Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
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Verruciform xanthoma in the hard palate: a case report and literature review

  • Garcia, Alexandre Simoes (Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of Sao Paulo) ;
  • Pagin, Otavio (Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of Sao Paulo) ;
  • da Silva Santos, Paulo Sergio (Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of Sao Paulo) ;
  • Oliveira, Denise Tostes (Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of Sao Paulo)
  • Received : 2016.01.26
  • Accepted : 2016.04.05
  • Published : 2016.12.31
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Abstract

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.

Keywords

References

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