1
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[Verrucous exophytic tumor of the glans penis]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2023; 74:195-198. [PMID: 36512101 PMCID: PMC9981705 DOI: 10.1007/s00105-022-05085-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/16/2022] [Indexed: 12/15/2022]
Abstract
A 59-year-old man presented with a growing tumor on the glans penis, which we excised. Histologically, there was an acanthotic epidermis under which the papillary dermis was filled with foamy macrophages, best seen in a CD 68 stain. Verruciform xanthoma was diagnosed. Knowledge of this benign diagnosis may prevent an overly hasty, aggressive approach, since the differential diagnosis of penile carcinoma requires much more radical therapy, and mutilating penile surgery is associated with considerable psychosexual distress for patients.
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2
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Baldwin A, Hartl M, Tschaikowsky M, Balzer BN, Booth BW. Degradation and release of tannic acid from an injectable tissue regeneration bead matrix in vivo. J Biomed Mater Res B Appl Biomater 2021; 110:1165-1177. [PMID: 34904786 DOI: 10.1002/jbm.b.34990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 11/03/2021] [Accepted: 11/27/2021] [Indexed: 12/26/2022]
Abstract
The development of multifunctional biomaterials as both tissue regeneration and drug delivery devices is currently a major focus in biomedical research. Tannic Acid (TA), a naturally occurring plant polyphenol, displays unique medicinal abilities as an antioxidant, an antibiotic, and as an anticancer agent. TA has applications in biomaterials acting as a crosslinker in polymer hydrogels improving thermal stability and mechanical properties. We have developed injectable cell seeded collagen beads crosslinked with TA for breast reconstruction and anticancer activity following lumpectomy. This study determined the longevity of the bead implants by establishing a degradation time line and TA release profile in vivo. Beads crosslinked with 0.1% TA and 1% TA were compared to observe the differences in TA concentration on degradation and release. We found collagen/TA beads degrade at similar rates in vivo, yet are resistant to complete degradation after 16 weeks. TA is released over time in vivo through diffusion and cellular activity. Changes in mechanical properties in collagen/TA beads before implantation to after 8 weeks in vivo also indicate loss of TA over a longer period of time. Elastic moduli decreased uniformly in both 0.1% and 1% TA beads. This study establishes that collagen/TA materials can act as a drug delivery system, rapidly releasing TA within the first week following implantation. However, the beads retain TA long term allowing them to resist degradation and remain in situ acting as a cell scaffold and tissue filler. This confirms its potential use as an anticancer and minimally invasive breast reconstructive device following lumpectomy.
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Affiliation(s)
- Andrew Baldwin
- Department of Bioengineering, Clemson University, Clemson, South Carolina, USA
| | | | - Mathaeus Tschaikowsky
- Institue of Physical Chemistry, University of Freiburg, Freiburg, Germany.,G.E.R.N. Center for Tissue Replacement, Regeneration & Neogenesis, Department of Orthopedics and Trauma Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Bizan N Balzer
- Institue of Physical Chemistry, University of Freiburg, Freiburg, Germany.,Cluster of Excellence livMatS @ FIT - Freiburg Center for Interactive Materials and Bioinspired Technologies, Freiburg, Germany.,Freiburg Materials Research Center (FMF), Albert Ludwig University of Freiburg, Freiburg, Germany
| | - Brian W Booth
- Department of Bioengineering, Clemson University, Clemson, South Carolina, USA
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3
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Rare case of large verrucous xanthoma of oral cavity managed with nasolabial flap and review of literature. ORAL AND MAXILLOFACIAL SURGERY CASES 2020. [DOI: 10.1016/j.omsc.2020.100170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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4
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Shigeoka M, Koma YI, Kodama T, Nishio M, Akashi M, Yokozaki H. CD163 + Foamy Macrophages Are Associated with the Morphogenesis of Oral Verruciform Xanthoma through Angiogenesis by VEGF Expression: An Immunohistochemical Study. Dent J (Basel) 2020; 8:E18. [PMID: 32075061 PMCID: PMC7175176 DOI: 10.3390/dj8010018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 01/25/2020] [Accepted: 02/12/2020] [Indexed: 12/12/2022] Open
Abstract
Oral verruciform xanthoma (OVX) is an uncommon benign lesion that is characterized histologically by the accumulation of several foamy macrophages in the lamina propria papillae. The pathogenesis of OVX has not been completely elucidated, although the significance of macrophage polarization (M1, tumor suppression; and M2, tumor promotion) and the contribution of M2 macrophages to angiogenesis are well established. This study investigated the role of foamy macrophages in OVX, with a focus on angiogenesis. Four patients who underwent surgical excision or total excisional biopsy for OVXs were enrolled in this study. We evaluated the expression of the macrophage markers CD68 (broad) and CD163 (M2) and the CD34-positive microvessel density (MVD) of OVXs. The foamy macrophages of all patients exhibited positivity to CD68 and CD163. We evaluated the MVD and the expression of the vascular endothelial growth factor (VEGF) based on histological architecture. The MVD of all OVX cases was significantly higher than that of the corresponding normal epithelia. Interestingly, the MVD of verrucous-type OVX cases was higher than that of the other type. VEGF was expressed on foamy macrophages in all cases. Overall, the foamy macrophages expressing CD163 were associated with the morphogenesis of OVX through the process of angiogenesis by VEGF expression.
