Strawberry-Like Gingival Tumor as the First Clinical Sign of Wegener's Granulomatosis
- Gonzalo Hernández Vallejo
- Cristina Serrano
- Lourdes Porras Leal
- Rosa López
- Lourdes Rubio Ramírez
- Jaime Yanes
ISSN: 0022-3492
Año de publicación: 2008
Volumen: 79
Número: 7
Páginas: 1297-1303
Tipo: Artículo
Otras publicaciones en: Journal of periodontology
Resumen
Background: Wegener's granulomatosis (WG) is a complex disease, characterized by a necrotizing vasculitis that usually involves the upper airways, lungs, and kidneys; occasionally, other organs may also be affected. Because of the severity and rapid progression of the disease, early diagnosis and treatment are critical; this type of vasculitis is potentially fatal if left unchecked. Methods: A 64-year-old woman presented with a chief complaint of a gingival mass that had appeared 2 months before and had grown rapidly. In the previous months she complained of malaise without weight loss. An intraoral examination revealed the presence of a solitary gingival mass, 2 cm in diameter, affecting the area above the upper central incisors. The lesion displayed a granular, erythematous, speckled surface with petechiae, characteristic of WG. Results: A biopsy of the lesion, a thoracic computed tomography, and the presence of high titers of antineutrophil cytoplasmic antibodies (ANCA) in the blood established the diagnosis of WG. An initial combination therapy of prednisone and cyclophosphamide successfully abated most of the patient's symptoms. Conclusions: The occurrence of an extremely rare tumor-like form of strawberry gingiva was the primary clinical sign that led to a diagnosis of WG. This case emphasizes the important role of the dentist in the diagnosis of this potentially fatal disease.