Gingival enlargement unveiling sarcoidosis: Report of a rare case

Abstract

Sarcoidosis is classified as an acquired systemic granulomatous disease. Because of the fact that sarcoidosis affects multiple tissues and organs, it is characterized by many potential signs and symptoms, as well as by the presence of non-caseating granulomas in the organs involved. Although oral sarcoidosis is relatively rare, it may however, present in the oral cavity. This report presents a rare case of sarcoidosis with the initial presenting symptom as severe generalized gingival enlargement. The gingival enlargement was treated by gingivectomy. After histopathological examination of gingival biopsy and certain special investigations, a diagnosis of sarcoidosis was made.

Keywords: Gingival enlargement; gingivectomy; sarcoidosis.

Figure 1

Pretreatment photograph showing generalized severe gingival enlargement

Figure 2

Orthopantomograph showing mild alveolar bone loss in relation to upper and lower anterior teeth. Also evident are missing teeth

Figure 3

Immediately after gingivectomy of lower anterior teeth

Figure 4

Photomicrograph showing granulomas with lymphocytes and epitheloid cells with Langhans giant cells (inset: Langhans giant cells)

Figure 5

Post-operative picture, 1 month after completion of full mouth gingivectomy