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Affiliation(s)
- Manabu Shigeoka
- Division of Pathology, Department of Pathology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Yu-ichiro Koma
- Division of Pathology, Department of Pathology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Takayuki Kodama
- Division of Pathology, Department of Pathology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Mari Nishio
- Division of Pathology, Department of Pathology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Masaya Akashi
- Division of Oral and Maxillofacial Surgery, Department of Surgery Related, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Hiroshi Yokozaki
- Division of Pathology, Department of Pathology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
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5
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Belknap AN, Islam MN, Bhattacharyya I, Cohen DM, Fitzpatrick SG. Oral Verruciform Xanthoma: A Series of 212 Cases and Review of the Literature. Head Neck Pathol 2020; 14:742-748. [PMID: 31898056 PMCID: PMC7413928 DOI: 10.1007/s12105-019-01123-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Accepted: 12/20/2019] [Indexed: 11/30/2022]
Abstract
Verruciform xanthoma (VX) of the oral cavity is an uncommon, reactive lesion of unknown etiology. In this study, we present a large series of VX with analysis of demographics, clinical appearance, histologic presentation and extensive review of literature. To the best of our knowledge, this is the largest series of oral VX reported to date. Following IRB approval, all cases diagnosed as VX found in the archives of the University of Florida Oral Pathology Biopsy Service (1994-2018) were included. Patient age, gender, location, clinical appearance, clinical impression, and duration of each lesion was collected. A total of 212 cases were included in our database with a mean age of 61 years (range of 9-94), and a female: male ratio of 1.06:1. The most common location in descending order was the gingiva (n = 110, 51.2%), followed by palate (n = 41, 19.3%), buccal mucosa (n = 18, 8.5%), tongue (n = 20, 9.4%), vestibule (n = 13, 6.1%), lip (n = 4, 1.9%), floor of mouth (n = 3, 1.4%), and unspecified (n = 1, 0.5%). The lesions were most frequently pink in color, and most often described as bumpy, rough, verrucoid and/or papillary. Clinical impression in descending order was papillary (n = 67, 31.6%), not specified or unknown (n = 41, 19.3%), hyperkeratosis (n = 24, 11.3%), fibroma (n = 20, 9.4%), leukoplakia (n = 17, 8.0%), dysplastic lesion (n = 13, 6.1%), pyogenic granuloma (n = 7, 3.3%), granulomatous reaction (n = 5, 2.4%), lichen planus, VX (n = 4 each, 2.0%), pigmented, other lesions (n = 3 each, 1.4%), and salivary and periapical lesions (n = 2 each, 0.9%). Three of the lesions were recurrences. The demographics and clinical parameters of this case series were in concordance with that of previously published reports. In our series, only 4 cases were suspected as VX, demonstrating the lack of familiarity clinicians have with this lesion.
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Affiliation(s)
- Austin N. Belknap
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, 1395 Center Drive, Gainesville, FL 32610 USA
| | - Mohammed N. Islam
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, 1395 Center Drive, Gainesville, FL 32610 USA
| | - Indraneel Bhattacharyya
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, 1395 Center Drive, Gainesville, FL 32610 USA
| | - Donald M. Cohen
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, 1395 Center Drive, Gainesville, FL 32610 USA
| | - Sarah G. Fitzpatrick
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, 1395 Center Drive, Gainesville, FL 32610 USA
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Gannepalli A, Appala A, Reddy L, Babu DBG. Insight into verruciform xanthoma with oral submucous fibrosis: Case report and review of literature. J Oral Maxillofac Pathol 2019; 23:43-48. [PMID: 30967723 PMCID: PMC6421923 DOI: 10.4103/jomfp.jomfp_210_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Verruciform xanthoma (VX) is a rare benign mucocutaneous verrucopapillary lesion, which mainly involves masticatory mucosa and gingiva. Clinically, it presents as a solitary, sessile or pedunculated, white- or yellow-white-colored growth with a pebbled surface, hence often misdiagnosed as papilloma. The hallmark of histological diagnosis is the presence of foam cells or xanthoma cells confined to the connective tissue papillae. We present a case of VX on the maxillary gingiva in a 52-year-old male patient with oral submucous fibrosis (OSF) with a review on histopathology and concomitant oral lesions. The exact etiopathogenesis is not clearly delineated more so when it is associated with diverse local and systemic conditions. Its concomitant association with other conditions such as lichen planus, leukoplakia, oral squamous cell carcinoma and OSF is rare, with only three cases of VX associated with OSF reported earlier.
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Affiliation(s)
- Ashalata Gannepalli
- Department of Oral and Maxillofacial Pathology, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Dilsukhnagar, Hyderabad, Telangana, India
| | - Amruta Appala
- Department of Oral and Maxillofacial Pathology, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Dilsukhnagar, Hyderabad, Telangana, India
| | - Lavanya Reddy
- Department of Oral Medicine and Radiology, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Dilsukhnagar, Hyderabad, Telangana, India
| | - Dara Balaji Gandhi Babu
- Department of Oral Medicine and Radiology, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Dilsukhnagar, Hyderabad, Telangana, India
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7
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Baig FAH, Luqman M, Vij H, Ibrahim M. Oral Verruciform Xanthoma of lateral border of tongue - a sheep in wolf's clothing. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2018; 120:480-482. [PMID: 30557744 DOI: 10.1016/j.jormas.2018.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 12/03/2018] [Accepted: 12/05/2018] [Indexed: 12/07/2022]
Abstract
Oral Verruciform Xanthoma (OVX) is an uncommon benign lesion of the oral cavity. Most authors consider it to develop as a response to chronic local irritation. It usually presents as a pink, yellow or greyish flat mass occurring on the gingiva, alveolar ridge or hard palate. This paper reports to you the management of a case of Oral Verruciform Xanthoma occurring on the latero-ventral border of the tongue in a young male patient, which is a rare location for this lesion. It goes on to discuss the etiopathogenesis and clinical features of this rare lesion and emphasizes the importance of having a broad knowledge of oral pathologic lesions especially for lesions that resemble malignant or pre-malignant pathologies in the oral cavity.
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Affiliation(s)
- F A H Baig
- OMS department, College of dentistry, King Khalid University, Abha, Saudi Arabia.
| | - M Luqman
- DDS Department, College of dentistry, King Khalid University, Abha, Saudi Arabia
| | - H Vij
- Boston School of Dentistry, USA
| | - M Ibrahim
- OMS department, College of dentistry, King Khalid University, Abha, Saudi Arabia
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8
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Tamiolakis P, Theofilou VI, Tosios KI, Sklavounou-Andrikopoulou A. Oral verruciform xanthoma: Report of 13 new cases and review of the literature. Med Oral Patol Oral Cir Bucal 2018; 23:e429-e435. [PMID: 29924759 PMCID: PMC6051686 DOI: 10.4317/medoral.22342] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 05/05/2018] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Oral verruciform xanthoma (OVX) is a rare lesion. The purpose of the present study is to describe the clinical features of 13 OVXs and review all cases reported in the English literature. MATERIAL AND METHODS Thirteen cases of OVX diagnosed during a 47-year period were retrospectively collected. The patients gender and age, as well as the main clinical features of the lesions were retrieved from the biopsy request forms. Pubmed, Scopus and Google ScholarTM electronic databases were searched with the key word verruciform xanthoma. Only cases of histologically confirmed OVX were included in the study. RESULTS The 13 OVXs represented approximately 0.04% of 35,617 biopsies accessioned during the study period. They affected 13 patients, 8 males and 5 females with a mean age of 48.8±14 years. They mainly appeared as asymptomatic granular nodules or plaques, with elastic or normal consistency and white color, in the gingiva or hard palate. Literature review yielded 416 cases of OVX. With the addition of cases of the present study, 429 cases of OVX have been presented in the English literature. OVX has a slight male predominance with a male to female ratio of 1.4:1 and the majority of patients are in the 5th to 7th decade of life. Clinically, OVX mainly presents as an asymptomatic, single, papillary or granular plaque or nodule, with elastic or soft consistency and white, red or pink color. It measures approximately 1cm and is most commonly located on the gingiva, tongue, hard palate or buccal mucosa. The treatment of choice is surgical excision with little rates of recurrence. CONCLUSIONS Verruciform xanthoma is a rare lesion most often encountered on the ginigival mucosa. As its clinical presentation is not pathognomonic, it should be included in the differential diagnosis of verrucous or papillary lesions.
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Affiliation(s)
- P Tamiolakis
- Department of Oral Medicine and Oral Pathology, School of Dentistry, National and Kapodistrian University of Athens, Greece, 2 Thivon Str, 11527, Goudi, Athens, Greece,
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Oral Verruciform Xanthoma within Lichen Planus: A Case Report and Literature Review. Case Rep Dent 2018; 2018:1615086. [PMID: 29850274 PMCID: PMC5937561 DOI: 10.1155/2018/1615086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 04/04/2018] [Indexed: 11/18/2022] Open
Abstract
Background Verruciform xanthoma is an uncommon benign tumor, which exhibits a wide range of clinical patterns. The occurrence of the lesion in patients with immune-mediated mucocutaneous diseases may suggest a role of localized epithelial cell damage and chronic inflammation in its pathogenesis. Case Report A case of verruciform xanthoma on the tongue of a 56-year-old female with oral lichen planus is reported. An asymptomatic pink-white lesion with a granular surface was observed in the left lateral lingual border, which was closely associated with a white plaque and striae. An incisional biopsy was performed, and histologically, epithelial projections in a verrucous pattern were observed. In the subepithelial connective tissue, aggregates of foamy cells that exhibited immunoreactivity for CD68 were noted. The final diagnosis was verruciform xanthoma. The mucosa adjacent to the lesion demonstrated histopathological features consistent with lichen planus. Conclusions A total of twelve cases of oral verruciform xanthomas in patients with oral lichen planus including the present case have been reported in the literature. The clinician should be aware that verruciform xanthoma may mimic malignancy, and therefore, biopsy is required for definitive diagnosis to be established, especially when this tumor develops within conditions that show potential for malignant transformation.
