EOSINOPHILIC ULCER MIMICKING FLOOR OF MOUTH SQUAMOUS CELL CARCINOMA

Abstract

A 50-year-old woman sought health care, complaining of a growing lesion below the tongue, with approximately 2 months of evolution, including problems with speech and swallowing. She was a non-smoker and non-alcoholic patient, with a history of breast cancer at age 37, with a cured outcome but without periodic follow-up. Clinical examination revealed an ulcerated lesion (± 3cm) with hard edges and a necrotic center, located on the left floor of the mouth and base of the tongue, asymptomatic on palpation. The clinical diagnostic hypothesis was squamous cell carcinoma. Incisional biopsy was performed. Microscopic analysis revealed hyperparakeratinized and hyperplastic squamous epithelium, with an extensive area of ulceration and granulation tissue with intense eosinophilic infiltrate in the submucosa. The final diagnosis was an eosinophilic ulcer. The 15-day follow-up revealed a spontaneous regression of more than two thirds of the lesion. Final diagnosis was made through the correlation of clinical and microscopic findings, confirming an eosinophilic ulcer lesion. A 50-year-old woman sought health care, complaining of a growing lesion below the tongue, with approximately 2 months of evolution, including problems with speech and swallowing. She was a non-smoker and non-alcoholic patient, with a history of breast cancer at age 37, with a cured outcome but without periodic follow-up. Clinical examination revealed an ulcerated lesion (± 3cm) with hard edges and a necrotic center, located on the left floor of the mouth and base of the tongue, asymptomatic on palpation. The clinical diagnostic hypothesis was squamous cell carcinoma. Incisional biopsy was performed. Microscopic analysis revealed hyperparakeratinized and hyperplastic squamous epithelium, with an extensive area of ulceration and granulation tissue with intense eosinophilic infiltrate in the submucosa. The final diagnosis was an eosinophilic ulcer. The 15-day follow-up revealed a spontaneous regression of more than two thirds of the lesion. Final diagnosis was made through the correlation of clinical and microscopic findings, confirming an eosinophilic ulcer lesion.