A unique presentation of spongiotic hyperplasia at the mucogingival junction

Spongiotic Gingival Hyperplasia (SGH), previously known as Localized Juvenile Spongiotic Gingival Hyperplasia (LJSGH), has been a subject of nomenclature debate due to its presentation in patients of all ages. SGH is characterized by erythematous, slightly raised plaques or nodules, often localized in the marginal gingiva. This case report presents a unique clinical presentation of Spongiotic Hyperplasia of the Mucogingival Junction (SHMJ), further elucidating SGH's clinical variability, with a particular focus on its differential diagnosis and management, followed by long-term clinical monitoring. A 67-year-old female presented with an asymptomatic, erythematous patch at the mucogingival junction between teeth #21 and #22. Clinical and radiographic examination revealed no signs of periodontal or pulpal infection/necrosis. An excisional biopsy of the lesion revealed marked spongiosis and exocytosis of a diffusely CK19-positive overlying mucosal epithelium. Histological findings were consistent with spongiotic hyperplasia. The lesion showed complete healing at a 9-month follow-up without recurrence. This case represents a peculiar instance of SHMJ, highlighting the need for heightened clinical awareness of SGH’s atypical presentations. Surgical excision remains the treatment of choice, as conservative periodontal treatments are ineffective. Histological and immunohistochemical analysis aid in definitive diagnosis; long-term follow-up is essential to exclude recurrence.