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10
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Affiliation(s)
- Zhiyu Li
- Department of Dermatology, Gulou Affiliated Hospital to Medical College of Nanjing University, Nanjing 210008, People's Republic of China
| | - Yihua Wang
- Department of Pathology, Gulou Affiliated Hospital to Medical College of Nanjing University, Nanjing 210008, People's Republic of China
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Capocasale G, Panzarella V, Tozzo P, Mauceri R, Rodolico V, Lauritano D, Campisi G. Oral verruciform xanthoma and erythroplakia associated with chronic graft-versus-host disease: a rare case report and review of the literature. BMC Res Notes 2017; 10:631. [PMID: 29183344 PMCID: PMC5704520 DOI: 10.1186/s13104-017-2952-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Accepted: 11/21/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Oral verruciform xanthoma is an uncommon benign lesion. Although oral verruciform xanthoma occurs in healthy individuals, it has been also reported in association with some inflammatory conditions. The aim of this study is to report a case of oral verruciform xanthoma associated with chronic graft-versus-host disease and to review the literature on this topic. CASE PRESENTATION A 47-year-old Caucasian male presented to the Sector of Oral Medicine "V. Margiotta", University Policlinic "P. Giaccone" of Palermo complaining of a mass on the gingiva. He first noticed the painless mass 1 year ago. He reported to have undergone allogenic hematopoietic stem cell transplantation 15 years ago for acute lymphoblastic leukaemia. Intraoral examination revealed a well-circumscribed, sessile yellowish and verrucous nodule upon canine, multiple yellowish and verrucous nodules on the hard palate, yellowish and verrucous nodules on left buccal mucosa. In addiction an area of white striae in a reticular pattern with erythema and ulceration was present on the dorsum of the tongue. This lesion was consistent with a known history of oral chronic graft versus host disease. Moreover, we observed a suspected area of oral erythroplakia yet on the dorsum of the tongue. In biopsy specimen of hard palate histopathological examination revealed a diagnosis of verrucous xanthoma of the oral cavity; in addiction in biopsy specimen of the dorsum of the tongue revealed the presence of erythroplakia with high grade dysplasia. CONCLUSION Verruciform xanthoma of the oral cavity associated with chronic graft-versus-host disease is a rare condition with a usually benign clinical course but malignant transformation has been described in association with oral potential malignant disorder (e.g. chronic graft versus host disease, erythroplakia). Very rare cases showed association with oral chronic graft versus-host-disease. To date, only eight cases were published in the world literature. Therefore it could be important follow up patients also for oral verruciform xanthoma onset.
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Affiliation(s)
- Giorgia Capocasale
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Vera Panzarella
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Pietro Tozzo
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Rodolfo Mauceri
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Vito Rodolico
- Human Pathology, Department of Health Promotion & Mother and Child Care, University of Palermo, Via Alfonso Giordano 3, 90127 Palermo, Italy
| | - Dorina Lauritano
- Department of Medicine and Surgery, University of Milan-Bicocca, Via Cadore, 48, 20900 Monza, Italy
| | - Giuseppina Campisi
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
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Abstract
Verruciform xanthoma is a benign, soft tissue lesion occurring on the orogenital mucosa. Presentation of oral lesions can be pink, yellow, or gray raised plaque or papule with granular, papillary, or verrucous in nature. There are many theories proposed for the etiopathogenesis of verruciform xanthoma. Clinical observations may be misguiding as the lesion resembles malignant and premalignant lesions. Histopathological confirmation is essential for diagnosis and avoiding radical surgery. Once excised, the lesion does not recur. Here, we present a case report of verruciform xanthoma of the tongue in a 50-year-old female patient.
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Affiliation(s)
- Sanjay Byakodi
- Department of Oral and Maxillofacial Surgery, Bharati Vidyapeeth Deemed University Dental College and Hospital, Sangli, Maharashtra, India
| | - Barun Kumar
- Department of Oral and Maxillofacial Surgery, Bharati Vidyapeeth Deemed University Dental College and Hospital, Sangli, Maharashtra, India
| | - Sandeep Patil
- Department of Oral and Maxillofacial Surgery, Bharati Vidyapeeth Deemed University Dental College and Hospital, Sangli, Maharashtra, India
| | - Swapnil Shinde
- Department of Oral and Maxillofacial Surgery, Bharati Vidyapeeth Deemed University Dental College and Hospital, Sangli, Maharashtra, India
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13
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Garcia AS, Pagin O, da Silva Santos PS, Oliveira DT. Verruciform xanthoma in the hard palate: a case report and literature review. J Korean Assoc Oral Maxillofac Surg 2016; 42:383-387. [PMID: 28053911 PMCID: PMC5206246 DOI: 10.5125/jkaoms.2016.42.6.383] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 04/02/2016] [Accepted: 04/05/2016] [Indexed: 11/20/2022] Open
Abstract
Oral verruciform xanthoma (OVX) is an uncommon lesion that appears on the oral mucosa. The aim of this paper was to discuss the probable etiopathogenesis of OVX in the hard palate, reinforcing the importance of including this lesion in the differential diagnosis of verrucous lesions. A 43-year-old male smoker presented with a painless lesion with a verrucous surface and erythematous spots on the hard palate. Excisional biopsy revealed oral mucosa consisting of hyperkeratosis, acanthosis, and elongated rete pegs. Subjacent connective tissue showed numerous foam cells with clear cytoplasm and pyknotic nucleus, negative on periodic acid-Schiff staining. Immunohistochemical analysis revealed foam cells positive for anti-CD68 antibody, while anti-KI-67 antibody was restricted to the basal layer of the oral epithelium. A final diagnosis of OVX was established. The patient showed no signs of recurrence after seven months of follow-up. Physical trauma and smoking habits can be directly related to the etiology of verruciform xanthoma because the lesion is chronic and inflammatory with slow growth, and sites if high trauma are more often affected by such a lesion. The hard palate is the second most commonly affected site, and local trauma caused by smoking can be a cause of this type of lesion.
