Case of thromboangiitis obliterans (Buerger's disease) of the upper lip

Abstract

Clinical symptoms of orofacial thromboangiitis obliterans may be misdiagnosed because this disease is described mainly as a segmental inflammatory and proliferative process of the tunica media of distal arteries and veins of the extremities together with obliteration by organized thrombus. In 1879, Felix von Winwarter gave the first description of a disease that is comparable with thromboangiitis obliterans, naming it endarteritis obliterans.’ Later, in 1908, Leo Buerger described occlusive inflammatory changes in arteries and veins of amputated lower extremities, and referred to the process as responsible for thromboangiitis obliterans.’ This phenomenon is also known as Buerger’s disease. Thromboangiitis obliterans is characterized by a predominant appearance in men before the age of ‘40 years. The pathogenesis has not been determined, although most of these patients are heavy tobacco smokers. Other etiological factors have been suggested as possible causes of thromboangiitis obliterans: genetic predisposition, autoimmune factors, infections, trauma and cold injuries.3‘7 Most cases of thromboangiitis obliterans present with ischaemia of the lower extremities, but with progression of the disease, the upper extremities may also become involved. Although the number of reported cases of thromboangiitis obliterans has decreased precipitously over the past 3 decades in North America, large numbers of such patients con-