Spongiotic Gingival Hyperplasia Synchronously Involving Multiple Sites: Case Report and Review of the Literature
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ORIGINAL PAPER
Spongiotic Gingival Hyperplasia Synchronously Involving Multiple Sites: Case Report and Review of the Literature Ioannis Siamantas1 · Eleni‑Marina Kalogirou2 · Konstantinos I. Tosios2 · Ioannis Fourmousis3 · Alexandra Sklavounou2 Received: 9 January 2018 / Accepted: 27 February 2018 © Springer Science+Business Media, LLC, part of Springer Nature 2018
Abstract Localized juvenile spongiotic gingival hyperplasia (LJSGH) is a gingival lesion with unique clinicopathologic features that may involve synchronously multiple sites. We present a case with lesions clinically consistent with LJSGH in four jaw quadrants, confirmed by biopsy and review the English literature on multifocal LJSGH cases. A 19 year-old woman presented with circumscribed, erythematous overgrowths on the right and left maxillary and mandibular gingiva. With the provisional diagnosis of multifocal LJSGH, total excision of four maxillary lesions was performed. Clinical, microscopic and immunohistochemical examination with cytokeratin 19 confirmed the diagnosis of LJSGH in multiple sites. The excised lesions showed partial to complete recurrence after 4 months, while spontaneous regression of all but one lesion was observed after 15 months. Twenty cases with synchronous involvement of the gingiva of at least two teeth were previously reported. Their clinical features were comparable to that of solitary LJSGH. Only one case involved all four jaw quadrants. Spontaneous remission has not been documented before. The recognition of multiple lesions with clinicopathologic features diagnostic of LJSGH in the same adult patient argue against the designations “localized” and “juvenile”. Recurrences are common, while remission might occur. Keywords Spongiotic gingival hyperplasia · Multifocal · Generalized · Localized · Gingivitis
Introduction Localized juvenile spongiotic gingival hyperplasia (LJSGH) is a lesion with unique clinicopathologic features and unclear pathogenesis [1] that was initially described as juvenile spongiotic gingivitis [2]. It is considered as a rare lesion and represented only 0.069% of 31,469 biopsies accessioned in an oral pathology laboratory during a 7-year period [3]. As the name of the lesion implies, it usually affects patients younger than 18 years, in particular in the first 5 years or the second decade of life [1–3]. However, as the * Konstantinos I. Tosios [email protected] 1
Private Practice, Athens, Greece
2
Department of Oral Medicine and Pathology, Dental School, National and Kapodistrian University of Athens, 2 Thivon Street, 11527 Athens, Greece
3
Department of Periodontology, Dental School, National and Kapodistrian University of Athens, 2 Thivon Street, Athens, Greece
age of reported cases ranges from 5 to 39 years [1, 2], the designation juvenile is not always justified. There is a preference for Caucasians [1] and no clear gender predominance [1–3]. Clinically, it presents as a solitary gingival mass with a bright red color and papillary or granular surface, measuring 0.2 to 1 cm in ma
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