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Affiliation(s)
- Alexandre Simões Garcia
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Otávio Pagin
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Paulo Sérgio da Silva Santos
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Denise Tostes Oliveira
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
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14
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Hiraishi Y, Tojyo I, Kiga N, Tanimoto K, Fujita S. A Case of Verruciform Xanthoma Arising in the Tongue. J Clin Diagn Res 2016; 10:ZD07-ZD08. [PMID: 28209012 DOI: 10.7860/jcdr/2016/22157.8965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 09/27/2016] [Indexed: 11/24/2022]
Abstract
Verruciform Xanthoma (VX) is a rare lesion of the oral cavity. Histologically, it is characterized by papillary or verrucous proliferation of squamous epithelium and numerous foam cells. VX arising in the tongue is comparatively rare, as most cases of VX in oral cavity occur in gingiva. A 65-year-old woman was referred to our clinic with a mass on the left side of the tongue. The lesion was yellowish, and its surface was granulated. The patient had neither tenderness nor any symptoms. The lesion was clinically diagnosed to be a benign tumor, and hence, biopsy was performed, according to which it was diagnosed as hyperparakeratosis. Based on this diagnosis, the tumor was excised under general anesthesia. Histopathologically, the tumor consisted of stratified squamous epithelium with parakeratosis and elongated rete ridges. Aggregation of foam cells was observed between and under the rete ridges. From these features, a diagnosis of VX was made. The patient has had no local recurrence as of three years post-operatively.
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Affiliation(s)
- Yukihiro Hiraishi
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Wakayama Medical University , Wakayama, Wakayama Prefecture, Japan
| | - Itaru Tojyo
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Wakayama Medical University , Wakayama, Wakayama Prefecture, Japan
| | - Norifumi Kiga
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Wakayama Medical University , Wakayama, Wakayama Prefecture, Japan
| | - Koji Tanimoto
- Consultant, Department of Oral and Maxillofacial Surgery, Shingu Municipal Medical Center, Shingu , Wakayama Prefecture, Japan
| | - Shigeyuki Fujita
- Professor, Department of Oral and Maxillofacial Surgery, Wakayama Medical University , Wakayama, Wakayama Prefecture, Japan
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15
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Kimura M, Ohto H, Shibata A, Enomoto A, Umemura M. Clinicopathological and Immunohistochemical Characteristics of Verruciform Xanthoma of the Lower Gingiva: A Case Report. J Clin Diagn Res 2016; 10:ZD05-6. [PMID: 27504422 DOI: 10.7860/jcdr/2016/15446.7950] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Accepted: 12/03/2015] [Indexed: 11/24/2022]
Abstract
Verruciform xanthoma (VX) is a rare benign lesion and mainly effects the oral mucosa. This slow-growing asymptomatic lesion typically develops along the gingival margin of the masticatory mucosa, followed by the hard palate, tongue, buccal mucosa, floor of the mouth, alveolar mucosa, soft palate and junction between the hard and soft palate. Moreover, this lesion can also affect the skin and genital organs. Clinically, VX generally presents a sessile or pedunculated appearance, forming a papule or single plaque with verrucous or papillomatous mucosal growth. The colour (white, pink, grey, or yellow) depends on the thickness of the overlying epidermis. In fact, the clinical findings of VX are similar to those of verrucous carcinoma and other benign tumours, such as squamous papilloma, verruca vulgaris and mucosal fibroma. For this reason, clinical and histopathological examinations are essential for accurate differential diagnosis. Histologically, VX is characterized by parakeratosis, rete ridges of uniform depth and the accumulation of foam cells, which are also called "xanthoma cells". Here, we describe the clinicopathological and immunohistochemical findings of a VX located on the lower gingiva of a 64-year-old male patient.
