Oral mycetoma of the upper lip nasolabial region in a healthy host: A case report and minireview of diagnostic and therapeutic considerations

Oral mycetoma, or fungal ball, is a rare entity typically affecting immunocompromised individuals; its presentation in the oral cavity, particularly the upper lip of healthy hosts, is exceedingly rare. We report a unique instance of upper lip nasolabial mycetoma in a 60-year-old immunocompetent male...

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Main Authors: Kenichi Ogata, Michiaki Akashi, Shintaro Kawano
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Oral and Maxillofacial Surgery Cases
Online Access:http://www.sciencedirect.com/science/article/pii/S221454192500015X
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author Kenichi Ogata
Michiaki Akashi
Shintaro Kawano
author_facet Kenichi Ogata
Michiaki Akashi
Shintaro Kawano
author_sort Kenichi Ogata
collection DOAJ
description Oral mycetoma, or fungal ball, is a rare entity typically affecting immunocompromised individuals; its presentation in the oral cavity, particularly the upper lip of healthy hosts, is exceedingly rare. We report a unique instance of upper lip nasolabial mycetoma in a 60-year-old immunocompetent male presenting with painless swelling. Initial imaging (magnetic resonance imaging/ultrasonography) revealed a well-defined, fluid-filled nodule, mimicking a benign neoplasm or mucocele. Excisional biopsy and subsequent histopathological examination with Grocott methenamine silver staining definitively diagnosed mycetoma, revealing encapsulated abscesses with filamentous fungal hyphae, suggestive of Aspergillus etiology. This case highlights the diagnostic ambiguity of atypical fungal infections in immunocompetent patients and underscores the necessity to consider fungal etiologies in the differential diagnosis of oral lesions, irrespective of patient immune status. Histopathology remains crucial for definitive diagnosis and appropriate management. Surgical excision with 1-year follow-up proved to be an effective therapeutic modality for localized oral fungal mycetoma in this healthy individual.
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spelling doaj-art-0ca774eb610542d583f1ea979ee801b42025-08-20T03:12:39ZengElsevierOral and Maxillofacial Surgery Cases2214-54192025-06-0111210040010.1016/j.omsc.2025.100400Oral mycetoma of the upper lip nasolabial region in a healthy host: A case report and minireview of diagnostic and therapeutic considerationsKenichi Ogata0Michiaki Akashi1Shintaro Kawano2Department of Dentistry and Oral Surgery, Karatsu Red Cross Hospital, 2430 Watada Karatsu City, Saga, 847-8588, Japan; Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan; Corresponding author. Department of Dentistry and Oral Surgery, Karatsu Red Cross Hospital, 2430 Watada Karatsu City, Saga, 847-8588, Japan.Department of Diagnostic Pathology, Karatsu Red Cross Hospital, 2430 Watada Karatsu City, Saga, 847-8588, JapanSection of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, JapanOral mycetoma, or fungal ball, is a rare entity typically affecting immunocompromised individuals; its presentation in the oral cavity, particularly the upper lip of healthy hosts, is exceedingly rare. We report a unique instance of upper lip nasolabial mycetoma in a 60-year-old immunocompetent male presenting with painless swelling. Initial imaging (magnetic resonance imaging/ultrasonography) revealed a well-defined, fluid-filled nodule, mimicking a benign neoplasm or mucocele. Excisional biopsy and subsequent histopathological examination with Grocott methenamine silver staining definitively diagnosed mycetoma, revealing encapsulated abscesses with filamentous fungal hyphae, suggestive of Aspergillus etiology. This case highlights the diagnostic ambiguity of atypical fungal infections in immunocompetent patients and underscores the necessity to consider fungal etiologies in the differential diagnosis of oral lesions, irrespective of patient immune status. Histopathology remains crucial for definitive diagnosis and appropriate management. Surgical excision with 1-year follow-up proved to be an effective therapeutic modality for localized oral fungal mycetoma in this healthy individual.http://www.sciencedirect.com/science/article/pii/S221454192500015X
spellingShingle Kenichi Ogata
Michiaki Akashi
Shintaro Kawano
Oral mycetoma of the upper lip nasolabial region in a healthy host: A case report and minireview of diagnostic and therapeutic considerations
Oral and Maxillofacial Surgery Cases
title Oral mycetoma of the upper lip nasolabial region in a healthy host: A case report and minireview of diagnostic and therapeutic considerations
title_full Oral mycetoma of the upper lip nasolabial region in a healthy host: A case report and minireview of diagnostic and therapeutic considerations
title_fullStr Oral mycetoma of the upper lip nasolabial region in a healthy host: A case report and minireview of diagnostic and therapeutic considerations
title_full_unstemmed Oral mycetoma of the upper lip nasolabial region in a healthy host: A case report and minireview of diagnostic and therapeutic considerations
title_short Oral mycetoma of the upper lip nasolabial region in a healthy host: A case report and minireview of diagnostic and therapeutic considerations
title_sort oral mycetoma of the upper lip nasolabial region in a healthy host a case report and minireview of diagnostic and therapeutic considerations
url http://www.sciencedirect.com/science/article/pii/S221454192500015X
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