GINGIVAL GLANDULAR ODONTOGENIC CYSTS OR GINGIVAL SALIVARY GLAND CHORISTOMA? AN UNUSUAL CASE

Abstract

The gingival injures have a multifactorial etiology as hormonal influences, trauma, bacterial plaque, and rests derived from odontogenic epithelium that can cause different developmental or odontogenic anomalies. Objective: To show an unusual case with presence of ectopic glandular tissue in gingiva. Medical description: A 72-year-old woman with a medical history of mastectomy 6 years ago, presents with a swelling above the alveolar ridge at the level of the right lower premolar, translucent, fluctuating, asymptomatic, of 2 months’ duration. Radiography description: Root tip with endodontic treatment; diffuse radiolucent cervical area extending 3 mm on each side. Histopathology description: Cuts of 5 µm, from excisional biopsy, stained with hematoxylin and eosin (H & E) observed in magnitude 10 x and 40 x; a bilayer epithelium, eosinophilic cuboidal cells with a sometimes-ciliated glandular appearance, band of fibrous tissue and chronic inflammatory infiltrate. Other histochemical stains: The Alcian blue–stained epithelial structures with mucinous content, and the periodic acid-Schiff (PAS) was not observed. Conclusion: Ectopic glandular tissue in the gingiva is rare and might be related to glandular odontogenic cyst (found more often intraosseous, this case is in the alveolar ridge) or gingival salivary gland choristoma, a mature tissue in ectopic location. Therefore, pluripotential embryonic epithelial cells can develop into glandular tissue. Collaboration: Pathology Institute Mejia Jimenez (Cali, Colombia). The gingival injures have a multifactorial etiology as hormonal influences, trauma, bacterial plaque, and rests derived from odontogenic epithelium that can cause different developmental or odontogenic anomalies. Objective: To show an unusual case with presence of ectopic glandular tissue in gingiva. Medical description: A 72-year-old woman with a medical history of mastectomy 6 years ago, presents with a swelling above the alveolar ridge at the level of the right lower premolar, translucent, fluctuating, asymptomatic, of 2 months’ duration. Radiography description: Root tip with endodontic treatment; diffuse radiolucent cervical area extending 3 mm on each side. Histopathology description: Cuts of 5 µm, from excisional biopsy, stained with hematoxylin and eosin (H & E) observed in magnitude 10 x and 40 x; a bilayer epithelium, eosinophilic cuboidal cells with a sometimes-ciliated glandular appearance, band of fibrous tissue and chronic inflammatory infiltrate. Other histochemical stains: The Alcian blue–stained epithelial structures with mucinous content, and the periodic acid-Schiff (PAS) was not observed. Conclusion: Ectopic glandular tissue in the gingiva is rare and might be related to glandular odontogenic cyst (found more often intraosseous, this case is in the alveolar ridge) or gingival salivary gland choristoma, a mature tissue in ectopic location. Therefore, pluripotential embryonic epithelial cells can develop into glandular tissue. Collaboration: Pathology Institute Mejia Jimenez (Cali, Colombia).