摘要
Abstract
Objective To explore the clinical and pathological characteristics,diagnosis,and differential diagnosis of oral verruciform xanthoma,and to provide a reference for accurate clinical identification and treatment.Methods Two cases of verruciform xanthoma occurring on the gingiva and vestibular mucosa are reported.The clinical features and pathological characteristics of both cases are described in detail,and information from a literature review on verruci-form xanthoma is provided.Results Case 1:a 37-year-old female patient presented with a pink,rough lesion on the gingiva of the right mandibular posterior teeth for one month.The lesion measured approximately 14 mm×7 mm,and it was firm and painless.After periodontal therapy,the lesion was excised under local anesthesia.Postoperative pathologi-cal examination showed that the epithelial nail protruded and was elongated,and a large number of foam cells filled the connective tissue papilla,leading to the diagnosis of verrucous xanthoma.Case 2:a 36-year-old male patient presented with a pale pink lesion on the right lower vestibular mucosa for three months.The lesion measured approximately 18 mm×10 mm with irregular margins,and it was firm and painless.The lesion was excised under local anesthesia,and postoperative pathological examination showed parateratosis of epithelium,hypertrophy and elongation of the nail pro-cess,and more foam cells in the lamina propria papilla area.The diagnosis was xanthoma verrucosa.The results of a lit-erature review show that the incidence of verruciform xanthoma is 0.025%-0.094%,it primarily occurs in patients aged 50-70 years,the incidence in males is slightly higher than that in females,and it primarily occurs in areas of the oral cavity that include the hard palate and gums.It is generally non-invasive.The etiology and pathogenesis remain unclear.Clinically,verruciform xanthoma lacks specific characteristics,so these lesions are frequently misdiagnosed as other conditions,such as papilloma,common warts,condyloma acuminatum,squamous cell carcinoma,or verrucous carcino-ma.The key to diagnosis lies in histopathology,with the hallmark feature being the accumulation of foam cells in the connective tissue papilla beneath the epithelium.Conclusion Verruciform xanthoma is a rare oral mucosal lesion with non-specific clinical manifestations and a high rate of misdiagnosis.It must be differentiated from conditions that in-clude squamous papilloma,common warts,condyloma acuminatum,squamous cell carcinoma,and verrucous carcinoma.Definitive diagnosis depends on histopathological examination,and the primary treatment is surgical excision,with a low recurrence rate and minimal risk of malignant transformation.关键词
疣状黄瘤/口腔黏膜病变/下颌牙龈/前庭沟/人乳头状瘤病毒/寻常疣/尖锐湿疣/鳞状细胞癌/疣状癌Key words
verruciform xanthoma/oral mucosal lesions/mandibular gingiva/vestibular sulcus/human papil-lomavirus/common warts/condyloma acuminatum/squamous cell carcinoma/verrucous carcinoma分类
口腔医学
