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LETTER TO EDITOR
Year : 2017  |  Volume : 9  |  Issue : 1  |  Page : 64-65

Unusual presentation of a traumatic ulcerative granuloma with stromal eosinophilia


1 Department of Oral Pathology and Microbiology, Dr. D. Y. Patil Dental College and Hospital, Nerul, Navi Mumbai, Maharashtra, India
2 Private Practioner, 1101, Maruti Mount View, Sector 8-B, C.B.D, Belapur, Navi Mumbai, Maharashtra, India

Date of Web Publication14-Jun-2017

Correspondence Address:
Treville Pereira
Department of Oral Pathology and Microbiology, Dr. D. Y. Patil Dental College and Hospital, Sector 7, Nerul, Navi Mumbai - 400 706, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0975-8844.207947

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How to cite this article:
Pereira T, Shetty S, Pereira S. Unusual presentation of a traumatic ulcerative granuloma with stromal eosinophilia. J Orofac Sci 2017;9:64-5

How to cite this URL:
Pereira T, Shetty S, Pereira S. Unusual presentation of a traumatic ulcerative granuloma with stromal eosinophilia. J Orofac Sci [serial online] 2017 [cited 2021 Aug 5];9:64-5. Available from: https://www.jofs.in/text.asp?2017/9/1/64/207947



Sir,

We would like to report an interesting case of a 24-year-old male patient who reported to our dental clinic at Airoli, Navi Mumbai with a growth on the left buccal mucosa. The patient gave a history of a toothbrush injury. Initially, the lesion was ulcerated which later on healed to form a firm bluish growth [Figure 1]. The lesion was surgically excised. On grossing, the specimen showed multiple hemorrhagic areas.
Figure 1: Intraoral photograph showing growth on the left buccal mucosa

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Histopathologically, the lesion showed a stratified squamous epithelium. The underlying connective tissue stroma showed a dense infiltrate of lymphocytes and abundant eosinophils and histiocytes. There were also large hemorrhagic areas present [Figure 2]. The lesion was diagnosed as an unusual presentation of a traumatic ulcerative granuloma with stromal eosinophilia.
Figure 2: Photomicrograph showing the stratified squamous epithelium with large haemorrhagic areas in the connective tissue (a) connective tissue showing an abundance of eosinophils (b). (H and E stain, a-10X, b-40X)

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Traumatic ulcerative granuloma with stromal eosinophilia is known by a number of other names such as traumatic granuloma, eosinophilic ulcer or eosinophilic granuloma.[1],[2],[3] It is a benign, reactive, self-limiting condition of the oral cavity.[4] It characteristically presents as a self-healing solitary ulcer of weeks or months in duration following trauma, although in most cases the history of trauma cannot be elicited.[5] Acute trauma from sharp tooth, sharp filling, ill-fitting partial dentures or physical sharp bite is said to be the cause. In the present case, the injury was caused by a toothbrush and the lesion presented itself as an ulcer initially but later on healed and formed a growth.

Traumatic ulcerative granuloma with stromal eosinophilia is more common in adults over the age of forty and more common in males [1] with male to female ratio of 1.6:1. In the present case, the patient was a 24-year-old male. Simple surgical excision is the treatment of choice. Most of the lesions undergo resolution after incisional biopsy.[1] Rapid healing was achieved in the present case following surgery [Figure 3].
Figure 3: Post-operative intra oral photograph

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It is interesting to note that such a case with an unusual presentation and location has not been reported in the literature.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Neville BW, Damm DD, Allen CM, Bouquot CE. Traumatic ulcerations. In: Oral and Maxillofacial Pathology. 3rd ed. Philadelphia: W.B. Saunders; 2009. p. 287-9.  Back to cited text no. 1
    
2.
Elzay RP. Traumatic ulcerative granuloma with stromal eosinophilia (Riga-Fede's disease and traumatic eosinophilic granuloma). Oral Surg Oral Med Oral Pathol 1983;55:497-506.  Back to cited text no. 2
    
3.
Sklavounou A, Laskaris G. Eosinophilic ulcer of the oral mucosa. Oral Surg Oral Med Oral Pathol 1984;58:431-6.  Back to cited text no. 3
    
4.
Marszalek A, Neska-Dlugosz I. Traumatic ulcerative granuloma with stromal eosinophilia. A case report and short literature review. Pol J Pathol 2011;62:172-5.  Back to cited text no. 4
    
5.
Chavan SS, Reddy P. Traumatic ulcerative eosinophillic granuloma with stromal eosinophilia of tongue. South Asian J Cancer 2013;2:144.  Back to cited text no. 5
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  [Figure 1], [Figure 2], [Figure 3]



 

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