Medication‐related fibrovascular hyperplasia lesion in tongue: Case report

• Published in: Special care in dentistry Vol. 40; no. 5; pp. 506 - 510
• Main Authors: Ballardin, Bárbara Soldatelli, Mobile, Rafael Zancan, Torres‐Pereira, Cassius Carvalho, Schussel, Juliana Lucena
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01-09-2020
• Subjects: Analgesics; Antibiotics; Antiviral agents; Biopsy; Case reports; Corticosteroids; cyclosporine; Cyclosporins; Diagnosis; hematopoietic stem cell transplantation; Hematopoietic stem cells; Hodgkin's lymphoma; Humans; Hyperplasia; Hyperplasia - chemically induced; Hyperplasia - pathology; Immunosuppression; Inflammation; Lesions; Mucosa; Nodules; Oral Ulcer - pathology; Patients; Stem cell transplantation; Tongue; Tongue Diseases - chemically induced; Tongue Diseases - diagnosis; Tongue Diseases - pathology; cyclosporine; hematopoietic stem cell transplantation; hyperplasia
• ISSN: 0275-1879; 1754-4505
• DOI: 10.1111/scd.12497

Objective
The objective of this study is to report the case of a patient who underwent hematopoietic stem cell transplantation for Hodgkin's lymphoma treatment and developed multiple tongue lesions during recovery.
Methods and results
This is the case report of a patient who developed ulcerated lesions with areas of depapillation on the border and dorsum of the tongue. The ulcer evolved to a reddish fibrous hyperplastic nodule, similar to adjacent mucosa. The patient was using a series of medications, such as antifungals, antibiotics, antivirals, corticosteroids, and analgesics in addition to immunosuppression with cyclosporine. Considering the medical history of the patient, a biopsy was performed. Histopathological analyses describe hyperplasia, granulation tissue, vascular proliferation, and intense inflammatory infiltrate, and the diagnosis was of medication‐related fibrovascular hyperplasia (MRFH).
Conclusion
Patients in use of cyclosporine are at risk to develop oral lesions, such as MRFH. The correct diagnosis is important, so the adequate treatment and follow‐up are instituted even considering the immunosuppression protocol.