TRAUMATIC ULCERATIVE GRANULOMA WITH STROMAL EOSINOPHILIA (TUGSE)-A PRECURSOR OF ORAL SQUAMOUS CELL CARCINOMA?

Abstract

Traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) isa benign, chronic, reactive and self-healing lesion. It is composed ofabundant eosinophils and small lymphocytes. Several studies haveshown varying observations on the relation of tissue eosinophilia withthe prognosis of oral cancer. Here, we present a case of a 65-year-oldmale who presented with a non-healing ulcer on the lateral border ofthe tongue, which was suggestive of TUGSE on histopathologicalexamination. The patient was kept on strict monthly follow up and thesecond re-biopsy was suggestive of moderately differentiatedsquamous cell carcinoma. Literature does not support thetransformation of TUGSE to oral squamous cell carcinoma; however,our experience suggests a close vigilance of such lesions due to itshigh clinical resemblance to malignancy. Hence, repeat biopsies on aregular basis are mandatory in cases where the clinical picture ishighly suspicious.