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Comprehensive clinicopathological evaluation of malignant localized gingival enlargements in the Thai population

  • Authors:
    • Dulyapong Rungraungrayabkul
    • Pawat Sripodok
    • Tawepong Arayapisit
    • Natchalee Srimaneekarn
    • Nakarin Kitkumthorn
    • Vichaya Neeranadpuree
    • Watjanee Amornwatcharapong
    • Supawit Hempornwisarn
    • Sirikorn Amornwikaikul
    • Puangwan Lapthanasupkul
  • View Affiliations / Copyright

    Affiliations: Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand, Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand, Department of Anatomy, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand, Department of Oral Biology, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand
    Copyright: © Rungraungrayabkul et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 71
    |
    Published online on: April 15, 2026
       https://doi.org/10.3892/br.2026.2144
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Abstract

Malignant localized gingival enlargements (LGEs) are rare and often clinically mimic reactive or benign lesions, creating diagnostic challenges. The present study aimed to evaluate the prevalence and origins of malignant LGEs, assess clinicopathological diagnostic concordance, and identify the distinction of clinical features in a Thai population. A total of 96 malignant LGEs diagnosed over a 40‑year period were retrospectively analyzed. Demographic data, clinical characteristics, and clinical and pathological diagnoses were collected. Malignant LGEs were categorized by origin, and diagnostic concordance was evaluated. Clinical features were compared between epithelial and non‑epithelial malignant LGEs, and a decision tree model was constructed to identify predictive factors. Epithelial (60.4%) and non‑epithelial (39.6%) malignant LGEs indicated a comparable distribution. Non‑epithelial lesions demonstrated substantially lower diagnostic concordance and were frequently misdiagnosed as reactive or benign conditions. Significant differences between groups were observed in age (P=0.004), surface texture (P=0.003), color (P=0.014), and location (P=0.044). Decision tree analysis identified age (P=0.018) and surface texture (P=0.03) as key predictors of non‑epithelial malignant LGEs. Non‑epithelial malignant LGEs are particularly prone to clinical misdiagnosis. Lesions occurring in younger patients, notably those with smooth surface texture, should raise suspicion for non‑epithelial malignancy and prompt timely biopsy and referral. These findings may aid clinicians in improving early recognition of malignant LGEs.
View Figures

Figure 1

Distribution and diagnoses of
malignant LGE Cases (n=96). (A) Pie chart illustrating the
distribution of malignant LGE cases by tumor type. (B) Bar graph
showing specific diagnoses, categorized and color-coded by tumor
type: epithelial tumors (red), hematological malignancies (orange),
salivary gland tumors (purple), metastatic tumors (blue), and other
tumors (green). Data between 2002 and 2021 were previously
published (3). The current figure
has been updated to include newly reviewed cases between 1982 and
2001, while retaining the original diagnoses and case numbers
between 2002 and 2021. LGE, localized gingival enlargement.

Figure 2

Decision tree model for
differentiating epithelial and non-epithelial malignant LGEs. The
model identifies key clinical predictors; age (in years) and
surface texture, for distinguishing between epithelial and
non-epithelial malignant LGEs. LGE, localized gingival
enlargement.
View References

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Copy and paste a formatted citation
Spandidos Publications style
Rungraungrayabkul D, Sripodok P, Arayapisit T, Srimaneekarn N, Kitkumthorn N, Neeranadpuree V, Amornwatcharapong W, Hempornwisarn S, Amornwikaikul S, Lapthanasupkul P, Lapthanasupkul P, et al: Comprehensive clinicopathological evaluation of malignant localized gingival enlargements in the Thai population. Biomed Rep 24: 71, 2026.
APA
Rungraungrayabkul, D., Sripodok, P., Arayapisit, T., Srimaneekarn, N., Kitkumthorn, N., Neeranadpuree, V. ... Lapthanasupkul, P. (2026). Comprehensive clinicopathological evaluation of malignant localized gingival enlargements in the Thai population. Biomedical Reports, 24, 71. https://doi.org/10.3892/br.2026.2144
MLA
Rungraungrayabkul, D., Sripodok, P., Arayapisit, T., Srimaneekarn, N., Kitkumthorn, N., Neeranadpuree, V., Amornwatcharapong, W., Hempornwisarn, S., Amornwikaikul, S., Lapthanasupkul, P."Comprehensive clinicopathological evaluation of malignant localized gingival enlargements in the Thai population". Biomedical Reports 24.6 (2026): 71.
Chicago
Rungraungrayabkul, D., Sripodok, P., Arayapisit, T., Srimaneekarn, N., Kitkumthorn, N., Neeranadpuree, V., Amornwatcharapong, W., Hempornwisarn, S., Amornwikaikul, S., Lapthanasupkul, P."Comprehensive clinicopathological evaluation of malignant localized gingival enlargements in the Thai population". Biomedical Reports 24, no. 6 (2026): 71. https://doi.org/10.3892/br.2026.2144
Copy and paste a formatted citation
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Spandidos Publications style
Rungraungrayabkul D, Sripodok P, Arayapisit T, Srimaneekarn N, Kitkumthorn N, Neeranadpuree V, Amornwatcharapong W, Hempornwisarn S, Amornwikaikul S, Lapthanasupkul P, Lapthanasupkul P, et al: Comprehensive clinicopathological evaluation of malignant localized gingival enlargements in the Thai population. Biomed Rep 24: 71, 2026.
APA
Rungraungrayabkul, D., Sripodok, P., Arayapisit, T., Srimaneekarn, N., Kitkumthorn, N., Neeranadpuree, V. ... Lapthanasupkul, P. (2026). Comprehensive clinicopathological evaluation of malignant localized gingival enlargements in the Thai population. Biomedical Reports, 24, 71. https://doi.org/10.3892/br.2026.2144
MLA
Rungraungrayabkul, D., Sripodok, P., Arayapisit, T., Srimaneekarn, N., Kitkumthorn, N., Neeranadpuree, V., Amornwatcharapong, W., Hempornwisarn, S., Amornwikaikul, S., Lapthanasupkul, P."Comprehensive clinicopathological evaluation of malignant localized gingival enlargements in the Thai population". Biomedical Reports 24.6 (2026): 71.
Chicago
Rungraungrayabkul, D., Sripodok, P., Arayapisit, T., Srimaneekarn, N., Kitkumthorn, N., Neeranadpuree, V., Amornwatcharapong, W., Hempornwisarn, S., Amornwikaikul, S., Lapthanasupkul, P."Comprehensive clinicopathological evaluation of malignant localized gingival enlargements in the Thai population". Biomedical Reports 24, no. 6 (2026): 71. https://doi.org/10.3892/br.2026.2144
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