This month's oral pathology case centers around a 0.5- x 0.5-inch radiopaque mass that has been present in the oral cavity of a 74-year-old patient for at least six years, unbeknownst to the patient. Compare two panoramic radiographs taken six years apart and see if you can diagnose this lesion based on its location.
Editor's note: This article first appeared in Breakthrough Clinical, the clinical specialties newsletter created just for dentists. Browse our newsletter archives to find out more and subscribe here.
Figure 1: Panoramic radiograph shows radiopaque mass on left side, just anterior to the angle of the mandible
Presentation and clinical exam
A healthy 74-year-old female presents for a comprehensive exam. A panoramic radiograph is taken. A radiopaque mass measuring approximately 0.5 x 0.5 inches is noted on the left side, just anterior to the angle of the mandible (figure 1). The area is asymptomatic upon palpation. The patient reports no knowledge of the lesion. Access to a previous pan from six years prior is acquired. The same lesion is noted on the radiograph, albeit somewhat less distinctive (figure 2).
Figure 2: Panoramic radiograph taken six years prior shows same lesion, although somewhat less distinctive
What are your differentials and recommended course of treatment for this patient?
Send your answers to [email protected]. Next month, we will present the final diagnosis and recommended treatment for this oral pathology case.
Editor's note: This article first appeared in Breakthrough Clinical, the clinical specialties newsletter created just for dentists. Browse our newsletter archives to find out more and subscribe here.