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Traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) is a rare, benign, and self-limiting ulcerative lesion, with the tongue being the most common site of occurrence and traumatic inflictions being the common etiology. Case report: A 45-year-old female reported to the dental operatory with a complaint of pain on the left side of her ton...
Contexts in source publication
Context 1
... also gave a history of having a tobacco chewing habit for 15 years, which she stopped 6 years ago. On examination, a single erythematous ulcer was seen on the left border of the tongue, measuring about 2 cm x 1.5 cm with irregular borders and everted margins, which was provisionally diagnosed as squamous cell carcinoma (Figure 1). The lesion was surgically excised under local anesthesia and sent for histopathological investigation. ...
Context 2
... also gave a history of having a tobacco chewing habit for 15 years, which she stopped 6 years ago. On examination, a single erythematous ulcer was seen on the left border of the tongue, measuring about 2 cm x 1.5 cm with irregular borders and everted margins, which was provisionally diagnosed as squamous cell carcinoma (Figure 1). The lesion was surgically excised under local anesthesia and sent for histopathological investigation. ...
Citations
... However, the definite diagnosis should be based on clinical and pathological features, and often supported by a history of trauma (2). TUGSE normally responds favorably to excision of the lesion, with rapid healing of the surgical site, and recurrence in unexpected (5). ...
... However, unlike the predominance of females observed by those authors, we found no sex predilection d in the current series, although the determinants of this supposed change in this demographic parameter are not entirely clear. Clinical features of TUGSE, such as rapid expansion and ulceration with typically indurated and rolled-appearing margins, just as observed in the current case, often lead to a presumptive misdiagnosis of malignancy despite its benign nature (3,5). Therefore, performing an incisional biopsy and histopathological analysis may be pivotal for establishing a correct diagnosis and, consequently, an appropriate therapeutic approach. ...
... Histologically, TUGSE is typically characterized by granulation tissue associated with inflammatory infiltrate rich in eosinophils. In some cases, the eosinophils are preferentially located around degenerated muscle fibers in the bottom of the lesion, suggesting a possible relation with muscular injury (5,9). Although most of these features were found in the current case, the eosinophils showed a diffuse distribution in the lesion, as also reported by Shen et al. (6). ...
Traumatic Ulcerative Granuloma with Stromal Eosinophilia ulcer of the oral mucosa is recognized as a benign, reactive, and selflimiting lesion with an uncertain pathophysiology that appears as a solitary, rapidly developing ulcer. These lesions can appear in
a variety of ways clinically, but most of these instances a complete history and clinical examination can determine both the etiology
and the consequence. It is utmost important to recognize these mucosal lesions which are characterized by the presence of
indurated elevated borders and mimics malignant ulcers such as squamous cell carcinoma of the mouth. Although most of times a
biopsy of such lesions is not required, in certain cases it may be necessary to conduct histological investigations in order to rule out
conditions which clinically resemble traumatic lesions; however, the condition tends to resolve on its own. The present case
highlights the clinical aspects, etiopathogenesis and histopathology of this uncommon lesion.
