BC oral pathology case 37: The silent lesion

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.

Jul 18th, 2018
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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 DEbreakthrough@pennwell.com. Next month, we will present the final diagnosis and recommended treatment for this oral pathology 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 Breakthrough Clinical, 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, Breakthrough Clinical,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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