Objective To present 5 new cases of a lesion reported fewer than 20 times in the literature, under a dozen different names, and to recommend the most appropriate name. Methods 5 new SPF cases are clinically and microscopically characterized, with a literature review. Findings 5 cases (3F & 2M) presented in patients 20-39 years of age. All presented as bilateral, symmetrical, asymptomatic, sessile, moderately firm or soft (n = 2) masses of the lateral posterior hard palate; 2 were isolated to the tuberosities. All masses were normal in color, with smooth, nonulcerated surfaces and occasional broad surface nodularity. One case had bilateral secondary, anterior extensions. Underlying bone was radiographically normal, and adjacent teeth were asymptomatic. All masses seemed to originate from tissues over the palatal bone, only secondarily extending to gingivae and/or crestal tuberosity bone, i.e. this does not appear to be a gingival entity, as previously thought. Cases had been present 2-15 years, with no familial or environmental etiologies identified. Histopathologically, masses were comprised of dense, avascular fibrous connective tissue with scattered thick bands of collagen and occasional slight surface nodularity. Surface epithelium showed regions with long, pointed and/or thin rete processes, and subepithelial stroma contained scattered large, angular fibroblasts, sometimes with multiple nuclei, sometimes with a “smudged” appearance, consistent with those in giant cell fibroma; melanin granules were not present. Conservative surgical excision affected cure in all cases. Conclusion The present investigators propose SPF as the most accurate name for this chronic, presumably rare and certainly unique entity. It fits the definition of fibromatosis more than reactive fibrous hyperplasia, and the presence of giant fibroblasts in the stroma is a unique, possibly required, histopathologic feature. Conservative surgical excision is the recommended treatment, with no recurrences reported to date.