is currently functioning well with no mandibular resection prosthesis and is receiving comprehensive care in the Dental Oncology Department. <h3>DISCUSSION/CONCLUSIONS</h3> This case report highlights a rare benign hybrid odontogenic entity and the successful management of the pathology. The case report provides further evidence of successful surgical treatment of hCGCG/COF without recurrence.