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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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}

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}

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}

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

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