Reappraising localized juvenile spongiotic gingival hyperplasia

Localized juvenile spongiotic gingival hyperplasia (LJSGH) is a gingival lesion of unknown cause. The purpose of this study is to present a series of LJSGH cases and compare the findings with the literature.

After obtaining institutional review board approval, cases of biopsy-proven LJSGH from 2008 through 2018 were retrieved from the University of Pittsburgh Oral Pathology Biopsy Service archives and reviewed. In addition, a comprehensive review of the literature was performed.

Twenty-eight cases were identified. No significant sex predilection was noted (male-female ratio, 1.25:1). The age range was from 3 through 64 years (median, 14.5 years). Twenty-six cases (92.9%) affected the anterior facial gingiva, and 27 cases (96.4%) occurred in the maxilla. The most common clinical impression was pyogenic granuloma (55.6%). All cases presented with the same histopathology regardless of patient age. Cytokeratin 19 immunohistochemistry was used to confirm the diagnosis in cases that occurred in patients outside the typically affected demographic.

Our results are in concordance with the literature, with most cases localized to the anterior maxillary gingiva of children and young adults. However, 5 of our cases occurred in adults. Cytokeratin 19 is of diagnostic utility in these cases.

Although LJSGH is most commonly seen in children and young adults, we present cases occurring in adults. Our series and the literature found that LJSGH is not restricted to juveniles and that it can be multifocal. Dentists should be aware of this when formulating a differential diagnosis. Therefore, the nomenclature may not represent the disease spectrum of these gingival lesions.