case_images: PMC11232812_01
case_images: Preoperative view (Buccal aspect)
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case_images: Local factors such as calculus and plaque were present with poor oral hygiene [Figure 1].
case_images: Preoperative view (Palatal aspect)
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case_images: Palatally, it involved the IDP in relation to distal of #11 to mesial of #14 [Figure 2].
case_images: Preoperative view (Palatal aspect) showing friable soft lesion getting detached from underlying tissues
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case_images: The soft tissue overgrowth was a painless lesion, friable in nature, that detached from the underlying tissues [Figure 3].
case_images: Preoperative intraoral periapical radiographic view of the region with lesion
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case_images: Preoperative view (Buccal aspect)- After Phase I periodontal therapy
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case_images: Two weeks later, the patient was reviewed and the lesion remained still the same; only slight surface changes were noted [Figure 5]. Thorough scaling and root planing was repeated again along with prescription of CHX mouthwash, Vitamin B complex and Vitamin C supplements to aid in the healing of the ulcerative lesion.
case_images: Immediate postoperative view
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case_images: Hence, complete excisional biopsy was planned and executed under local anesthesia (2% lignocaine with 1:80,000 adrenaline), with a 1 mm narrow margin of normal tissue, to ensure total removal of the mass and to prevent recurrence [Figure 6].
case_images: Immediate postoperative view - The excised mass
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case_images: The excised mass [Figure 7] was sent for histopathological examination (HPE) after fixing in 10% neutral formalin buffer.
case_images: Postoperative view, 2 weeks
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case_images: Recurrence was seen 2 weeks following the excisional biopsy [Figure 8].
case_images: Photomicrograph (H and E, x40) of the lesion showing multiple Langhans type giant cells with peripherally positioned nuclei (black arrows), epitheliod type cells (yellow arrows) and numerous chronic inflammatory cells (red arrows)
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case_images: The histopathological findings were suggestive of "chronic inflammatory mass" [Figures 9 and 10].
case_images: Photomicrograph (H and E, x40) showing areas of necrosis (red arrows)
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case_images: The histopathological findings were suggestive of "chronic inflammatory mass" [Figures 9 and 10].
case_images: Radiographic view - Chest
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case_images: Chest radiograph findings [Figure 11] were normal and Mantoux test was negative.
case_images: Postoperative views after 2 weeks of prophylactic antitubercular therapy - (a) Buccal view & (b) Palatal view
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case_images: There was appreciable clinical improvement in the lesion [Figures 12a and b] following prophylactic ATT for 2 weeks.
case_images: Postoperative views after 6 months of prophylactic antitubercular therapy - (a) Buccal view & (b) Palatal view
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case_images: The lesion resolved completely with a 6 months course of ATT [Figures 13 a and b].