Unifocal orofacial granulomatosis in retromolar mucosa: surgical treatment with Er,Cr:YSGG laser

Abstract

Orofacial granulomatosis is defined by permanent or recurrent swelling of orofacial tissues with different multiform and multifocal clinical patterns. An 11-year old boy presented with a 2-month history of mucosa enlargement. Intraoral examination revealed an erythematous, polylobulated, exophytic lesion with a smooth surface located in retromolar mucosa, non-tender and non-infiltratated to palpation. The diagnosis was inflammatory lesion compatible with pyogenic granuloma and laser excision was decided. Haematological parameters were within normal range, as well as chest Xrays. These findings lead to a diagnosis of non-symptomatic orofacial granulomatosis, whose early diagnosis can minimize the impact of systemic-related disorders, like Chron's disease. Key words:Laser, orofacial granulomatosis, childhood, oral lesions, diagnosis.

Figure 1

Clinical presentation of the lesion.

Figure 2

Histopathological examination revealed epithelial hyperplasia with a dense submucosal, mixed inflammatory infiltration that focally showed granulomatous features. Note the mild penetration in the tissue of the heat distortion induced by the laser.

Figure 3

Granulomas were irregularly distributes in the specimen. They had giant multinucleated cells and did not show necrosis.