Submucosal calcified nodule of the lower lip: report of a case

Abstract

Background The subepidermal calcified nodule is a form of idiopathic calcinosis cutis that affects children and is occasionally present at birth. The most common locations are the extremities and the face. The oral and perioral regions are very rarely affected by calcinosis cutis of any type. Case report A 1-year-old white girl was referred to the Department of Oral Medicine and Maxillofacial Pathology of the School of Dentistry, Aristotle University, Thessaloniki, Greece, for evaluation of a white hard nodular lesion that had been present on her lower lip since birth. The patient had no history of connective tissue disease or calcium and phosphorus abnormalities. The nodule was surgically excised and was histopathologically and immunohistochemically examined. The sections stained with H&E revealed a cystic lesion filled with calcified material. A thin layer of inflammatory and epithelioid cells was arranged around the calcium deposits. Immunohistochemically these cells were CD68-positive and negative to keratins. These findings were compatible with a diagnosis of submucosal calcified nodule. Conclusion The subepidermal calcified nodule is characterized by the presence of calcified material which is usually located in the uppermost lamina propria. The calcium is present as irregular granules and globules. The exact mechanism that leads to excessive calcification is not clear.