Traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) is a rare distinctive ulcerative lesion of the oral mucosa that is generally considered to be associated with trauma. Clinically, it may mimic malignant ulcerative lesions, making accurate diagnosis particularly important. This retrospective study analyzed 64 patients diagnosed with TUGSE at the Department of Oral Pathology, Seoul National University Dental Hospital over a 25-year period from 2000 to 2025. Clinical information and histopathologic findings were analyzed through review of medical records and pathological slides. Among the 64 cases, 38 patients (59.4%) were male and 26 (40.6%) were female, with a mean age of 47 years (range, 8–86 years). The tongue was the most commonly affected site, accounting for 37 cases (57.8%), followed by the buccal mucosa and the floor of the mouth. Biting-related trauma was considered the most likely etiologic factor in 22 cases (34.3%). All lesions showed spontaneous healing following biopsy. Histopathologically, all cases demonstrated proliferation of granulation tissue beneath the ulcerated epithelium accompanied by infiltration of chronic inflammatory cells. Prominent eosinophilic infiltration extending deeply into the underlying muscle layer was a characteristic finding. 33.7% of the lesions were initially suspected to be malignant or potentially malignant lesions prior to biopsy, suggesting that histopathologic examination is essential for the accurate diagnosis and appropriate management of TUGSE.

• 신호아(서울대학교 치의학대학원 구강병리학 교실) | Ho-A Shin (Department of Oral Pathology, School of Dentistry, Seoul National University, Seoul 03080, Republic of Korea)
• 홍성두(서울대학교 치의학대학원 구강병리학 교실) | Seong-Doo Hong (Department of Oral Pathology, School of Dentistry, Seoul National University, Seoul 03080, Republic of Korea)
• 이재일(서울대학교 치의학대학원 구강병리학 교실) | Jae-Il Lee (Department of Oral Pathology, School of Dentistry, Seoul National University, Seoul 03080, Republic of Korea)
• 윤혜정(서울대학교 치의학대학원 구강병리학 교실) | Hye-Jung Yoon (Department of Oral Pathology, School of Dentistry, Seoul National University, Seoul 03080, Republic of Korea) Corresponding author