Aggressive localized juvenile spongiotic gingival hyperplasia (LJSGS) in a 33-year-old patient
a case report
DOI:
https://doi.org/10.5935/2525-5711.20230213Keywords:
Gingiva, Gingival Diseases, Gingival Hyperplasia, Pathology, OralAbstract
The aim of this study is to report a case of an extensive and aggressive gingival lesion, compatible with localized juvenile spongiotic gingival hyperplasia (LJSGH), demonstrating the difficulties of diagnosis and management. A 33 years-old male patient was referred to Department of Oral and Maxillofacial Surgery at the Erasto Gaertner Hospital with a lesion on anterior maxillary gingiva, with 3-months evolution period. The patient had complete permanent dentition and good oral hygiene. The gingival hyperplasia involved the gums of teeth 11 and 12, and was solitary, asymptomatic, red, flaccid and bleeding on palpation. No palpable lymph nodes were found. An incisional biopsy was performed, with anatomopathological result of “squamous mucosa with pseudoepitheliomatous hyperplasia and lymphoplasmocytic infiltrate with neutrophils”. The lesion was fully excised and the anatomopathological report confirmed the biopsy showing no malignancy in the sample and negative for the investigation of fungus. Biofilm control, mouth rinses with hydrogen peroxide, Chlorhexidine Digluconate 0.12% and Amoxicilin 500mg+Potassium Clavulanate 125mg have not demonstrated efficacy, and the patient kept showing recurrence of the lesion in short time even after the complete excision. Against this situation, the patient was referred to an infectologist, by the suspicion of a resistant microorganism. He started antibacterial therapy with Sulfamethoxazole 800mg+Trimethoprim 160mg that showed good results after 3 months. Currently, the patient remains in follow-up without signs of recurrence. LJSGH is a clinicopathological benign entity that appears in young patients as a soft, bleeding and reddish mass, mainly in the buccal gingiva of the upper anterior maxilla and lonely in most cases. The management of this condition is very difficult because of the few cases described in literature, and establishing the correct diagnosis is essential to ensure that the appropriate treatment is followed.
References
Wang MZ, Jordan RC. Localized juvenile spongiotic gingival hyperplasia: a report of 27 cases. J Cutan Pathol. 2019 Nov;46(11):839-43.
Vieira DL, Leite AF, Figueiredo PTS, Vianna LM, Moreira-Mesquita CR, Melo NS. A conservative approach for localized spongiotic gingivitis hyperplasia using photodynamic therapy: a case report and review of the literature. Photobiomodulation, Photomedicine Laser Surg. 2019 Jan;37(1):57-61. DOI: https://doi.org/10.1089/photob.2018.4454
Kalogirou EM, Chatzidimitriou K, Tosios KI, Piperi EP, Sklavounou A. Localized juvenile spongiotic gingival hyperplasia: report of two cases. J Clin Pediatr Dent. 2017;41(3):228-31. DOI: https://doi.org/10.17796/1053-4628-41.3.228
Darling MR, Daley TD, Wilson A, Wysocki GP. Juvenile spongiotic gingivitis. J Periodontol. 2007;78(7):1235-40.
Chang JYFC, Kessler HP, Wright JM. Localized juvenile spongiotic gingival hyperplasia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Sep;106(3):411-8.
Lafuente-Ibáñez IM, Alberdi-Navarro J, Marichalar-Mendia X, Mosqueda-Taylor A, Aguirre-Urizar JM. Characterisation of juvenile spongiotic gingival hyperplasia as an entity of odontogenic origin. J Periodontol. 2019 Dec;90(12):1490-5. DOI: https://doi.org/10.1002/JPER.19-0022
Theofilou VI, Pettas E, Georgaki M, Daskalopoulos A, Nikitakis NG. Localized juvenile spongiotic gingival hyperplasia: microscopic variations and proposed change to nomenclature. Oral Surg Oral Med Oral Pathol Oral Radiol. 2021 Mar;131(3):329-38. DOI: https://doi.org/10.1016/j.oooo.2020.10.024
Allon I, Lammert KM, Iwase R, Spears R, Wright JM, Naidu A. Localized juvenile spongiotic gingival hyperplasia possibly originates from the junctional gingival epithelium - an immunohistochemical study. Histopathology. 2016 Mar;68(4):549-55.
Innocentini LMAR, Santos TT, Reis MBL, Mandetta CMR, Santos RMC, Mesquita RA, et al. Juvenile spongiotic gingival hyperplasia: clinicopathological features of eight cases and a literature review. Oral Health Prev Dent. 2020;18:953-8. DOI: https://doi.org/10.3290/j.ohpd.a45435
Argyris PP, Nelson AC, Papanakou S, Merkourea S, Tosios KI, Koutlas IG. Localized juvenile spongiotic gingival hyperplasia featuring unusual p16INK4A labeling and negative human papillomavirus status by polymerase chain reaction. J Oral Pathol Med. 2014 Jan;44(1):37-44.
Vargo RJ, Bilodeau EA. Reappraising localized juvenile spongiotic gingival hyperplasia. J Am Dent Assoc. 2019;150:147-153.e2.
Nogueira VKC, Fernandes D, Navarro CM, Giro EMA, Almeida LY, León JE, et al. Cryotherapy for localized juvenile spongiotic gingival hyperplasia: preliminar findings on two cases. Int J Paediatr Dent. 2017;27(3):231-35. DOI: https://doi.org/10.1111/ipd.12278
Solomon LW, Trahan WR, Snow JE. Localized juvenile spongiotic gingival hyperplasia: a report of 3 cases. Pediatr Dent. 2013;35(4):360-3.
Silva BSF, Silva Sant'Ana SS, Watanabe S, Vencio EF, Roriz VM, Yamamoto-Silva FP. Multifocal red bands of the marginal gingiva. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2015;119(1):3-7. DOI: https://doi.org/10.1016/j.oooo.2014.07.005
Fernandes DT, Wright JM, Lopes SMP, Santos-Silva AR, Vargas PA, Lopes MA. Localized juvenile spongiotic gingival hyperplasia: a report of 4 cases and literature review. Clin Adv Periodontics. 2018 Feb;8(1):17-21. DOI: https://doi.org/10.1902/cap.2017.170018
Siamantas I, Kalogirou EM, Tosios KI, Fourmousis I, Sklavounou A. Spongiotic gingival hyperplasia synchronously involving multiple sites: case report and review of the literature. Head Neck Pathol. 2018;12:517-21. DOI: https://doi.org/10.1007/s12105-018-0903-9
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Joana Leticia Vendruscolo, Kariana Wan-Dall Gonçalves, Juliana Lucena Schussel, Laurindo Moacir Sassi
This work is licensed under a Creative Commons Attribution 4.0 International License.
