%0 Journal Article
%T Idiopathic Orofacial Granulomatosis with Varied Clinical Presentation
%A Rathy Ravindran
%A Anila Karunakaran
%J Case Reports in Dentistry
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/701749
%X Orofacial granulomatosis is a granulomatous disease of orofacial region, which can occur for a variety of reasons. The clinical features are highly variable and sometimes so insidious that signs and symptoms are not frequently severe to cause alarm. The lips are most commonly involved with persistent/recurrent swelling. The medical history is very important as Crohn¡¯s disease and sarcoidosis can present oral manifestation. Other causes like mycobacterial infection, foreign body reaction, fungal infection, and allergy were excluded with further investigation to establish diagnosis. Here and we report a case of orofacial granulomatosis with a review of the literature. 1. Introduction Orofacial granulomatosis (OFG) is a chronic inflammatory disorder characterized by persistent or recurrent soft tissue enlargement, oral ulceration, and a variety of orofacial features. The term orofacial granulomatosis was proposed by Wiesenfield et al. in 1985. Focal granulomas may occur anywhere in the oral mucosa or in the subcutaneous tissue of the skin where they present as localized firm mass that are occasionally multinodular. When diagnosis of noncaseating granuloma is made microscopically, the patient should be evaluated for several systemic diseases such as crohn¡¯s disease, sarcoidosis, TB and the local processes (Table 1) that may be responsible for similar oral lesion has to be ruled out. Orofacial granulomatosis is a term which encompasses variety of clinical presentation that upon biopsy reveal presence of nonspecific granulomatosis inflammation. Here we report a case of idiopathic orofacial granuloma and the etiology, diagnostic approach and treatment of orofacial granulomatosis reviewed. Table 1: Oral granuloma. 2. Case Report A 40-year-old male patient reported to our OPD with complaint of swelling of lower lip. The patient gave a history of similar swelling 8 months back which was biopsied at another hospital and the report is unavailable. The medical history was noncontributory. Intraoral examination revealed diffuse swelling of lower lip (Figure 1). On palpation the swelling was nodular with diffuse margin, soft to firm in consistency. A provisional diagnosis of mucocele was made. Routine hematological examination was performed and all were with normal limits. Biopsy of the lip lesion revealed circumscribed aggregates of noncaseating granulomatous inflammation consisting of lymphocyte and epithelioid histiocytes with multinucleated giant cells. The granuloma consists of central aggregates of histiocytes with peripheral rim of inflammatory cells chiefly
%U http://www.hindawi.com/journals/crid/2013/701749/