Skip to main content

Advertisement

SpringerLink
Log in

Oral Verruciform Xanthoma: A Series of 212 Cases and Review of the Literature

  • Original Paper
  • Published:
Head and Neck Pathology Aims and scope Submit manuscript

Abstract

Verruciform xanthoma (VX) of the oral cavity is an uncommon, reactive lesion of unknown etiology. In this study, we present a large series of VX with analysis of demographics, clinical appearance, histologic presentation and extensive review of literature. To the best of our knowledge, this is the largest series of oral VX reported to date. Following IRB approval, all cases diagnosed as VX found in the archives of the University of Florida Oral Pathology Biopsy Service (1994–2018) were included. Patient age, gender, location, clinical appearance, clinical impression, and duration of each lesion was collected. A total of 212 cases were included in our database with a mean age of 61 years (range of 9–94), and a female: male ratio of 1.06:1. The most common location in descending order was the gingiva (n = 110, 51.2%), followed by palate (n = 41, 19.3%), buccal mucosa (n = 18, 8.5%), tongue (n = 20, 9.4%), vestibule (n = 13, 6.1%), lip (n = 4, 1.9%), floor of mouth (n = 3, 1.4%), and unspecified (n = 1, 0.5%). The lesions were most frequently pink in color, and most often described as bumpy, rough, verrucoid and/or papillary. Clinical impression in descending order was papillary (n = 67, 31.6%), not specified or unknown (n = 41, 19.3%), hyperkeratosis (n = 24, 11.3%), fibroma (n = 20, 9.4%), leukoplakia (n = 17, 8.0%), dysplastic lesion (n = 13, 6.1%), pyogenic granuloma (n = 7, 3.3%), granulomatous reaction (n = 5, 2.4%), lichen planus, VX (n = 4 each, 2.0%), pigmented, other lesions (n = 3 each, 1.4%), and salivary and periapical lesions (n = 2 each, 0.9%). Three of the lesions were recurrences. The demographics and clinical parameters of this case series were in concordance with that of previously published reports. In our series, only 4 cases were suspected as VX, demonstrating the lack of familiarity clinicians have with this lesion.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Shafer WG. Verruciform xanthoma. Oral Surg Oral Med Oral Pathol. 1971;31(6):784–9.

    Article  CAS  PubMed  Google Scholar 

  2. Santa Cruz DJ, Martin SA. Verruciform xanthoma of the vulva: report of two cases. Am J Clin Pathol. 1979;71(2):224–8.

    Article  CAS  PubMed  Google Scholar 

  3. Kimura S. Verruciform xanthoma of the scrotum. Arch Dermatol. 1984;120(10):1378–9.

    Article  CAS  PubMed  Google Scholar 

  4. Kraemer BB, et al. Verruciform xanthoma of the penis. Arch Dermatol. 1981;117(8):516–8.

    Article  CAS  PubMed  Google Scholar 

  5. Barr RJ, Plank CJ. Verruciform xanthoma of the skin. J Cutan Pathol. 1980;7(6):422–8.

    Article  CAS  PubMed  Google Scholar 

  6. Roy SF, et al. Wart on fire: a rare entity of verruciform xanthoma arising on a lower leg in a setting of chronic lymphedema. JAAD Case Rep. 2017;3(1):36–8.

    Article  PubMed  Google Scholar 

  7. Buchner A, Hansen LS, Merrell PW. Verruciform xanthoma of the oral mucosa: report of five cases and review of the literature. Arch Dermatol. 1981;117(9):563–5.

    Article  CAS  PubMed  Google Scholar 

  8. de Andrade BA, et al. Oral verruciform xanthoma: a clinicopathologic and immunohistochemical study of 20 cases. J Cutan Pathol. 2015;42(7):489–95.

    Article  PubMed  Google Scholar 

  9. Ide F, et al. Cellular basis of verruciform xanthoma: immunohistochemical and ultrastructural characterization. Oral Dis. 2008;14(2):150–7.

    Article  CAS  PubMed  Google Scholar 

  10. Schafer DR, Glass SH. A guide to yellow oral mucosal entities: etiology and pathology. Head Neck Pathol. 2019;13(1):33–46.

    Article  PubMed  Google Scholar 

  11. Mainville GN. Non-HPV papillary lesions of the oral mucosa: clinical and histopathologic features of reactive and neoplastic conditions. Head Neck Pathol. 2019;13(1):71–9.

    Article  PubMed  Google Scholar 

  12. Val-Bernal JF, et al. Verruciform xanthoma is another condition associated with pseudoepitheliomatous hyperplasia. Am J Dermatopathol. 2012;34(3):341–2.

    Article  PubMed  Google Scholar 

  13. Philipsen HP, et al. Verruciform xanthoma–biological profile of 282 oral lesions based on a literature survey with nine new cases from Japan. Oral Oncol. 2003;39(4):325–36.