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Affiliation(s)
- Masashi Kimura
- Attending Staff, Department of Dentistry Oral and Maxillofacial Surgery, Ogaki Municipal Hospital , 4-86 Minaminokawa-cho, Ogaki, Gifu, Japan
| | - Hiroyuki Ohto
- Chief, Department of Dentistry Oral and Maxillofacial Surgery, Ogaki Municipal Hospital , 4-86 Minaminokawa-cho, Ogaki, Gifu, Japan
| | - Akio Shibata
- Attending Staff, Department of Dentistry Oral and Maxillofacial Surgery, Ogaki Municipal Hospital , 4-86 Minaminokawa-cho, Ogaki, Gifu, Japan
| | - Atsushi Enomoto
- Associate Professor, Department of Pathology, Nagoya University Graduate School of Medicine , 65 Tsurumai-cho, Showa-ku, Nagoya, Japan
| | - Masahiro Umemura
- Director, Department of Dentistry Oral and Maxillofacial Surgery, Ogaki Municipal Hospital , 4-86 Minaminokawa-cho, Ogaki, Gifu, Japan
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Andreychik C, Bernstein LJ, Elston D. Dermatopathology quiz: Cerebriform papules of the scrotum. Indian Dermatol Online J 2016; 6:416-8. [PMID: 26751781 PMCID: PMC4693356 DOI: 10.4103/2229-5178.169719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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de Andrade BAB, Agostini M, Pires FR, Rumayor A, Carlos R, de Almeida OP, Romañach MJ. Oral verruciform xanthoma: a clinicopathologic and immunohistochemical study of 20 cases. J Cutan Pathol 2015; 42:489-95. [PMID: 25930961 DOI: 10.1111/cup.12500] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 04/05/2015] [Accepted: 04/18/2015] [Indexed: 01/02/2023]
Abstract
Verruciform xanthoma of the oral cavity is an uncommon benign lesion that usually affects the palate and gingiva mainly as a well-circumscribed solitary yellowish to whitish plaque or nodule, which is promptly recognized microscopically by identification of sub-epithelial foamy macrophages. The aim of this study was to evaluate the clinicopathologic and immunohistochemical features of 20 cases of oral verruciform xanthoma. All cases were evaluated by conventional hematoxylin/eosin staining and six of those were submitted to immunohistochemical reactions for CD68, CD63, CD163, syndecan-1 (CD138), S-100 protein and cytokeratins (CK) 8, 14 and 19. Oral verruciform xanthoma presented as yellowish papillary nodules affecting mainly the palate (30%), buccal mucosa (30%) and gingiva (25%) of middle-aged male patients. Most cases presented papillary epithelial hyperplasia and sub-epithelial foamy cells, which were immunopositive for CD68, CD63 and CD163 in all cases. The orange parakeratin superficial layer was negative for CK14 and presented a distinct granular membrane pattern of positivity for CD138. S-100 protein, CK8, and CK19 were negative.
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Affiliation(s)
- Bruno A B de Andrade
- Oral Pathology, Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Michelle Agostini
- Oral Pathology, Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Fábio R Pires
- Oral Pathology, School of Dentistry, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Alicia Rumayor
- Oral Pathology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (FOP-UNICAMP), Piracicaba, Brazil
| | - Román Carlos
- Pathology Section, Centro Clínico de Cabeza y Cuello/Hospital Herrera Llerandi, Guatemala City, Guatemala
| | - Oslei P de Almeida
- Oral Pathology, School of Dentistry, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Mário J Romañach
- Oral Pathology, Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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Oral verruciform xanthoma: a case report and literature review. Case Rep Pathol 2014; 2014:641015. [PMID: 25548705 PMCID: PMC4274645 DOI: 10.1155/2014/641015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 11/24/2014] [Indexed: 11/29/2022] Open
Abstract
Oral verruciform xanthoma represents an uncommon entity, which affects mainly oral mucosa. This paper presents the major clinical and histological features of oral verruciform xanthoma and reports a case on the tongue. The differential diagnosis and a literature review are also provided in light of recent information.
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Aggarwal S, Aggarwal A, Gill S, Bakshi Y, Singh HP. Verruciform xanthoma of oral cavity- a case report. J Clin Diagn Res 2014; 8:FD11-2. [PMID: 25177573 DOI: 10.7860/jcdr/2014/8822.4590] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Accepted: 06/06/2014] [Indexed: 11/24/2022]
Abstract
Verruciform xanthoma is an uncommon benign lesion of undetermined aetiology. It is a superficial normo-lipemic xanthoma, probably reflecting a multifactorial reactive and dystrophic process. Its clinical and pathological recognition and correct diagnosis is critical because it can occur in conjunction with other systemic and cutaneous inflammatory diseases; therefore, it necessitates further clinical assessment. We, hereby report a rare case of verruciform xanthoma in 46-year-old male patient with history of leukemia with emphasis on need of vigilant comprehensive analysis of clinicopathological and immunohistohemical finding to arrive at definitive diagnosis and for better understanding of pathogenesis.
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Affiliation(s)
- Shivani Aggarwal
- Professor & Head, Department of Oral and Maxillofacial Pathology, Manav Rachna Dental College , Faridabad, Haryana, India
| | - Ashim Aggarwal
- Professor & Head, Department of Oral Surgery, Manav Rachna Dental College , Faridabad, Haryana, India
| | - Sharanjeet Gill
- Senior Lecturer, Department of Oral Pathology & Microbiology, Manav Rachna Dental College , Faridabad, Haryana, India
| | - Yujika Bakshi
- Senior Lecturer, Department of Prosthodontics, DJ Dental College , Uttar Pradesh, India
| | - Harkanwal Preet Singh
- Senior Lecturer, Department of Oral Pathology & Microbiology, Dasmesh Institute of Research and Dental Sciences , Faridkot,India
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Hegde U, Doddawad VG, Sreeshyla H, Patil R. Verruciform xanthoma: A view on the concepts of its etiopathogenesis. J Oral Maxillofac Pathol 2014; 17:392-6. [PMID: 24574658 PMCID: PMC3927341 DOI: 10.4103/0973-029x.125205] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Verruciform xanthoma is a very uncommon papillary growth seen chiefly in the oral mucosa. The presence of foam cells in the connective tissue papillae between the epithelial rete ridges forms the hallmark in its diagnosis. There has been wide speculation and various hypotheses put forth in explaining the etiopathogenesis of verruciform xanthoma and the origin of foam cells. This article aims to update the different hypotheses in understanding the pathogenesis of the lesion.
