OBJECTIVE: Gingival fibromas (GFs) are fibrous lesions of the gingiva that are not well defined in the literature. They are histologically similar to peripheral ossifying fibromas (POFs), both being characterized as cellular proliferations of dense fibrous tissue, with POFs differing in that they demonstrate foci of calcification. This study aims to expand upon the immunohistochemical characterization of GFs, and to confirm their osteoblastic phenotype.
METHODS: Formalin fixed, paraffin embedded GFs, POFs and fibroepithelial polyps (FEPs) of the gingiva were examined. Immunohistochemical staining was performed for special AT-rich sequence binding protein 2 (SATB2), runt-related transcription factor 2 (RUNX2), osteocalcin and alpha-smooth muscle actin (αSMA). Sections were evaluated by light microscopy and the immunohistochemical staining patterns were assigned immunoreactive scores (IRS) based on percentage of stained cells and intensity of staining.
RESULTS: GFs, POFs, and FEPs of the gingiva expressed osteoblastic markers SATB2, RUNX2 and osteocalcin. GFs and POFs expressed αSMA while FEPs of the gingiva did not. GFs and POFs had similar staining patterns of SATB2, RUNX2 and αSMA.
CONCLUSIONS: These findings demonstrate that GFs and POFs exhibit a similar immunohistochemical profile, and supports a theory that GFs are osteoblastic lesions possibly related to POFs.

Peripheral giant-cell granulomas (PGCGs) are reddish color lesions of the gingiva which are frequently diagnosed on a routine basis by many dentists in the regular dental practice. Most of the lesions of PGCG are slow-growing, nonaggressive with asymptomatic, and tend to recur. Here, we exhibit a case of PGCG of the upper jaw in a 15-year-old girl child. She presented with a chief complaint of a lump on her upper anterior tooth region for 2-3 months. A well-defined painless, sessile exophytic growth, measuring about 1 cm × 0.5 cm in dimension with pinkish red in color with a firm consistency, was noted. Moreover, no secondary changes were seen. On the radiograph also, no changes in the bone/tooth were observed. The provisional diagnosis was identified as benign lesions such as pyogenic granuloma, peripheral ossifying fibroma, and PGCG and was made based on the clinical history and radiographic findings, and the confirmative diagnosis was given after histopathological examination. To improve the esthetic and function of teeth as well as psychological problems in the young patient, we tend to manage the case more simply by conservative surgical procedure at the earliest to prevent a recurrence.

Maxillofacial metastases are rare but represent advanced disease progression and a poor prognosis. The primary purpose of this article is to describe a patient with previously diagnosed and treated invasive ductal breast carcinoma who developed a metastatic lesion in the maxillary gingiva. In addition, this article presents a brief literature review of case reports on metastatic breast cancer manifestations in the gingiva. In the present case, a 68-year-old woman had been diagnosed and treated for invasive ductal breast carcinoma. At the 6-month follow-up after treatment for breast cancer, she complained of pain in the right leg and spine, swelling in the right arm associated with redness, and a nodular growth in the maxillary gingiva that was painful, friable, and associated with tooth mobility. Imaging examinations and microscopic analysis of an oral biopsy specimen revealed disease progression to the oral cavity, femur, lung, and brain. Because of the advanced disease, the patient died within a few weeks. The literature review identified 6 articles that reported varied clinical presentations of metastatic breast cancer in the gingiva. Invasive ductal carcinoma was the most common histologic type. Routine dental follow-up of patients with cancer is essential for the identification and diagnosis of oral lesions to ensure early intervention for lesions that may be distant metastases mimicking benign lesions.

Pyogenic granuloma is a non-neoplastic reactive lesion that commonly occurs in gingiva. It is rarely found in other locations such as the lips, tongue, palate and buccal mucosa. Lesions affecting the upper lip are even rarer and very few cases have been reported in the literature. In such situations, the lesion may mimic other conditions such as minor salivary gland tumours, mesenchymal tumours, and infectious lesions, which may create diagnostic difficulty. This case report describes an uncommon location of pyogenic granuloma occurring on the upper lip in a 49-year-old male patient.

Adenomatoid odontogenic tumor constitutes an uncommon benign odontogenic tumor which is well-known as \"two-thirds tumor\" (two-thirds of adenomatoid tumors occur in the maxilla, two-thirds occur in young females, two-thirds of the cases are associated with un-erupted teeth and two-thirds of the affected teeth are canines). Larger part of these present as intra - osseous tumors while peripheral counterparts are extremely rare. Peripheral adenomatoid odontogenic tumor is a unique entity which generally presents as a slow growing gingival swelling with minimal bone involvement. This often leads to its erroneous diagnosis as a simple gingival lesion and the real diagnosis is only revealed after its microscopic evaluation. It exhibits a marked predilection for maxillary gingiva of incisor region and most commonly affects the younger females.
We report a case of 25 years old female patient of African ethnicity who presented with a 2 × 2 cm mass attached to the left mandibular gingiva in cuspid- bicuspid region which is an unusual site for AOT. It was accompanied by slight bone loss. With the differential diagnosis of gingival epulis and peripheral ossifying fibroma; surgical excision was performed. The light microscopic examination of the specimen aided the final diagnosis of Adenomatoid odontogenic tumor with the histopathological features identical to its intra osseous counterpart.
In this case, the tumor is present on the mandibular gingiva in a 25 years old patient which is an atypical location and age for this tumor; also, the only individual case reported in an African patient. Only, a meager number of peripheral adenomatoid odontogenic tumor cases have been logged so far with majority of them occurring in maxillary gingiva. Furthermore, an ambiguity still prevails regarding its true origin and possible biological course. Hence, reporting of similar cases should be encouraged to facilitate the better understanding of its varied epidemiological details and clinical presentation.

Isolated lesions of gingiva arise in succession to the hyperinflammatory reactions in response to the underlying local irritants. Despite their overlapping clinical and histological features, these lesions are distinctive regarding their biological behavior. Recurrence has been reported after surgical excision because of the incomplete removal of underlying local irritants. This article describes the clinical and histological features of four localized gingival lesions, adding a note on their molecular pathogenesis and surgical management.

Oral focal mucinosis (OFM) is a rare soft tissue lesion of unknown etiology. Clinically, it is most commonly found on the gingiva and presents as a painless, sessile or pedunculated mass of the same colour as the surrounding mucosa. Histologically, it is characterized by focal myxoid degeneration of connective tissue. OFM occurs predominantly in adults during the fourth and fifth decade of life, although it has been reported infrequently in children and adolescents. Its diagnosis mainly relies on histological analysis and the treatment involves complete surgical excision. Its recurrence is unreported. The aim of this report of two cases is to describe the clinical and histological presentation and subsequent management of OFM. The cause of OFM remains unknown. The cases presented in this report bring OFM to the attention of anatomical pathologists while considering the differential diagnosis of myxoid lesions of the oral cavity.