Diagnóstico e tratamento de fibroma verdadeiro em mucosa jugal em paciente feoderma: relato de caso

Abstract

Fibroma is a benign connective tissue lesion frequently observed in the oral mucosa and, in most cases, represents a reactive fibrous hyperplasia resulting from chronic trauma. However, true fibroma corresponds to a rare fibroblastic neoplasm, whose clinical distinction from irritation fibroma is limited, making definitive diagnosis dependent on histopathological evaluation. This study reports the case of a 35-year-old male patient with dark skin who presented to the Stomatology clinic with a sessile nodular lesion of soft consistency, floating on palpation, and exhibiting slow growth on the left buccal mucosa. The patient reported no pain and an evolution of approximately one month. Initial diagnostic hypotheses included lipoma and focal fibrous hyperplasia. A relevant clinical finding was the presence of missing posterior teeth on the same side as the lesion, reducing the likelihood of chronic masticatory trauma and contributing to the exclusion of irritation fibroma. The lesion was removed through excisional biopsy, and macroscopic examination revealed a well-delimited fragment of soft, brownish tissue. Histopathological analysis demonstrated disorganized collagen fiber arrangement and absence of patterns characteristic of reactive lesions, leading to the diagnosis of true fibroma, which was confirmed after discussion with faculty members. Surgical treatment was effective, with satisfactory healing observed at the 7-day follow-up and no complications. This case highlights the importance of correlating clinical and histopathological findings, as well as performing careful assessment of local factors, for the appropriate differential diagnosis of fibrous lesions in the oral cavity.