Focus of epithelial dysplasia arising in hereditary gingival fibromatosis

The gingiva of a 32-year-old black male was biopsied for evidence of vasculitis, but instead an area of epithelial dysplasia was found. Further investigation revealed that the patient and several members of his family had hereditary gingival fibromatosis. Treatment included four quadrants of gingivectomy plus inverse bevel incisions for trimming those areas which were too thick for simple gingivectomy. Histopathologic examination of the excised tissues supported the diagnosis of gingival fibromatosis, but no other areas of epithelial dysplasia were seen. To our knowledge, this is the only reported instance of a premalignancy or malignancy arising in gingival fibromatosis, and thus there is no reason to regard the gingival disorder as predisposing to carcinoma. However, the pedigree reported here supports a previous suggestion that hereditary gingival fibromatosis is not as rare among blacks as the literature has indicated.