A case of chronic graft-versus-host-disease with hyperplasia of the oral mucosa

A case of chronic graft-versus-host-disease (GVHD) associated with multiple hyperplastic changes of the oral mucosa is described. The patient was 14-year-old boy referred to our department because of oral dryness. He had a past history of acute lymphatic leukemia and bone marrow transplantation. After 1 month, skin lesions developed. GVHD was diagnosed on examination of a biopsy specimen. Subsequently, oral symptoms, such as lichenoid lesions, oral dryness, and bulla, also developed. During follow-up, hyperplastic lesions were observed on the right side of the buccal mucosa and soft palate. Biopsies were performed, and the condition of the buccal mucosa was diagnosed as papillary hyperplasia with candidal infection. The condition of the soft palate was diagnosed as papilloma. The results of immunohistochemical studies suggested a relationship between these hyperplastic regions and GVHD. At present, hyperplasia of the oral mucosa is not considered an oral manifestation of GVHD. However, chronic GVHD is an established risk factor for oral cancer. Hyperplastic lesions in the oral mucosa should therefore be cautiously followed up in patients with chronic GVHD.