Diagnostic challenges of oral leishmaniasis: unusual presentation of two cases

Leishmaniasis is a non-contagious infectious disease and has a broad spectrum of clinical forms. Isolated oral mucosal leishmaniasis is rare and challenges clinicians and pathologists. We report two cases of oral leishmaniasis manifested as ulcerative growth on the palate and tongue nodule. Histopathological analysis was performed and the final diagnosis was made with the visualization of amastigote-like structures. Both cases had unusual clinical manifestations and many differential diagnoses were considered, including syphilis, paracoccidioidomycosis and mesenchymal or epithelial neoplasms. The broad spectrum of clinical manifestations and the often-inconclusive findings in histopathology reinforce the importance of clinicopathological correlation in diagnosis of leishmaniasis.