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Oral pigmented lesions can be physiological or pathological, exogenous or endogenous, as well as focal, multifocal, or diffuse. Among them, the oral melanotic macule (OMM) is a small, well-delimited brown-to-black macule, often affecting the lip and gingiva. Amalgam tattoo (AT) is a grey or black area of discoloration on the oral mucosa as a result of entry of dental amalgam into the soft tissues, commonly gingiva and alveolar ridge. Herein, we present a patient with gingival pigmentation with features of both OMM and AT in the same location.

Several cases of elastofibromatous lesion affecting the oral mucosa have been reported. Clinically, these lesions may appear as small exophytic lesions or less often as white lesions. Therefore, fibrous hyperplasia and leukoplakia are not uncommonly considered in clinical differential diagnosis. Microscopically, elastic and fibrous connective tissue deposition is seen. Rarely, elastofibromatous changes can be detected when assessing intraoral lesions, including cysts, salivary gland neoplasms, and epithelial dysplasia. Here we report two oral lesions showing elastofibromatous changes, expanding their clinicopathological spectrum. The first case was a 46‐year‐old man with a history of asymptomatic nodular lesion on the palate 1 year ago, diagnosed as giant cell fibroma with elastofibromatous changes. The second case was a 79‐year‐old woman who presented a pigmented and mildly symptomatic lesion on the mandibular alveolar mucosa several months ago, diagnosed as amalgam tattoo associated with elastofibromatous changes. [ABSTRACT FROM AUTHOR]

This article discusses a case report of a rare finding of intraoral epithelioid and spindle cell hemangioma associated with pseudoepitheliomatous hyperplasia (PH). Epithelioid hemangioma (EH) is a benign vascular tumor that typically affects the skin and subcutaneous tissue. In this case, a 58-year-old male patient presented with an asymptomatic gingival lesion. The lesion was surgically removed, and the patient experienced complete healing after 2 months of follow-up. The article provides a detailed analysis of the histopathological features and immunohistochemical findings of the lesion. Treatment for oral EH is typically surgical excision, and the prognosis is usually good. [Extracted from the article]

Xanthomas are microscopically characterized by localized infiltrates of lipid-laden macrophages, usually on the skin and mucosal surfaces (respiratory and gastrointestinal tracts).1-8 Cutaneous xanthoma in particular may represent a localized idiopathic phenomenon or systemic hyperlipidemia.3 While several types of cutaneous xanthomas have been described in the literature,1,2 those affecting the respiratory and gastrointestinal tracts are usually named "xanthomas."3-8 Recent studies have also reported xanthomas at intraosseous locations, affecting the jaws.9-11 Interestingly, xanthomas, as described in the respiratory and gastrointestinal tracts,3-8 have not been reported in the oral mucosa. Microscopic examination (H&E stain) revealed exuberant foam cell proliferation in the superficial part, permeated by lymphomononuclear infiltrate (B, ×100; C, ×400). JXG is a histiocytic disorder with frequent cutaneous involvement.14-16 Microscopically, JXG exhibits a proliferation of histiocytes with a foamy, eosinophilic, and vacuolated cytoplasm, often admixed with Touton-type giant cells. Microscopic examination revealed exuberant foam cell proliferation, with foci of lymphomononuclear infiltrate, in close contact with normal-appearing surface squamous epithelium. [Extracted from the article]

Oral pigmented lesions can be physiological or pathological, exogenous or endogenous, as well as focal, multifocal, or diffuse. Among them, the oral melanotic macule (OMM) is a small, well-delimited brown-to-black macule, often affecting the lip and gingiva. Amalgam tattoo (AT) is a grey or black area of discoloration on the oral mucosa as a result of entry of dental amalgam into the soft tissues, commonly gingiva and alveolar ridge. Herein, we present a patient with gingival pigmentation with features of both OMM and AT in the same location. [ABSTRACT FROM AUTHOR]

Since the publication of Potter et al,[1] few oral cases of elastofibroma, hyperelastosis, and elastofibromatous lesions have been reported in the literature.[[2]] Notably, to date, four cases clinically presenting as leukoplakia, and microscopically diagnosed as elastofibromatous changes, have been published.[[2], [4]] Here, we report two additional cases, which presented with a whitish lesion in the oral mucosa and diagnosed as elastofibromatous lesion, expanding its clinicopathological spectrum. Elastofibroma and elastofibromatous lesion of the oral cavity are tumor-like lesions composed of elastic and fibrous connective tissue, which may represent a reactive process associated with friction irritation or trauma.[[1]] Several cases of oral elastofibroma[[1]] and oral elastofibromatous lesion[[4]] have been published. In summary, oral elastofibromatous lesion is a rare lesion, which can present as a mass or polyp or, infrequently, as a white lesion. [Extracted from the article]

