Breakthrough Clinical oral pathology case: No. 35

A patient presents with a 4 mm x 5 mm red, tissue-colored, raised, fluctuant mass that never really goes away. After you read the full oral pathology presentation and clinical assessment, email us at DEBreakthrough@pennwell.com and tell us: (1) your first thoughts, (2) how you would diagnose this mass, and (3) how you would begin treatment.

Mar 20th, 2018
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A patient presents with a 4 mm x 5 mm red, tissue-colored, raised, fluctuant mass that never really goes away. After you read the full pathology presentation and clinical assessment, email us at DEBreakthrough@pennwell.com and tell us: (1) your first thoughts, (2) how you would diagnose this mass, and (3) how you would begin treatment.

Editor's note: This article first appeared in DE's Breakthrough Clinical with Stacey Simmons, DDS, the clinical specialties newsletter created just for dentists. Browse our newsletter archives to find out more and subscribe here.


Presentation and chief complaint

A healthy, 54-year-old female presents for her routine exam and cleaning. Her chief complaint at this visit is that she has a lump under her tongue on the left side that has been there for approximately two weeks. The patient commented that it hurts when she eats because the food irritates that spot directly. Furthermore, it fluctuates in size to a small degree, but it never really goes away.

Clinical exam

Clinical assessment reveals a red, tissue-colored, raised, fluctuant mass on the left side of the lingual frenum, in the area of the submandibular gland duct. There is a slight tenderness to palpation with some firmness to the lesion overall. The mass measures approximately 4 mm x 5 mm in length (see the photos below).




What are your differentials and recommended course of treatment for this patient? Send your answers to DEbreakthrough@pennwell.com. Next month, we will present the final diagnosis and recommended treatment for this case.

CALL FOR PATHOLOGY CASES

Do you have an interesting oral pathology case you would like to share with Breakthrough’s readers? If so, submit a clinical radiograph or high-resolution photograph, a patient history, diagnosis, and treatment rendered to DEbreakthrough@pennwell.com.


Editor's note: This article first appeared in DE's Breakthrough Clinical with Stacey Simmons, DDS, the clinical specialties newsletter created just for dentists. Browse our newsletter archives to find out more and subscribe here.



For more oral pathology articles, click here.


Stacey L. Simmons, DDS, is in private practice in Hamilton, Montana. She is a graduate of Marquette University School of Dentistry. Dr. Simmons is a guest lecturer at the University of Montana in the Anatomy and Physiology Department. She is the editorial director of PennWell’s clinical dental specialties newsletter, DE’s Breakthrough Clinical with Stacey Simmons, DDS, and a contributing author for DentistryIQ, Perio-Implant Advisory, and Dental Economics. Dr. Simmons can be reached at ssimmonsdds@gmail.com.


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