A case of epithelioid cell granuloma that led to the discovery of ulcerative colitis

Abstract

We report a case of epithelioid cell granuloma on the lower right gingiva that led to the diagnosis of ulcerative colitis and improved oral lesions along with treatment for ulcerative colitis. The patient, an 18-year-old female with no medical history of interest, was referred to the oral surgery department of a university hospital for swelling of the lower right gingiva. A depression, with a ulcerative lesion with partial erosion, was observed. A biopsy was taken, given a malignant tumor was suspected. However, epithelioid cell granuloma was diagnosed based on the histopathological examination; thus, sarcoidosis, Crohn's disease, and tuberculosis were suspected. The patient was transferred to our hospital and consulted with the Internal Medicine department. Careful gastroenterology and ophthalmology examinations ultimately led to the diagnosis of ulcerative colitis. Both the digestive symptoms and oral lesions improved with the start of mesalazine treatment for ulcerative colitis.