oprm-web-case-op-st-14

Oral Pathology:  Soft Tissue Case #14

 

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Patient: Child, either sex.

Chief Complaint:
Parents request a routine examination.

Medical History:
No abnormalities are identified.

Dental History:
This is the patient's first dental appointment.

Clinical Findings:
A 2 x 3 mm, well-circumscribed pigmentation is present on the right hard palate. The lesion is raised, firm, smooth surfaced and fixed to overlying mucosa and underlying structures. The lesion does not blanch upon pressure. The patient and parents were unaware of the lesion.

Clinical Images
mirror view of palate, teeth, lips hard palate and maxillary teeth, right side
Mirror View of Palate, Teeth, Lips Hard Palate and Maxillary Teeth, Right Side

 

There are no radiographs available for this case.

There are no charts available for this case.

Summary:
This is a localized pigmented surface lesion

Lesions to Exclude from Differential Diagnosis:
Intravascular blood lesions
  ~Blanch upon pressure
  ~Color – red, blue or purple
Extravasated blood lesions
  ~Red, Blue or Purple, not brown
Ephelis
  ~Flat and not thickened
  ~Occurs only on sun-exposed skin
Oral Melanotic Macule
  ~Flat and not thickened

Lesions to Include in the Differential Diagnosis:
Nevus
Melanoma
Tattoo from pencil lead

Management:
Excisional biopsy is indicated for any lesion in which nevus or melanoma are included in the differential diagnosis.  Explain the differential diagnosis to the patient and parents and the indications for biopsy.  Melanoma in a child is rare but must still be considered.

Final Diagnosis:
Nevus