Verruciform Xanthoma of the Oral Mucosa: A Series of Eight Typical and Three Anomalous Cases

Abstract

In this series, there are 8 typical verruciform xanthomas of the oral mucosa and 3 anomalies, 1 polypoid, 1 florid, and 1 carcinomatous. All were characterized by infiltrates of CD68-positive xanthomatous histiocytes in the lamina propria. The 11 patients comprised 6 men and 5 women (mean age = 54.5 years, range = 40-69). Both keratinized and nonkeratinized sites were affected. A history of lichenoid inflammation was recorded in 5 patients. The polypoid xanthoma presented in a woman aged 54 years as a polyp of the labial commissure. The florid lesion affected the dorsum of the tongue of a man aged 54 years and at 20 mm was the largest of the 11 lesions, but the only one with candidal infection. The squamous cell carcinoma manifested as a papilloverrucous hyperkeratosis of the palatal gingiva in a man aged 69 years. The latter 2 (and 1 “typical” verruciform xanthoma) required re-excision, but none has since recurred.

Xantoma verruciforme de encía: presentación de un caso

“…Estos datos motivan la decisión de realizar una excisión quirúrgica con mínimos márgenes de seguridad (a pesar de que la lesión era más rojiza que blanca). Caso contrario se indicaría para un paciente que sea fumador excesivo, con historia de pérdida de peso reciente, crecimiento rápido, dolor y factores de riesgo, como antecedentes familiares positivos, inmunodeficiencias o leucoplasias, donde realizar una biopsia incisional para descartar que sea una lesión maligna o algún tipo de displasia presente sea lo más seguro para el tratamiento definitivo (4,6,7,10,12,13,15). Histológicamente, el carcinoma verrugoso se puede distinguir del XV por la presencia de proliferación epitelial invasiva, atipia celular y falta de infiltrado histiocítico espumoso.…”

“…El concepto más reciente en su etiopatogenia es un mecanismo inmune al trauma o inflamación local. Los estudios inmunohistoquímicos han demostrado que las células predominantes en el infiltrado inflamatorio son las células T. Se cree que las células espumosas son de linaje de monocitos/macrófagos, ya que son positivas ante el anticuerpo CD68 (un marcador de macrófagos) (1)(2)(3)(6)(7)(8).…”

Verruciform xanthoma associated with lichen planus

“…16 In PubMed, only 16 cases have been reported, associating VX with OLP in the oral mucosa, including the present case. 6,8,10,12,15,[17][18][19][20][21][22] It stands out that the studies of Yu et al, 10 Ide et al 15 and Andrade et al, 6 did not present data about the demographic, clinical, or histologic characteristics of the VX and OLP. For this reason, these three articles were not included in Table 1.…”