Verruciform xanthoma of the oral cavity - a case report

Abstract

Verruciform Xanthoma (VX) is a relatively rare benign mucocutaneous lesion of unknown aetiology. VX occurs predominantly in oral cavity which also occasionally affects skin and genital mucosa. It was first reported in the oral cavity in 1971. This rare harmless lesion usually presents as sessile or pedunculated, appear as a papule or single plaque showing verrucous or papillomatous mucosal growth with variable color from reddish pink to gray. In majority of oral cases, it affects gingiva and alveolar mucosa that may be mistaken for benign, premalignant and malignant conditions. VX is diagnosed with certainly only on histopathologic examination. Histologically VX is characterized by the presence of parakeratinized epithelium showing papillary or verrucous growth with thin rete ridges and connective tissue papillae extending up to the surface. The papillae characteristically consist of foam cells also called xanthoma cells. Here we describe a case report of verruciform xanthoma occurring on the buccal mucosa in a 42-years old male patient along with its clinical, pathogenesis, histological features and treatment modalities discussed.

Keywords: Oral cavity; Pathogenesis; Verruciform xanthoma; Xanthoma cells.

[Table/Fig-1]:

A solitary cauliflower like growth seen on the left buccal mucosa

[Table/Fig-2]:

Photomicrograph showing papillary projections lined by stratified epithelium along with underlying connective tissue stroma. (H & E, 4x)

[Table/Fig-3]:

Photograph showing papillary projections lined with thin epithelium and core of connective tissue extending into the epithelium. (H&E,10x)

[Table/Fig-4]:

Photomicrograph showing large swollen cells that filled the connective tissue papillae between the epithelial rete ridges. The cells show clear to eosinophilic granular cytoplasm with eccentrically placed nuclei and are called foam cells or xanthoma cells. (H & E, 40x)