Forum for Clinical and Surgical Oral Pathology

Case BBOPF 09-3

Dr. Jaana Hagström (Dept. of Pathology. Haartman Institute, University of Helsinki. Finland) invites your comments and suggestions for the ensuing case. Please send your comments in the window located below the images. This case will be posted from March 13-20, 2009. A summary of the responses will be posted in BBOP.

Medical History

The patient is an active and healthy 80 years-old lady who rides a horse twice a week. Last summer she got an ulceration under her upper lip (as a result of a broken dental prostheses). After that episode of trauma, she developed a swelling.

Many biopsies have been obtained. The microscopic findings show just chronic inflammation with a lichenoid pattern and epithelial hyperplasia. No evidence of Candidiasis or granulomas has been noted in the tissues examined. All microbial and viral tests have been negative. The lesion is well demarcated from the normal mucosa but continues to spread. Antimicrobial and antifungal medications have been used with no success.

I would greatly appreciate your ideas to help us reach a diagnosis to properly manage this patient, please let me know.

Yours sincerely
Jaana Hagström

Images

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Case prepared by Dr. Alfredo Aguirre (BBOP Manager) and Daniel Emmer (Web Administrator, University at Buffalo School of Dental Medicine).