In Oral Pathology, students were tasked with finding an oral lesion in the clinic and presenting their findings to the class. I found an interesting lesion that was tricky to diagnose. My final diagnosis is based on clinical findings only, as no biopsy was performed.

1. LESION CASE STUDY
Kalvin Smith
Oral Pathology
State Fair Community College

2. MEDICAL
HISTORY
64 year-old female
Patient is in good health
Medications:
• Avistatin
• Fluoxetine
Vitals:
• Blood Pressure: 130/82
• Pulse: 64 bpm
• Respiration: 14 rpm
• Temperature: 98.1℉

3. DENTAL HISTORY
• Patient receives routine dental cleanings
• This was her first appointment at SFCC
• Recently had a restoration placed on #18
• Brushes teeth 2x daily
• Flosses or uses Waterpik 1x daily
• Uses fluoridated toothpaste and mouth rinse

4. CLINICAL APPEARANCE OF
LESION

5. VELESCOPE

6. LESION CHARACTERISTICS
• Location: Pterygomandibular fold, distal to #18
• Size: 3x3x1mm
• Shape: Circular
• Base: Sessile
• Color: Whitish pink
• The patient was completely unaware of the lesion and feels no pain or
discomfort.

7. DIFFERENTIAL DIAGNOSIS

8. POSSIBLE
DIAGNOSES
Lymph tissue
Irritation fibroma

9. LYMPH TISSUE
• The supervising dentist at SFCC believed that the lesion could possibly
be lymph tissue that had come to the surface.
• He was not certain this was the true diagnosis
• Lymph tissue may surface in the mouth as a sign of illness (Ibsen &
Phelan, 2014).
• A referral was written to the patient’s general dentist for closer
inspection and a biopsy if needed.

10. IRRITATION FIBROMA
• An irritation fibroma is a “broad-
based, persistent exophytic lesion
composed of dense, scar like
connective tissue containing few
blood cells” (Ibsen & Phelan, 2014).
• Benign
• Occurs as result of trauma
• Patient recently had restoration placed on
#18
• Usually a small lesion (less than 1cm)
• Lesion was 3x3x1mm
• Frequently found on buccal mucosa
• Light pink to white in color
• May have sessile or pedunculated base

11. DIAGNOSIS
• Based on the clinical findings, this lesion is likely an irritation fibroma.
• Caused by trauma
• Small in size/sessile base
• Found on buccal mucosa
• To confirm this diagnosis, excision and microscopic examination of the
tissue must be performed.

12. PROGNOSIS
• Both the supervising dentist at SFCC and the patient’s general dentist
believe that this lesion is nothing to worry about.
• A biopsy was not performed due to lack of concern about the lesion and
no patient discomfort.
• The lesion will be monitored and remeasured at each continuing care
appointment.

13. REFERENCE
Ibsen, O. A., & Phelan, J. A. (2014). Oral Pathology for the Dental Hygienist. St. Louis,
MO: Elsevier.