Traumatic Ulcerative Granuloma with Stromal Eosinophilia: A Case Report

Main Article Content

Pattaramon Tanasubsinn

Abstract

Traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) is a rare benign self-limiting reactive lesion. Clinically it presents as asymptomatic to painful non-healing ulcer with raised and indurated border mimicking oral squamous cell carcinoma. Biopsy is indicated when oral malignancy cannot be excluded. The presence of eosinophil rich mixed inflammatory infiltration is the characteristic for diagnosis of TUGSE. Biopsy procedure can promote the healing process leading to normal wound healing. This report presents a case of 67-year-old female suffering from a large painful chronic ulcer with indurated and irregular surface at lower lip and left buccal mucosa. The patient had history of several recurrent episodes in one and a half year. Final diagnosis was acquired by histopathological report. The ulcer resolved spontaneously after tissue biopsy. The possible etiological factor was ruled out and removed. No recurrence was found after 6-month follow-up.

Article Details

How to Cite
1.
Tanasubsinn P. Traumatic Ulcerative Granuloma with Stromal Eosinophilia: A Case Report. Khon Kaen Dent J [Internet]. 2021 Dec. 9 [cited 2024 Nov. 20];24(3):82-90. Available from: https://he01.tci-thaijo.org/index.php/KDJ/article/view/246182
Section
Clinical Science
Share |

References

Segura S, Pujol RM. Eosinophilic ulcer of the oral mucosa: a distinct entity or a non-specific reactive pattern? Oral Dis 2008;14(4):287-95.

Elzay RP. Traumatic ulcerative granuloma with stromal eosinophilia (Riga-Fede's disease and traumatic eosinophilic granuloma). Oral Surg Oral Med Oral Pathol 1983; 55(5):497-506.

Hirshberg A, Amariglio N, Akrish S, et al. Traumatic ulcerative granuloma with stromal eosinophilia: a reactive lesion of the oral mucosa. Am J Clin Pathol 2006; 126(4):522-9.

Shen W-R, Chang JY-F, Wu Y-C, Cheng S-J, Chen H-M, Wang Y-P. Oral traumatic ulcerative granuloma with stromal eosinophilia: A clinicopathological study of 34 cases. J Formos Med Assoc 2015;114(9):881-5.

el-Mofty SK, Swanson PE, Wick MR, Miller AS. Eosinophilic ulcer of the oral mucosa. Report of 38 new cases with immunohistochemical observations. Oral Surg Oral Med Oral Pathol 1993;75(6):716-22.

Butler JN, Kobayashi TT. Traumatic ulcerative granuloma with stromal eosinophilia: a malignant-appearing benign lesion. Cutis 2017;100(2):E28-31.

Benitez B, Mülli J, Tzankov A, Kunz C. Traumatic ulcerative granuloma with stromal eosinophilia - clinical case report, literature review, and differential diagnosis. World J Surg Oncol 2019;17(1):184.

Setti G, Martella E, Mancini C, Vescovi P, Magnoni C, Bellini P, et al. Self-healing CD30-T-clonal proliferation of the tongue: report of an extremely rare case. BMC oral health 2019;19(1):186.

Segura S, Romero D, Mascaró Jr JM, Colomo L, Ferrando J, Estrach T. Eosinophilic ulcer of the oral mucosa: another histological simulator of CD30+ lymphoproliferative disorders. Br. J. Dermatol. 2006;155(2):460-3.

Ficarra G, Prignano F, Romagnoli P. Traumatic eosinophilic granuloma of the oral mucosa: a CD30+ (Ki-1) lymphoproliferative disorder? Oral Oncol 1997; 33(5):375-9.

Scully C. 57-Other conditions. In: Scully C, ed: Oral and Maxillofacial Medicine (Third Edition). 3rd ed: Churchill Livingstone;2013:397-410.

Kampangsri W, Vatanasapt P, Kamsa-Ard S, Suwanrungruang K, Promthet S. Betel quid chewing and upper aerodigestive tract cancers: a prospective cohort study in khon kaen, Thailand. Asian Pac J Cancer Prev 2013;14(7):4335-8.

Neville BW DD, Chi AC, Allen CM. Oral and maxillofacial pathology. 4th ed. Missouri: Elsevier; 2016: 419-420.

Sarode G, Sarode S, Sengupta N, Patil S. True epithelial dysplasia vs. reactive atypia/dysplasia: A pragmatic viewpoint. Med Hypotheses 2020;145:110349.

Bouquot J, Muller S, Nikai H. Lesions of the Oral Cavity. In: DR G, ed: Diagnostic surgical pathology of the head and neck. 2nd ed. Philadelphia: Saunders; 2009: 191-308.

Sah K, Chandra S, Singh A, Singh S. Eosinophilic ulcer of the tongue masquerading as malignant ulcer: An unexplored distinct pathology. J Oral Maxillofac Pathol 2017;21(2):321.

Kuhl S, Schulze R, Hansen T, Muller-Hermelink H, Hans-Ullrich V. Granuloma Riga-Fede (eosinophile traumatic ulcerative granuloma): A variant of a monoclonal CD30+ lymphoproliferative disorder. J Oral Maxillofac Pathol 2008;12:34.

Al-Talqani M, Abdullah B, Hameedi A. Clinicopathological and Immunohistochemical analysis of 21 cases of traumatic ulcerative granuloma with stromal eosinophilia using CD30, CD68 and TGF-β1. JBCD 2018;30:45-53.

Regezi JA, Zarbo RJ, Daniels TE, Greenspan JS. Oral traumatic granuloma. Characterization of the cellular infiltrate. Oral Surg Oral Med Oral Pathol 1993; 75(6):723-7.

Soyele O, Adesina O, Ladeji A, Kuye K, Owotade F. Traumatic ulcerative granuloma with stromal eosinophilia: Review of the literature and case report. Afr J Med Health Sci. 2017;16(2):115-9.

Salisbury CL, Budnick SD, Li S. T-Cell Receptor Gene Rearrangement and CD30 Immunoreactivity in Traumatic Ulcerative Granuloma With Stromal Eosinophilia of the Oral Cavity. Am J Clin Pathol 2009;132(5):722-7.

Elovic AE, Gallagher GT, Kabani S, Galli SJ, Weller PF, Wong DTW. Lack of TGF-α and TGF-β1 synthesis by human eosinophils in chronic oral ulcers. Oral Surg Oral Med Oral Pathol 1996;81(6):672-81.

Barret AW, Speight PM. Use of oral pathology services by general histopathologists and their attitudes to training of oral pathologists. J Clin Pathol 1996;49(7):565-9.

Binmadi N, Almazrooa S. The use of oral and maxillofacial pathology services by general pathologists and their attitude towards it in Saudi Arabia. Saudi Med J 2017;38: 857-62.

Kumar M, Vineetha R, Pai K, Kamath A, Chandrashekar C. Traumatic ulcerative granuloma with stromal eosinophilia (TUGSE)-A precursor of oral squamous cell carcinoma? Cumhur Dent J 2020;23: 67-70.