ARTICLE IN PRESSYBJOM-4443; No. of Pages 3
British Journal of Oral and Maxillofacial Surgery xxx (2015) xxx–xxx
Available online at www.sciencedirect.com
Primary oral leishmaniasis mimicking report
A. Celentano a,∗, E. Ruoppo a, G. Mansueto b, M.D. Mignogna a a Department ersity Federico II of Naples, Italy b Department tics, Pathology Section, University Federico II of Naples, Italy
Accepted 27 J
Primary mu unocompetent patients. We present a 50-year-old patient with a 6-week hi ancer. The exophytic lesion looked invasive, and we took an incisional bi as unexpected, and the patient was successfully treated with amphoterici rrence. Chronic exophytic and ulcerated mucosal lesions that do not heal w r, but primary oral leishmaniasis can easily mimic it. © 2015 The by Elsevier Ltd. All rights reserved.
Keywords: Exophytic lesion; Infectious diseases; Mucosal leishmaniasis; Oral cancer; Oral leishmaniasis
Leishmania are classifi neous, and head and can imitate neoplasms.
We pres white man six-week h mucosa, w smoker and of Naples, and had no of pain, sp ∗ Correspon and Odontost
Pansini n.5, N
E-mail a elvira.ruoppo (G. Mansueto http://dx.doi.o 0266-4356/© this article in press as: Celentano A, et al. Primary oral leishmaniasis mimicking oral cancer: a case report. Br J Oral Maxillofac ), http://dx.doi.org/10.1016/j.bjoms.2015.01.021 ses are neglected tropical parasitic diseases that ed clinically into three forms, visceral, cutamucosal leishmaniasis.1,2 They can all affect the neck region with primary mucosal lesions that a wide range of oral infectious diseases and 1–3 ent the case of a 50-year-old, immunocompetent, who was referred to us in January 2014 with a istory of a symptomatic lesion of the left buccal hich looked malignant (Fig. 1) He was a heavy had no contributory history. He was from an area
Southern Italy, where leishmaniasis is endemic, history of recent travels abroad. He complained asm of the jaw, and weight loss of 6 kg. His ding author at: Department of Neurosciences, Reproductive omatological Sciences, University Federico II of Naples, Via aples, 80131, Italy. Tel.: +39 0817462181. ddresses: email@example.com (A. Celentano), @gmail.com (E. Ruoppo), firstname.lastname@example.org ), email@example.com (M.D. Mignogna).
Fig. 1. Clinical features of our case: a widespread exophytic mass of the left buccal mucosa extending to the upper and lower fornix, and the retromolar area. The surface showed erythema, multiple erosions, and mild keratosis that was speckled anteriorly and had a deep ulcer posteriorly. dental history included poor oral hygiene and the presence of a crown fracture of 28.
Routine haematological tests showed no abnormality except for increased activity of lactate dehydrogenase (650 U/L). rg/10.1016/j.bjoms.2015.01.021 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved. of Neurosciences, Reproductive and Odontostomatological Sciences, Univ of Advanced Biomedical Sciences, Morphological and Functional Diagnos anuary 2015 cosal leishmaniasis is a rare infectious disease, particularly in imm story of a painful lesion of the left buccal mucosa that mimicked c opsy specimen to exclude cancer. The diagnosis of leishmaniasis w n B for five weeks. After five months the patient had a visceral recu ithin 3–4 weeks should be regarded as the first signs of oral cance
British Association of Oral and Maxillofacial Surgeons. Published oral cancer: a case
ARTICLE IN PRESSYBJOM-4443; No. of Pages 3 2 A. Celentano et al. / British Journal of Oral and Maxillofacial Surgery xxx (2015) xxx–xxx
Fig. 2. Histo ruption of the dyskeratotic a tion ×10).
Fig. 3. Furthe extracellular L magnification
There w mucosa tha retromolar terised by e and ulcerat
Clinical ination of number of
Dermatolo tomograph a diagnosis
Leishmaniases are a worldwide threat with about 58,000 cases of visceral and 220,000 cases of cutaneous disease ted annually, high rates of mortality and morbidity,3–5 accord k of c e fem mits t (such ees) a stemi ve the s, and and a n immrepor and ( at ris
Th trans areas refug
Sy invol node ease, rare i this article in press as: Celentano A, et al. Primary oral leishmaniasis mim ), http://dx.doi.org/10.1016/j.bjoms.2015.01.021 pathological examination of the buccal lesion showing disepithelial layer, which was partially ulcerated and partially nd hyperplastic (haematoxylin and eosin, original magnificar magnification showed a wide number of intracellular and eishmania spp. amastigotes (haematoxylin and eosin, original ×63). as a widespread exophytic mass of the left buccal t extended to the upper and lower fornix, and to the area. The lesion was hard, and the surface characrythema, erosions, and keratosis, partly speckled ed. features were consistent with malignancy. Examan incisional biopsy specimen showed a large
Leishmania spp. amastigotes (Figs. 2 and 3). gical examination and abdominal computed y excluded systemic involvement and confirmed of primary oral leishmaniasis. festation. D diseases in
The stan based on p
Oral SC wide, and and HPV lesion of th white patc ated areas, particular o
However, t infectious d as an ELIS
We have no
Reference 1. Ready PD. 2014;6:147– 2. Stockdale L leishmanias 3. Strazzulla A an underest 2013;2013:8 4. World Healt mittee on th
WHO; 2010 5. World Heal improving picking oral cancer: a case report. Br J Oral Maxillofac ing to the WHO) an estimated 350 million people ontracting the infection.4 ale sand fly (genus Phlebotomus or Lutzomyia) he parasite.2 People that have to stay in endemic as inhabitants, migrant workers, soldiers, and re considered at risk.6 c spread of the disease is common, and may liver, spleen, abdominal lymphatic system, lymph bone marrow. Oral involvement with mucosal disny mucosal leishmaniasis of the head and neck, is unocompetent patients, at least as the only maniifferential diagnoses encompass a range of other cluding oral squamous cell carcinoma (SCC).7 dard treatment of mucosal forms of the disease is entavalent antimonial drugs.8