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Affiliation(s)
- Usha Hegde
- Department of Oral Pathology and Microbiology, Jagadguru Sri Shivarathreeshwara Dental College and Hospital (A Constituent College of Jagadguru Sri Shivarathreeshwara University), Mysore, Karnataka, India
| | - Vidya G Doddawad
- Department of Oral Pathology and Microbiology, Jagadguru Sri Shivarathreeshwara Dental College and Hospital (A Constituent College of Jagadguru Sri Shivarathreeshwara University), Mysore, Karnataka, India
| | - Hs Sreeshyla
- Department of Oral Pathology and Microbiology, Jagadguru Sri Shivarathreeshwara Dental College and Hospital (A Constituent College of Jagadguru Sri Shivarathreeshwara University), Mysore, Karnataka, India
| | - Rekha Patil
- Department of Oral Pathology and Microbiology, Jagadguru Sri Shivarathreeshwara Dental College and Hospital (A Constituent College of Jagadguru Sri Shivarathreeshwara University), Mysore, Karnataka, India
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El-Kaissi AMN. Verruciform Xanthoma in Severe Phenytoin-Induced Gingival Overgrowth: A Case Report. Clin Adv Periodontics 2014. [DOI: 10.1902/cap.2012.120107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Moktefi A, De Parades V, Fléjou JF. Xanthome verruciforme anal chez une patiente transplantée hépatique et rénale. Ann Pathol 2013; 33:335-8. [DOI: 10.1016/j.annpat.2013.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Revised: 06/04/2013] [Accepted: 08/30/2013] [Indexed: 10/26/2022]
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Dorankula SPR, Ramani P, Premkumar P, Anuja, Sherlyn HJ. Verruciform xanthoma of the oral cavity - a case report. J Clin Diagn Res 2013; 7:1799-801. [PMID: 24086918 DOI: 10.7860/jcdr/2013/6559.3309] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Accepted: 07/07/2013] [Indexed: 11/24/2022]
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.
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Affiliation(s)
- Shyam Prasad Reddy Dorankula
- Senior lecturer, Department of Oral & Maxillofacial Pathology, Kamineni Institute of Dental Sciences , Narketpally, Nalgonda (dt), Andhra Pradesh, India
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Blankenship DW, Zech L, Mirzabeigi M, Venna S. Verruciform xanthoma of the upper-extremity in the absence of chronic skin disease or syndrome: a case report and review of the literature. J Cutan Pathol 2013; 40:745-52. [PMID: 23656213 DOI: 10.1111/cup.12159] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2012] [Revised: 06/10/2012] [Accepted: 06/12/2012] [Indexed: 11/29/2022]
Abstract
Verruciform xanthoma is a rare, benign lesion classically presenting on the oral mucosa or genital area. The etiology is not yet completely understood; however, verruciform xanthoma is often associated with (a) conditions of chronic inflammation or trauma, such as lichen sclerosis, recessive dystrophic epidermolysis bullosa, and pemphigus vulgaris, as well as in a setting of (b) chronic lymphedema, (c) chronic graft versus host disease, or (d) congenital epidermal nevi, such as those associated with the Congenital Hemidysplasia with Ichthyosiform nevus and Limb Defects (CHILD) syndrome. We report a case of a solitary verruciform xanthoma on the forearm of an 82-year-old man without history of chronic dystrophic skin disease or syndrome. In addition, a thorough literature review of extra-oral and extra-genital verruciform xanthomas is presented. On the basis of this review, we believe this case is an extremely rare presentation of a solitary verruciform xanthoma on the upper-extremity of an otherwise healthy individual.
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El-Kaissi AMN. Verruciform Xanthoma in a Severe Context of Phenytoin-Induced Gingival Overgrowth: a Case Report. Clin Adv Periodontics 2013. [DOI: 10.1902/cap.2013.120107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Bhalerao S, Bhat P, Chhabra R, Tamgadge A. Verruciform xanthoma of buccal mucosa: A case report with review of literature. Contemp Clin Dent 2012; 3:S257-9. [PMID: 23230376 PMCID: PMC3514948 DOI: 10.4103/0976-237x.101109] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Verruciformxanthoma (VX) is an uncommon benign mucocutaneous lesion of unknown etiology. It appears as a papule or single plaque with verrucous or papillomatous surface and variable color from reddish pink to gray. It occurs primarily in the masticatory mucosa. Histologically, VX is characterized by the presence of parakeratinized epithelium with thin rete ridges and connective tissue papillae extending up to the surface. The papillae characteristically consist of foam cells, also called xanthoma cells. We report a case of VX in the buccal mucosa and discuss their clinical and histopathological findings.
