Traumatic ulcerative Granuloma with Stromal eosinophilia (TUGSE)

Acute or chronic trauma to the oral mucosa may result in surface ulcerations. Eosinophilic ulcer or traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) is a chronic benign, reactive and self-limiting lesion. Its etiopathogenesis is still uncertain but trauma seems to play a fundamental role. Clinically the lesion manifests as an isolated ulcer, showing a raised and indurated border in addition to a white or yellowish bed. Histopathologically, it is characterized by eosinophilic inflammatory infiltrate penetrating into the submucosal layers degenerating the underlying muscle. Hereby, reporting a case of a 62-year-old female patient who presented with a chief complaint of non-healing painful ulcer on the right ventral aspect of tongue. The lesion was excised and sent for histopathologic examination. Microscopic examination showed an ulcerated epithelium and the underlying connective tissue showed dense inflammatory infiltrate predominantely PMNs, lymphocytes, plasma cells and significant number of eosinophils. Based on microscopic findings, the lesion was diagnosed as “TUGSE”.