Eosinophilic Ulcer Mimicking Spinocellular Carcinoma

Abstract

An eosinophilic ulcer is a benign, rare, and self-limiting lesion of uncertain pathogenesis, easily confused with oral carcinoma. A 49-year-old woman, with no risk factors, presented with a lesion of 5 months evolution. During an intraoral examination, a solitary, oval ulcer that was white in color, with a yellowish background, clear borders, sessile base, painful sensation, on the left posterior border of the tongue was evident. An incisional biopsy was performed and the diagnostic hypothesis was squamous cell carcinoma. Histological sections revealed fragments of mucosa coated with ulcerated pavement epithelium. The lamina propria was fibrosed and exhibited areas of mononuclear and polymorphonuclear inflammatory infiltrate rich in lymphocytes and eosinophils in the muscle fibers. The diagnosis was compatible with eosinophilic ulceration, excluding the possibility of a malignant lesion. The treatment included extraction of the tooth that traumatized the area. After 4 months, partial regression of the lesion was observed.