Content Dam Diq Online Articles 2018 03 18mar22bcpath35t

Breakthrough Clinical oral pathology case: No. 35

March 20, 2018

A patient presents with a 4 mm x 5 mm red, tissue-colored, raised, fluctuant mass that never really goes away. After you read the full oral pathology presentation and clinical assessment, email us at [email protected] and tell us: (1) your first thoughts, (2) how you would diagnose this mass, and (3) how you would begin treatment.

Stacey L. Simmons, DDS, Editorial Director of DE's Breakthrough Clinical e-newsletter

A patient presents with a 4 mm x 5 mm red, tissue-colored, raised, fluctuant mass that never really goes away. After you read the full pathology presentation and clinical assessment, email us at [email protected] and tell us: (1) your first thoughts, (2) how you would diagnose this mass, and (3) how you would begin treatment.

Editor's note: This article first appeared in DE's Breakthrough Clinical with Stacey Simmons, DDS, the clinical specialties newsletter created just for dentists. Browse our newsletter archives to find out more and subscribe here.

Presentation and chief complaint

A healthy, 54-year-old female presents for her routine exam and cleaning. Her chief complaint at this visit is that she has a lump under her tongue on the left side that has been there for approximately two weeks. The patient commented that it hurts when she eats because the food irritates that spot directly. Furthermore, it fluctuates in size to a small degree, but it never really goes away.

Clinical exam

Clinical assessment reveals a red, tissue-colored, raised, fluctuant mass on the left side of the lingual frenum, in the area of the submandibular gland duct. There is a slight tenderness to palpation with some firmness to the lesion overall. The mass measures approximately 4 mm x 5 mm in length (see the photos below).

What are your differentials and recommended course of treatment for this patient? Send your answers to [email protected]. Next month, we will present the final diagnosis and recommended treatment for this 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 [email protected].

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, DE’s Breakthrough Clinical with Stacey Simmons, DDS, and a contributing author for DentistryIQ, Perio-Implant Advisory, and Dental Economics. Dr. Simmons can be reached at [email protected].

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About the Author

Stacey L. Simmons, DDS | Editorial Director of DE's Breakthrough Clinical e-newsletter

Dr. Stacey Simmons grew up in Hamilton, Montana. She did part of her undergraduate work at Purdue University and then received her bachelor’s degree in exercise physiology from the University of Utah. After applying to both medical and dental school, she decided that dentistry was her career of choice. She received her DDS degree from Marquette University School of Dentistry in Milwaukee, Wisconsin, in 2004. In private practice, she focuses her care on prosthodontics and cosmetic dentistry. She is a guest lecturer in the Anatomy and Physiology Department at the University of Montana. Outside the office, she trains for triathlons and spends time with her family. You may contact Dr. Simmons by email at [email protected].

In 2015, Dr. Simmons became the editorial director of DE's Breakthrough Clinical with Stacey Simmons, DDS, an e-newsletter focused on breaking through plateaus in clinical practice. Subscription information may be found here.

Updated May 4, 2016