Lymphangiectasia Mimicking Lichenoid Contact Reaction

Lymphangiectasia, otherwise known as acquired lymphangioma, is unusual to occur in the oral cavity. Among the frequently recognised forms of congenital and acquired entities, the acquired form of the lymphangiectasia may be caused due to trauma or obstruction to the lymphatic system. Commonly, this condition is asymptomatic; however, the needs of aesthetics and functions warrant treatment. This was a case report of a 55-year-old male patient, who came with a chief complaint of burning sensation in his left cheek region for the past three weeks. Clinically, silver amalgam restoration was evident in relation to the tooth numbers 26,27,36 and 37. Soft tissue examination revealed evidence of greyish radiating striae interspersed with hyperpigmentation on the left buccal sulcus and left lateral border of the tongue. Considering the clinical features, a working diagnosis of lichenoid contact reaction was proposed. Further, an incisional biopsy was performed. Histopathological examination showed thin stratified squamous epithelium with vacuolar spaces, which strongly supported the diagnosis of lymphatic malformation. The patient was symptomatically managed with topical triamcinolone acetonide 0.1% twice daily for two weeks. At two weeks follow-up, the patient was symptom-free and hence the medication was withdrawn. The patient is currently under regular follow-ups.