    Article  CAS  PubMed  Google Scholar 

  14. Cebeci F, et al. Verruciform xanthoma of a lower lip lesion: a new case and review of the literature. Case Rep Dermatol. 2017;9(2):130–5.

    Article  PubMed  Google Scholar 

  15. Tamiolakis P, et al. Oral verruciform xanthoma: Report of 13 new cases and review of the literature. Med Oral Patol Oral Cir Bucal. 2018;23(4):e429–e435435.

    CAS  PubMed  Google Scholar 

  16. Zegarelli DJ, Zegarelli-Schmidt EC, Zegarelli EV. Verruciform xanthoma: further light and electron microscopic studies, with the addition of a third case. Oral Surg Oral Med Oral Pathol. 1975;40(2):246–56.

    Article  CAS  PubMed  Google Scholar 

  17. Nowparast B, Howell FV, Rick GM. Verruciform xanthoma: a clinicopathologic review and report of fifty-four cases. Oral Surg Oral Med Oral Pathol. 1981;51(6):619–25.

    Article  CAS  PubMed  Google Scholar 

  18. Herrera-Goepfert R, Lizano-Soberón M, García-Perales M. Verruciform xanthoma of the esophagus. Hum Pathol. 2003;34(8):814–5.

    Article  PubMed  Google Scholar 

  19. Oliveira PT, et al. Verruciform xanthoma of the oral mucosa: report of four cases and a review of the literature. Oral Oncol. 2001;37(3):326–31.

    Article  CAS  Google Scholar 

  20. Neville BW et al. Oral and maxillofacial pathology. 4th edition, Elsevier, St. Louis p. 912

    Google Scholar 

  21. Harris L, Staines K, Pring M. Oral verruciform xanthoma. BMJ Case Rep, 2015. 2015. bcr2014209216

    Article  PubMed  Google Scholar 

  22. Blanco C, et al. Verruciform xanthoma of the lip: two lesions in a woman. Am J Dermatopathol. 1988;10(2):176–8.

    Article  CAS  PubMed  Google Scholar 

  23. Colonna TM, Fair KP, Patterson JW. A persistent lower lip lesion: verruciform xanthoma. Arch Dermatol, 2000. 136(5): p. 665–6, 669.

    Article  CAS  PubMed  Google Scholar 

  24. Allen CM, Kapoor M. Verruciform xanthoma in a bone marrow transplant recipient. Oral Surg Oral Med Oral Pathol. 1993;75(5):591–4.

    Article  CAS  PubMed  Google Scholar 

  25. Archana M, Bahirwani S, Raja JV. A verruciform xanthoma of the lower lip and review of the differential diagnosis. Oral Health Dent Manag. 2014;13(3):712–6.

    CAS  PubMed  Google Scholar 

  26. Pereira T, et al. Verruciform xanthoma of the lip: a rarity. Indian Dermatol Online J. 2016;7(3):180–2.

    Article  PubMed  Google Scholar 

  27. Qi Y, et al. A case of multiple verruciform xanthoma in gingiva. Br J Oral Maxillofac Surg. 2014;52(1):e1–3.

    Article  PubMed  Google Scholar 

  28. Khaskhely NM, et al. Association of human papillomavirus type 6 with a verruciform xanthoma. Am J Dermatopathol. 2000;22(5):447–52.

    Article  CAS  PubMed  Google Scholar 

  29. Iamaroon A, Vickers RA. Characterization of verruciform xanthoma by in situ hybridization and immunohistochemistry. J Oral Pathol Med. 1996;25(7):395–400.

    Article  CAS  PubMed  Google Scholar 

  30. Neville BW, Weathers DR. Verruciform xanthoma. Oral Surg Oral Med Oral Pathol. 1980;49(5):429–34.

    Article  CAS  PubMed  Google Scholar 

  31. Mostafa KA, et al. Verruciform xanthoma of the oral mucosa: a clinicopathological study with immunohistochemical findings relating to pathogenesis. Virchows Arch A Pathol Anat Histopathol. 1993;423(4):243–8.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, 1395 Center Drive, Gainesville, FL, 32610, USA

    Austin N. Belknap, Mohammed N. Islam, Indraneel Bhattacharyya, Donald M. Cohen & Sarah G. Fitzpatrick

Authors
  1. Austin N. Belknap
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mohammed N. Islam
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Indraneel Bhattacharyya
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Donald M. Cohen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sarah G. Fitzpatrick
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Austin N. Belknap.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Belknap, A., Islam, M.N., Bhattacharyya, I. et al. Oral Verruciform Xanthoma: A Series of 212 Cases and Review of the Literature. Head and Neck Pathol 14, 742–748 (2020). https://doi.org/10.1007/s12105-019-01123-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12105-019-01123-0

Keywords

Search

Navigation