Tuméfaction gingivale chronique

Epulis is a common hyperplastic benign pseudotumor of the gums. It meets two criteria which are unanimous: topographical with the epulis affecting the neck of one or two adjacent teeth; benign, because the epulis is a tumor that does not recur after complete excision, does not produce metastases or lymph node involvement. We here report the case of a 70-year-old patient who was referred by his dentist to perform total mandibular edentation before making complete denture prosthesis and with a diagnosis of suspicious indurated lesion that had progressed for 3 years, spontaneously bleeding on contact and associated with homogeneous osteolytic lesion in relation to tooth 47. The patient had only a history of prostatic neoplasia which wasn’t associated with alcohol-tobacco poisoning and treated by surgery in 2012. Symptoms were vague; only low intermittent pain relieved with analgesic use. Vincent’s sign was negative. Initial radiological appearance was characterized by homogeneous osteolysis centered to the apex of the right second molar with radiopaque border, respecting the alveolar nerve canal, thus suggesting benign lesion. Anatomopathological examination showed inflammatory epulis. Clinical and radiological assessment was performed 15 days after surgery and showed good healing without pain or infection. Given the clinical and radiological findings, differential diagnoses included squamous cell carcinoma, metastasis from prostatic adenocarcinoma, inflammatory epulis or lymphoma.