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Affiliation(s)
- Sudhir Bhalerao
- Department of Oral and Maxillofacial Pathology and Microbiology, Padmashree Dr. D Y Patil Dental College and Hospital, Sector 7, Nerul, Navi Mumbai, Maharashtra, India
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Ito C, Kitazawac R, Makita K, Watanabe T, Toda A, Haraguchi R, Tanaka S, Kitazawa S. Scrotal cutaneous verruciform xanthoma with monocyte chemoattractant protein-1 immunohistochemical study: a case report. J Med Case Rep 2012; 6:260. [PMID: 22937911 PMCID: PMC3469401 DOI: 10.1186/1752-1947-6-260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Accepted: 06/08/2012] [Indexed: 11/23/2022] Open
Abstract
Introduction Verruciform xanthoma is a rare, benign lesion characterized by hyperkeratosis and aggregates of foam cell macrophages. Here, we describe a case of verruciform xanthoma on the scrotum, in which the immunohistochemical localization of monocyte chemoattractant protein-1, a chemokine of the C-C or beta family that has been shown to induce the recruitment of monocytes for injured tissue, was analyzed to determine which cells release chemoattractants for macrophages. Case presentation A 75-year-old Japanese man with a well-defined nodule on the left scrotum was admitted to the hospital. An excision biopsy revealed epidermal papillary proliferation with parakeratosis, hyperkeratosis, and infiltration of foam cell macrophages, whereby a pathological diagnosis of benign cutaneous verruciform xanthoma was made. Immunohistochemically, monocyte chemoattractant protein-1 was observed predominantly on cytokeratin AE1/AE3-positive differentiating keratinocytes in the prickle cell layer. However, while infiltrating macrophages were densely stained for monocyte chemoattractant protein-1, keratinocytes in the basal and parabasal layers were almost negative. Conclusions We demonstrated that keratinocyte-derived monocyte chemoattractant protein-1 plays an important role in the establishment of particular histological features of verruciform xanthoma. However, in the present case, unlike in previous reports, monocyte chemoattractant protein-1 immunostaining in keratinocytes in the basal and parabasal layers was not prominent. We speculate that in the active phase of verruciform xanthoma, when continuous stimuli that release monocyte chemoattractant protein-1 from keratinocytes to the surrounding stromal area are present, the apparent immunostaining of monocyte chemoattractant protein-1 can be underestimated because of the void created by accelerated keratinocyte release from the cytoplasmic fraction.
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Affiliation(s)
- Chihiro Ito
- Division of Molecular Pathology, Ehime University Graduate School of Medicine, Shitsukawa, Toon City, Ehime, 791-0295, Japan.
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Shahrabi Farahani S, Treister NS, Khan Z, Woo SB. Oral verruciform xanthoma associated with chronic graft-versus-host disease: a report of five cases and a review of the literature. Head Neck Pathol 2011; 5:193-8. [PMID: 21305367 PMCID: PMC3098333 DOI: 10.1007/s12105-011-0246-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2010] [Accepted: 01/27/2011] [Indexed: 12/18/2022]
Abstract
Verruciform xanthoma (VX) is an uncommon benign inflammatory mucocutaneous condition that chiefly occurs in the oral cavity. It is often associated with pre-existing epithelial and/or inflammatory disorder and is characterized histopathologically by papillary epithelial hyperplasia and the presence of foamy macrophages in connective tissue papillae. We report of a series of five cases with VX who concurrently had chronic oral graft-versus-host disease following hematopoietic stem cell transplantation.
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Cumberland L, Dana A, Resh B, Fitzpatrick J, Goldenberg G. Verruciform xanthoma in the setting of cutaneous trauma and chronic inflammation: report of a patient and a brief review of the literature. J Cutan Pathol 2009; 37:895-900. [PMID: 19958440 DOI: 10.1111/j.1600-0560.2009.01470.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We report a rare case of multiple, co-exisitng verruciform xanthomas (VXs) of the anogenital region in the setting of cutaneous trauma. VX is a rare benign mucocutaneous neoplasm that typically presents as a solitary lesion with a predilection for the oral cavity, although extra-oral lesions have been reported involving the vulva, scrotum, penis, anal region and extremities. The etiology and pathogenesis of VX have yet to be determined; however, recent literature has reported that multifocal cutaneous VX are frequently associated with pre-existing inflammatory processes. A significant number of VXs of the skin have been found to co-exist with cutaneous disorders including graft vs. host disease, discoid lupus erythematosus, pemphigus vulgaris, and recessive dystrophic epidermolysis bullosa. Therefore, we speculate severe cutaneous trauma and chronic inflammation may induce epithelial keratinocytes to respond aberrantly leading to epidermal hyperplasia and foamy cell formation characterizing the VX lesion.
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Affiliation(s)
- Lara Cumberland
- Department of Dermatology, Mount Sinai School of Medicine, New York, NY 10029, USA
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Huang KP, Mattoch IW, Sundram UN, Bruckner AL. Warty plaque in a boy with recessive dystrophic epidermolysis bullosa. Pediatr Dermatol 2009; 26:747-8. [PMID: 20199455 DOI: 10.1111/j.1525-1470.2009.01027.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Kathie P Huang
- Department of Dermatology, Stanford University School of Medicine, Stanford, California 94063, USA.
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