Recurrent gingival fibrous lesions: comparison of 2 cases and potential need for additional classification

Historically, the classification of localized gingival fibrous lesions has been inconsistent, leading to multiple naming schemes and confusion among pathologists. Currently, lesions are broadly grouped into localized hyperplastic lesions and true neoplasms. Although some cases are clearly defined histologically (i.e., peripheral ossifying fibroma, peripheral odontogenic fibroma), another set of "reactive" fibrous lesions exhibit overlapping histologic features including nondistinctive fibrosis and inflammation. This group can exhibit recurrence, classically related to a local stimulus. However, when local factors are absent, recurrence suggests inherent neoplastic potential. Herein, we describe 2 recurrent fibrous gingival masses, one of which reportedly recurred 3 times with no obvious inciting agent. The histologic appearance of both lesions was similarly distinctive but not well classifiable, while the immunohistochemical profile indicated divergent lesions. This highlights the need for further study of recurrent gingival fibrous lesions to better predict independent growth potential.