Traumatic ulcerative granuloma with stromal eosinophilia of the tongue: case report in a pediatric patient

Abstract

Introduction: Traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) is a rare, benign lesion of the oral mucosa, characterized by a prolonged clinical course and histopathological findings that can mimic malignant processes. Its presentation in the pediatric population is uncommon, which can hinder its recognition and timely management. We report a pediatric case of TUGSE to facilitate its clinical and histopathological identification and highlight its importance in the differential diagnosis of chronic oral ulcers. Case presentation: An 8-year-old boy presented with a three-month history of a progressive lingual ulcer that was refractory to topical treatment. Examination revealed an oval ulcer with indurated borders, and initial laboratory tests showed only mild inflammation. Given the clinical changes, differential diagnoses of chronic traumatic ulcer, lymphoproliferative disorder, and neoplastic epithelial lesion were considered. A biopsy was performed, and histopathological analysis showed an ulcer with fibrin, fibrosis, and scant exudate, along with negative CD30 and EBER results and positive CD68, consistent with TUGSE in the cicatricial phase. The outcome was favorable, with complete healing and no recurrence in two years. Conclusions: This case highlights the importance of recognizing TUGSE as a benign entity that can mimic neoplastic processes, especially in children, and emphasizes the value of histopathological examination to establish an accurate diagnosis and guide appropriate management.