Combined lesion of central giant cell granuloma and ossifying fibroma: A case report of a rare event in oral cavity

Introduction and importance: Giant cell granulomas (GCG) and ossifying fibroma (OF) of the jaw are benign reactive lesions. GCG characterized by the presence of abundant multinucleated giant cells in a cellular stroma. On the other hand, the characteristic feature of OF is benign connective tissue replaces the normal bone. Combination of these two lesions, GCG with OF, in the jaw is extremely rare.Case presentation: A 35-year-old woman presented with complains of right jaw swelling with no history of previous disease or lesion and no family history of such lesions. By physical examination, a painful swelling in the right jaw was observed. A computed tomography scan of the facial bone showed a large, expansible, lytic lesion with narrow zone of transition and internal septations, involving the right side of the maxilla and floor of the right maxillary sinus. Histopathologic examination revealed a lesion with combined features of OF and GCG.Clinical discussion: GCG and OF are two of the most frequent oral lesions. Presence of both tumors in one patient as a combined lesion is highly unusual, with only a few reported cases in the literature. On clinical and radiologic examination, diagnosing such a combined lesion is not possible, however, such lesions can be easily diagnosed by microscopic examination, indicating the importance of pathologic examination.Conclusion: Occurrence of combined OF and GCG is a rare event. Proper histopathologic evaluation can contribute to accurate diagnosis and better management of such lesions. Confirmative diagnosis of such lesions by radiology alone is not possible.