Verruciform Xanthoma in Severe Phenytoin‐Induced Gingival Overgrowth: A Case Report. Issue 2 (1st May 2014)

• Record Type: Journal Article
• Authors: El‐Kaissi, Abdel‐Magid N.
• Is Part Of: Clinical advances in periodontics. Volume 4:Issue 2(2014)
• Page Start: 99
• Page End: 104
• Publication Date: 2014-05-01
• Subjects: Gingival hyperplasia -- immunosuppression -- neoplasms -- phenytoin -- xanthomatosis; Periodontics -- Periodicals; Periodontics; Periodontics; Periodicals; Periodicals; 617.632
• DOI: 10.1902/cap.2012.120107
• Languages: English
• ISSNs: 2573-8046

Abstract

Abstract : Introduction: Phenytoin is involved in drug‐induced gingival overgrowth (GO), with a prevalence rate reaching 50%. In the literature, tumorigenic implication has been discussed with this form of hyperplasia with considerable controversy. To the author's knowledge, this is the first report since 1971 of a combined phenytoin‐induced hyperplasia with verruciform xanthoma (VX). The importance of differentiating this lesion from classic hyperplasia is emphasized in this case report. Case Presentation: A 23‐year‐old male presented with an advanced case of GO attributable to prolonged intake of phenytoin. Oral examination showed total coverage of the dentition, with one unusual cauliflower‐like lesion. Surgery was performed and a biopsy was taken. Histopathologic examination revealed the diagnosis of VX. No recurrence of the disease was evident 12 months after therapy. Conclusions: The definitive pathogenesis of GO and VX is under discussion and some similarities and possible immunologic interactions that might determine the correct sequence of events can be found. The most relevant differential diagnosis of VX is squamous cell carcinoma, which needs to be detected as early as possible. Although no malignancy was found in this case, VX could be a potentially premalignant lesion.