Oral verruciform xanthoma: Report of 13 new cases and review of the literature

Abstract

BackgroundOral 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 MethodsThirteen 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.ResultsThe 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.ConclusionsVerruciform 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. Key words:Oral verruciform xanthoma, oral tumors.

CD163+ Foamy Macrophages Are Associated with the Morphogenesis of Oral Verruciform Xanthoma through Angiogenesis by VEGF Expression: An Immunohistochemical Study

“…According to previous reports, the incidence rate of OVX within a 12-year-period was 0.025%-0.094% [19,20]. In a study by Tamiolakis et al (2018), 13 patients with OVX represented approximately 0.04% of 35,617 samples accessioned from 1971 to 2017 [21]. In this study, approximately 0.06% of 6499 cases were histologically confirmed as being OVX.…”

HPV-Related Papillary Lesions of the Oral Mucosa: A Review

“…The clinical and histologic differential diagnosis includes papillary lesions of various etiologies, including benign and [21]. VX and SP appear similarly to VV, and are best distinguished by histology [21].…”

“…The clinical and histologic differential diagnosis includes papillary lesions of various etiologies, including benign and [21]. VX and SP appear similarly to VV, and are best distinguished by histology [21]. VXs are sessile lesions that sometimes impart a yellow hue and are more likely to occur on the gingiva [21].…”

“…VX and SP appear similarly to VV, and are best distinguished by histology [21]. VXs are sessile lesions that sometimes impart a yellow hue and are more likely to occur on the gingiva [21]. Histologically, they are differentiated by the presence of foamy, lipid-laden histiocytes within fibrovascular cores [21].…”

“…VXs are sessile lesions that sometimes impart a yellow hue and are more likely to occur on the gingiva [21]. Histologically, they are differentiated by the presence of foamy, lipid-laden histiocytes within fibrovascular cores [21]. These "xanthoma cells," in combination with orange parakeratin plugging of crypts, are characteristic [21].…”