Oral fibroma

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Oral fibroma, typically referred to as simply fibroma, is a very common benign lesion in oral pathology.

Oral fibroma
Diagnosis in short

Oral fibroma. H&E stain.

Synonyms fibroma, focal fibrous hyperplasia, peripheral fibroma, peripheral ossifying fibroma, fibroid epulis (old term), fibroepithelial polyp

LM fibrous stroma +/-collagen bundles, prominent (dilated) vessels, overlying (squamous) mucosa benign +/-hyperkeratosis +/-focal ulceration
Gross polypoid lesion, usually small
Site oral cavity - see oral pathology and head and neck pathology

Prevalence very common
Prognosis benign
Clin. DDx squamous papilloma, other polypoid lesions
Treatment removal

It is also known as focal fibrous hyperplasia, peripheral fibroma, peripheral ossifying fibroma, fibroid epulis (old term), and fibroepithelial polyp.[1][2][3]


  • Most common oral cavity tumour.[3]
  • Female predominance (female:male = 2:1), usually 30-50 years old.[3]

Clinical DDx:



  • Fibrous stroma - key feature.
    • "Very pink" at low power.
  • +/-Collagen bundles, may be prominent.
  • Prominent (dilated) vessels.
  • Overlying (squamous) mucosa benign (flat).
    • +/-Hyperkeratosis +/-focal ulceration.[3]


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Lower Buccal Lesion, Left, Excision:
- Fibroma.
- NEGATIVE for malignancy.
Left Tongue Lesion, Excision:
- Fibroma with overlying squamous epithelium with parakeratosis.
- NEGATIVE for malignancy.

Block letters



The sections show a polypoid fragment of squamous mucosa with a thin layer of parakeratosis. The subepithelial tissue consists of abundant fibrous tissue and has dilated small blood vessels.

No significant inflammation is present. No nuclear atypia is apparent. No necrosis is present. No proliferative activity is apparent.

See also


  1. Mills, Stacey E; Carter, Darryl; Greenson, Joel K; Reuter, Victor E; Stoler, Mark H (2009). Sternberg's Diagnostic Surgical Pathology (5th ed.). Lippincott Williams & Wilkins. pp. 775. ISBN 978-0781779425.
  2. URL: http://emedicine.medscape.com/article/1080948-overview#aw2aab6b3. Accessed on: 20 August 2012.
  3. 3.0 3.1 3.2 3.3 Thompson, Lester D. R. (2006). Head and Neck Pathology: A Volume in Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 240. ISBN 978-0443069604.
  4. Segura Saint-Gerons, R.; Ceballos Salobreña, A.; Toro Rojas, M.; Gándara Rey, JM. (Aug 2006). "Oral manifestations of Cowden's disease. Presentation of a clinical case.". Med Oral Patol Oral Cir Bucal 11 (5): E421-4. PMID 16878060.
  5. Oliveira, MA.; Medina, JB.; Xavier, FC.; Magalhães, M.; Ortega, KL. (2010). "Cowden syndrome.". Dermatol Online J 16 (1): 7. PMID 20137749.
  6. 6.0 6.1 Fernandez-Flores, A. (Jul 2010). "Solitary oral fibromas of the tongue show similar morphologic features to fibrous papule of the face: a study of 31 cases.". Am J Dermatopathol 32 (5): 442-7. doi:10.1097/DAD.0b013e3181c47142. PMID 20421776.