Abstract
Oral verruciform xanthoma (VX) is an infrequently encountered benign lesion in the oral cavity. We report an unusual case of VX on the left buccal mucosa presented as a red and white exophytic mass with a greyish white diffuse patch associated with it. A differential diagnosis of papilloma, verrucous carcinoma, and squamous cell carcinoma associated with leukoplakia was listed. Histopathological findings were suggestive of VX due to the presence of characteristic foam cells in the connective tissue papillae. Immunohistochemical analysis with CD68 showed strong positive immunoreactivity revealing expression of foam cells. After the excisional biopsy, the patient was followed up for the next 6 months with no recurrence. Follow-up is very essential in such a case as the exophytic lesion was associated with a potentially malignant disorder. A short review of reported recurrent cases of verruciform xanthoma is also discussed.