The low‐fat and fat‐free spindle cell lipomas (SCLs) are rare and often mistaken for other benign and malignant morphological mimics, because of the fact that the diagnosis relies on its non‐lipogenic component analysis. Here, we report the clinicopathological features of two oral SCLs (low‐fat and fat‐free variants). Both lesions presented clinically as an asymptomatic nodule, which initially yielded diagnostic difficulties on the morphological analysis alone. One case was diagnosed as low‐fat SCL on the lower lip in a 29‐year‐old man, and the other as fat‐free SCL on the buccal mucosa in a 46‐year‐old man. In both cases, immunohistochemistry showed strong positivity for CD34 and, remarkably, retinoblastoma (Rb) protein was deficient. Mast cell (MC) tryptase and toluidine blue stain highlighted numerous MCs distributed throughout all tumor stroma. Alpha‐SMA and desmin were negative. S100 evidenced scarce adipocytes only in the low‐fat SCL case. Conservative surgical treatment was performed and no recurrence was noticed in about 2‐year of follow‐up in both cases. Because of the potential pitfalls, careful morphological analysis of the tumor stroma in the low‐fat/fat‐free SCL diagnosis, supported by immunohistochemistry (especially CD34, Rb and MC tryptase), is strongly recommended. To the best of our knowledge, these are the first and second cases reported of fat‐free and low‐fat SCL in the oral cavity. [ABSTRACT FROM AUTHOR]

We report a case of atypical oral hairy leukoplakia (OHL) in a 9‐year‐old immunocompetent girl treated with fluticasone propionate nasal spray for allergic rhinitis. The OHL in childhood is uncommon and should be included in a differential diagnosis of white lesions in the oral mucosa. [ABSTRACT FROM AUTHOR]

Epithelioid angiomatous nodule (EAN) is a rare benign vascular proliferation, regarded as part of the morphologic spectrum of benign and malignant epithelioid vascular lesions. EAN is a rare lesion affecting the oral mucosa and, to date, only three cases have been reported in the English-language literature. We report the second EAN case affecting the gingival mucosa of a 69-year-old female patient. Oral examination revealed an asymptomatic, well-defined nodule exhibiting a smooth and erythematous surface, measuring 0.8 cm in greater diameter. The lesion was fully excised and histopathological study showed a mucosal epithelioid proliferation with solid and organoid growth patterns, and vascular lumens scattered focally throughout the lesion. The large epithelioid cells showed intracytoplasmic vacuoles and vesicular nuclei with prominent nucleoli, surrounding by scarce extravasated erythrocytes. Immunohistochemistry showed positivity for vimentin, α-SMA, CD34, focally for D2-40, and Ki-67 was 15%. Noteworthy, numerous immune cells (HLA-DR+/CD68+/CD163+/FXIIIa + ) scattered throughout the lesion, were detected. To the best of our knowledge, this is the first report, which highlights the immune cell population, with M2-like phenotype, as an important component of EAN, suggesting the participation on their etiopathogenic mechanisms. [ABSTRACT FROM AUTHOR]

Pleomorphic lipomas are extremely rare in the oral cavity. Due to the significant overlap of morphological findings with several benign and malignant soft tissue tumors, especially in the absence of adipocytes, the diagnosis is challenging. We reported the clinicopathological and immunohistochemical features of an uncommon case of a fat-free variant of pleomorphic lipoma in a 48-year-old female presenting clinically as a painless nodule on the buccal mucosa. Microscopically, the lesion showed atypical spindle cells, numerous floret-like giant multinucleated cells, and abundant ropey collagen fibers bundles. Immunohistochemistry showed strong positivity for vimentin and CD34. Mast cell tryptase highlighted numerous mast cells distributed throughout all tumor stroma. S-100 protein, pan-cytokeratin, desmin, α-SMA, EMA, CD68, STAT6, Bcl-2, MDM2, and CDK4 were negative. Conservative surgical excision was carried out, and no recurrence was observed after 13 months of follow-up. Careful histopathological and immunohistochemistry analysis of these lesions is recommended to ensure the correct diagnosis and provide adequate management through a conservative surgical approach. To the best of our knowledge, this is the second case of fat-free pleomorphic lipoma in the oral cavity. [ABSTRACT FROM AUTHOR]