Abstract
Median rhomboid glossitis could present histologic features of pseudoepitheliomatous hyperplasia (PEH). An 82-year-old white man presented with a wound in the tongue dorsum. The lesion presented an erythroleukoplakia appearance, well-defined borders, and ardency symptom. An incisional biopsy was performed based on the clinical diagnosis of oral squamous cell carcinoma (OSCC). Microscopic analysis showed a hyperplastic benign epithelium, few mitotic figures, and keratin pearls. Absence of vascular, lymphatic, and perineural invasion was noted. Because PEH resembles systemic diseases, systemic conditions were excluded by laboratory tests. The immunohistochemistry analyses by ki-67 revealed nuclear positivity limited to basal cells. The histopathological features were compatible with median rhomboid glossitis. The patient was treated with oral hygiene instruction and topical antifungal. The patient remains in a follow-up of 7 months. In conclusion, the distinction between PEH and OSCC is necessary to avoid inappropriate therapy and to reach a correct histologic and clinical diagnosis.
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