title: Strawberry-like gingival tumor as the first clinical sign of Wegener's granulomatosis.
abstract: BACKGROUND
  Wegener's granulomatosis (WG) is a complex disease, characterized by a necrotizing vasculitis that usually involves the upper airways, lungs, and kidneys; occasionally, other organs may also be affected. Because of the severity and rapid progression of the disease, early diagnosis and treatment are critical; this type of vasculitis is potentially fatal if left unchecked.
  
  
  METHODS
  A 64-year-old woman presented with a chief complaint of a gingival mass that had appeared 2 months before and had grown rapidly. In the previous months she complained of malaise without weight loss. An intraoral examination revealed the presence of a solitary gingival mass, 2 cm in diameter, affecting the area above the upper central incisors. The lesion displayed a granular, erythematous, speckled surface with petechiae, characteristic of WG.
  
  
  RESULTS
  A biopsy of the lesion, a thoracic computed tomography, and the presence of high titers of antineutrophil cytoplasmic antibodies (ANCA) in the blood established the diagnosis of WG. An initial combination therapy of prednisone and cyclophosphamide successfully abated most of the patient's symptoms.
  
  
  CONCLUSIONS
  The occurrence of an extremely rare tumor-like form of strawberry gingiva was the primary clinical sign that led to a diagnosis of WG. This case emphasizes the important role of the dentist in the diagnosis of this potentially fatal disease.
authors.affiliation: Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, Madrid, Spain. ghervall@odon.ucm.es
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Hernández
authors.forename: Cristina
authors.initials: C
authors.lastname: Serrano
authors.forename: Lourdes
authors.initials: L
authors.lastname: Porras
authors.forename: Rosa
authors.initials: R
authors.lastname: Lopez-Pintor
authors.forename: Lourdes
authors.initials: L
authors.lastname: Rubio
authors.forename: Jaime
authors.initials: J
authors.lastname: Yanes
mesh_terms: D019268:Antibodies, Antineutrophil Cytoplasmic / Q000032:analysis; D001706:Biopsy; D003937:Diagnosis, Differential; D004890:Erythema / Q000175:diagnosis; D005260:Female; D005882:Gingival Diseases / Q000175:diagnosis*; D005887:Gingival Neoplasms / Q000175:diagnosis; D014890:Granulomatosis with Polyangiitis / Q000175:diagnosis*; D006801:Humans; D008875:Middle Aged; D011693:Purpura / Q000175:diagnosis
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic