Traumatic ulcerative granuloma with stromal eosinophilia: Review of the literature and case report

Abstract

Traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) is an ulcerative condition of the oral mucosa with a chronic course and delayed healing. It is a reactive lesion that commonly affects the tongue. TUGSE is a relatively uncommon mucosal lesion that presents as an ulcer or an indurated submucosal mass and may cause diagnostic dilemma for the dental surgeon as it mimics a traumatic or neoplastic ulcer the pathogenesis of this lesion is obscure; however, chronic irritation from traumatic agents is considered to be a major initiating factor. The lesion is also known to undergo resolution following incisional biopsy. Histopathologically, it is characterized by eosinophilic inflammatory infiltrate penetrating into the underlying muscle. It is important to recognize this mucosal lesion as it mimics malignant ulcers and other ulcerative conditions of the oral cavity; however, the condition tends to resolve on its own. The lesion is also known to undergo resolution following incisional biopsy. Immunohistochemical positivity to CD30 found in nonneoplastic cutaneous conditions rich in neutrophils and eosinophils suggest CD30 cells as components of a reactive process. This is a review and report of a 37-year-old Nigerian woman who with an ulceroproliferative growth in the left side of the mouth. The aim of this article is to describe the presentation of TUGSE so as to enhance prompt diagnosis and rule lesions such as traumatic ulcer or squamous cell carcinoma of the tongue that may present in a similar way.