Is this lesion on the gum a worrisome growth? by ProQuest


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									                                      Dermatology Digest
                                     D E N I S E R I ZZO LO, PA-C , PhD; T HO M AS A . C HI ODO, DDS

                                                    ›CASE                                         erode the adjacent bone, so a radiograph
                                                    A 58-year-old male presented with             should be ordered as well. Because the
                                                    an asymptomatic lesion on his right           lesion is benign, prognosis is good; and
                                                    upper gum (Figure 1). The patient             provided the irritating agent is removed,
                                                    noticed the slowly growing mass in            the lesion should not recur.
                                                    the area but attributed it to an irrita-         A giant cell fibroma would be high
                                                    tion from his denture. He was unsure          on the differential but was ruled out
                                                    of how long the lesion had been pres-         by location and histopathology. These
                                                    ent and had not tried any alleviating         lesions are benign growths that can
                                                    measures. When it did not resolve,            occur at any age. The exact cause of the
                                                    he decided to have it evaluated. The          lesion is unknown, but some potential
                                                    patient was otherwise healthy with no         reasons for growth include tooth abra-
                                                    history of alcohol or tobacco use.            sion, cheek biting, or sucking trauma.
                                                       On examination, a 1-cm erythema-           Giant cell fibromas most commonly
                                                    tous, smooth, nonulcerated nodule             occur on the buccal mucosa and appear
                                                    was noted on the right upper maxil-           rounded, nonblanchable, and painless
                                                    lary gingiva. Manipulation of the             even if manipulated.
                                                    lesion did not cause pain or bleeding.           An epulis fissuratum is an inflam-
  FIGURE 1                                          The patient was edentulous with no            matory fibrous hyperplasia that arises
  A lesion on the right                             other lesions in his mouth.                   secondary to irritation, typically from
  upper gum                                                                                       an ill-fitting denture. The lesion is com-
                                                    ›WHAT IS THE MOST LIKELY                      monly located in the mucolabial and
                                                    DIAGNOSIS?                                    mucobuccal folds corresponding to the

Is this lesion                                       • Gingival carcinoma
                                                     • Epulis fissuratum
                                                     • Peripheral giant cell proliferation
                                                                                                  margins of the denture. The manifesta-
                                                                                                  tion can range from a small pink to
                                                                                                  reddish area appearing as excess gum
on the gum                                           • Giant cell fibroma                         tissue to
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