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Oral Pathology:  Soft Tissue Case #10

 

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When you have determined a diagnosis and treatment, select the Discussion tab.

 

Patient: Adult, either sex

Chief Complaint:
The patient requests a routine examination. The patient has been aware of a blue lesion since childhood. The lesion has not changed in size. It is painful or bleeds only when traumatized.

Medical History:
No abnormalities identified.

Dental History:
No abnormalities identified.

Clinical Findings:
The lesion is a flat, thickened, blue-purple lesion extending from the left buccal mucosa to the left commissure area. There is no evidence of a thrill, bruit, or neuropathy. The lesion bleeds only if it is pierced by a sharp instrument. The lesion is compressible, nontender, and fixed to the surface mucosa and underlying structures. The surface of the lesion is smooth. The lesion blanches upon pressure.

Clinical Image
blue lesion of left buccal mucosa
Blue Lesion of Left Buccal Mucosa

 

There are no radiographs available for this case.

There are no lab reports available for this case.

There are no charts available for this case.

Summary:
This is a pigmented, localized, intravascular surface lesion:
  ~Pigmented – it is a localized blue-purple lesion
  ~Intravascular lesion – blanches upon pressure

Lesions to Exclude from Differential Diagnosis:
Kaposi’s Sarcoma
  ~Occurs in immunocompromised people
  ~Not congenital
Varix
  ~Rarely occurs in early childhood
  ~Typically not this large

Lesions to Include in the Differential Diagnosis:
Hemangioma

Management:
No treatment is necessary since the patient has no complaint.  Explain the lesion to the patient and that it can be surgically removed if it is traumatized or becomes a nuisance.

Final Diagnosis:
Hemangioma