Verruciform xanthoma: Report of two cases and review on pathogenesis

Oral verruciform xanthoma (OVX) is an uncommon lesion that appears on the oral mucosa. The aim of this paper was to discuss the probable etiopathogenesis of OVX in the hard palate, reinforcing the importance of including this lesion in the differential diagnosis of verrucous lesions. A 43-year-old male smoker presented with a painless lesion with a verrucous surface and erythematous spots on the hard palate. Excisional biopsy revealed oral mucosa consisting of hyperkeratosis, acanthosis, and elongated rete pegs. Subjacent connective tissue showed numerous foam cells with clear cytoplasm and pyknotic nucleus, negative on periodic acid-Schiff staining. Immunohistochemical analysis revealed foam cells positive for anti-CD68 antibody, while anti-KI-67 antibody was restricted to the basal layer of the oral epithelium. A final diagnosis of OVX was established. The patient showed no signs of recurrence after seven months of follow-up. Physical trauma and smoking habits can be directly related to the etiology of verruciform xanthoma because the lesion is chronic and inflammatory with slow growth, and sites if high trauma are more often affected by such a lesion. The hard palate is the second most commonly affected site, and local trauma caused by smoking can be a cause of this type of lesion.

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“…Ultrastructural and in situ hybridization have not shown an association between HPV and OVX, excluding a viral etiology for this lesion24.…”

Section: Discussionmentioning

confidence: 76%

Verruciform xanthoma in the hard palate: a case report and literature review

Garcia

Pagin

Santos

et al. 2016

J Korean Assoc Oral Maxillofac Surg

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“…Thus, it reflects thinning of the epithelium overlying the macrophages in the connective tissue papillae. [4]…”

Section: Discussionmentioning

confidence: 99%

Verruciform xanthoma of buccal mucosa: A case report with review of literature

et al. 2012

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Verruciformxanthoma (VX) is an uncommon benign mucocutaneous lesion of unknown etiology. It appears as a papule or single plaque with verrucous or papillomatous surface and variable color from reddish pink to gray. It occurs primarily in the masticatory mucosa. Histologically, VX is characterized by the presence of parakeratinized epithelium with thin rete ridges and connective tissue papillae extending up to the surface. The papillae characteristically consist of foam cells, also called xanthoma cells. We report a case of VX in the buccal mucosa and discuss their clinical and histopathological findings.

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“…More cases have been described involving Asians; Philipsen et al 4 found 109 verruciform xanthomas in Japanese in their series of 282 cases, and another 15 cases were described in Taiwan more recently 8 . Changes in the lipid metabolism and viruses do not seem to induce verruciform xanthoma 7,9 . Oliveira et al…”

Section: Discussionmentioning

confidence: 99%

“…Up to 2001, only 282 cases had been reported4. Since 2001, the following reports written in English were found in PubMed: a series with 15 new cases described by Yu et al 8 ; another two cases reported by Sah et al 7 ; and 11 isolated case reports, totaling 29 new cases including the present case 5,[11][12][15][16][17][18][19][20][21][22] . Among all cited studies, only five verruciform xanthomas were described, in addition to the present case 12,14 .…”

Section: Discussionmentioning

confidence: 99%

“…Sopena et al 5 described a case of disseminated verruciform xanthoma involving the hands, feet, genital region, ears, and palate. From the clinical point of view, verruciform xanthoma is characterized by a well delimited rough or papillary elevation and may be depressed or ulcerated at the center 4,[6][7] . Its color varies from pink, red, yellow, or brownish, to whitish or grey 4 .…”

Section: Introductionmentioning

confidence: 99%

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A rare case of giant verruciform xanthoma in the palate

Rosa

Amorim

2014

RGO, Rev. Gaúch. Odontol.

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RESUMOO xantoma verruciforme é uma lesão rara de etiologia não determinada, que acomete, principalmente, a mucosa oral. Na maioria das vezes é assintomática, caracterizando-se por uma elevação bem-delimitada, de superfície rugosa ou papilar, e sua principal localização na boca é a gengiva. Com relação ao tamanho, a maioria das lesões não ultrapassa 2 cm no seu maior diâmetro. O objetivo do presente trabalho é relatar um caso raro de extenso xantoma verruciforme em paciente do gênero masculino, de 55 anos, apresentando lesão localizada no palato duro e na gengiva palatina. Clinicamente, a lesão possuía bordas bem-destacadas, de superfície levemente granular e coloração avermelhada, com consistência elástica, medindo aproximadamente 2,8 X 1,5cm. O exame histopatológico demonstrou a presença de proliferação do epitélio de revestimento, exibindo papilomatose, paraceratose e alongamento das cristas epiteliais. Na lâmina própria, células xantomatosas com citoplasma claro e vacuolado puderam ser observadas. O paciente encontra-se livre de recidivas após 18 meses de acompanhamento clínico. De acordo com extensa pesquisa em bases de dados (pubmed, medline, lilacs), o presente caso representa uma das maiores lesões do tipo xantoma verruciforme já relatadas na literatura.Termos de indexação: Mucosa bucal. Palato. Patologia bucal. Xantomatose.

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Verruciform xanthoma: Report of two cases and review on pathogenesis

Cited by 18 publications

References 21 publications

Verruciform xanthoma in the hard palate: a case report and literature review

Verruciform xanthoma in the hard palate: a case report and literature review

Verruciform xanthoma of buccal mucosa: A case report with review of literature

A rare case of giant verruciform xanthoma in the palate

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