Case Report

Published: 30 Aug, 2019

Journal of Clinical Case Reports

Traumatic Fibroma – A Case Report
Borkar P1*, Gattani D2 and Uike S1
1
PG Student, Department of Periodontology, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital,
India
2
HOD and Professor, Department of Periodontology, Swargiya Dadasaheb Kalmegh Smruti Dental College and
Hospital, India

Abstract
Traumatic or irritation fibroma is a benign exophytic oral lesion that develops secondary to tissue.
It is the benign reactive lesion, and the treatment of choice is surgical excision. Here is a case of
Irritational fibroma on lower lip which was managed by excision biopsy and was diagnosed as
irritation fibroma after histopathological evaluation.
Keywords: Traumatic fibroma; Irritation fibroma; Hyperplasia

Introduction
The oral mucosa frequently encounters localized overgrowths. Most of them are hyperplastic
and true neoplasms are very rare [1]. A Inflammatory hyperplastic lesion may be defined as “an
increase in the size of an organ or tissue due to an increase in the number of constituent cells, as a
local response of tissue to injury [2].
Various types of localized reactive lesions such as focal fibrous hyperplasia, pyogenic granuloma,
peripheral giant cell granuloma and peripheral ossifying fibroma may occur in the oral cavity [3].
The lips are the most common site for a variety of benign and malignant lesions as the lips form the
border between two different tissues i.e. the skin and mucosa due to this there is increased risk of
development of alterations in comparison to other areas [4]. Fibrous hyperplasia is the healed end
product of the inflammatory hyperplastic lesion [5]. Various terms has been used in oral pathology
to describe a non neoplastic fibrous lesion of oral mucosa like Irritation Fibroma, Irritational
Fibroma, Fibrous Hyperplasia, Focal Fibrous Hyperplasia, Traumatic Fibroma, Localized Fibrous
Hyperplasia and Fibro epithelial Polyp [6].

OPEN ACCESS It is a focus of hyperplastic fibrous connective tissue representing a reactive response to local
irritation or masticatory trauma [7]. Fibroma is seen in approximately 1.2 percent of adults [8]. It
*
Correspondence: is a result of a chronic repair process that includes granulation tissue and scar formation resulting
Priyanka Borkar, Department of in a fibrous sub mucosal mass [9]. The most common location of fibroma is along the occlusal line
Periodontology, Swargiya Dadasaheb of the buccal mucosa although other locations, such as the labial mucosa, tongue, and gingiva, are
Kalmegh Smruti Dental College and possible. Clinically, Fibroma are manifested as asymptomatic, moderately firm, smooth-surfaced,
Hospital, Nagpur, Maharashtra, India. pink, sessile or pedunculated nodules [10].
Tel: +91-8669191161
They appear as broad based lesions, lighter in colour than the surrounding normal tissue, with
E-mail: priborkar18@gmail.com
the surface often appearing white because of hyperkeratosis or with surface ulceration caused by
Received Date: 20 Jul 2019 secondary trauma. The growth potential of fibroma does not exceed 10-20 mm in diameter [11].
Accepted Date: 23 Aug 2019 It is treated by surgical excision, and also the source of irritation must be eliminated. Conservative
Published Date: 30 Aug 2019 excisional biopsy is curative and its findings are diagnostic [12]. Recurrences are rare and may be
Citation: Borkar P, Gattani D, Uike S. caused by repetitive trauma at the same site. This lesion does not have a risk for malignancy [13].
Traumatic Fibroma – A Case Report. J
Case Report
Clin Case Rep. 2019; 2(2): 1021.
A 44 year old female patient was reported in Department of Periodontology with chief complaint
ISSN 2643-8194
of growth in lower lip on left side of the angle of mouth since last seven months. A detailed case
Copyright © 2019 Borkar P. This is an history was recorded wherein she gave no significant medical or dental history. The lesion was first
open access article distributed under noticed seven months ago, which was smaller in size initially and has increased gradually to the
the Creative Commons Attribution present size. The growth has interfered in chewing and normal functioning of the mouth.
License, which permits unrestricted
use, distribution, and reproduction in
Intraoral examination revealed, a solitary, sessile, painless, well circumscribed mass with
smooth surface, firm in consistency, and lobulated pink swelling measuring 6×6 mm in its greatest
any medium, provided the original work
diameter in relation to tooth number 34 and 35 on lower lip on left side of the angle of mouth along
is properly cited.

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Borkar P, et al., Journal of Clinical Case Reports

Figure 1: Pre-operative view of growth present on lower labial mucosa. Figure 5: Excised lesion.

Figure 2: Lesion held with suture to stabilise during excision. Figure 6: Postoperative view after 7 days.

Figure 3: Intra-operative view of excisional biopsy.

Figure 7: Histopathological image.

scalpel blade no 15 and the wound was sutured (Figure 2, 3, 4 and 5).
Post-operative healing was uneventful and no pain or discomfort in
chewing was reported on 7 days follow up (Figure 6).
Histopathology
Haematoxylin & Eosin stained section exhibit parakeratinized
stratified squamous epithelium. The connective tissue shows
increased cellularity with numerous small and large endothelial cell
lined blood vessels, diffuse chronic inflammatory infiltrate chiefly
comprising of plasma cells and lymphocytes and dense collagen fibre
Figure 4: Suture placed. bundles arranged haphazardly. These finding confirm a diagnosis of
“Irritational /Traumatic fibroma” (Figure 7).
the occlusal plane of maxillary and mandibular teeth (Figure 1).
Discussion
Surgical Procedure Unhealthy habits, when repeated excessively become harmful,
After haematological and general medical investigation, excisional and can contribute to dentofacial abnormalities. The literatures
biopsy was performed intra orally under local anaesthesia using have mentioned the reason for a few of the oral lesions like irritation

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Borkar P, et al., Journal of Clinical Case Reports

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In 1986, Bouquot & Gundlach examined 23,616 white persons Irritation fibroma of the oral mucosa: a clinicopathological study of 129
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