Buccal

Question 1

buccal lesions include…

Answer 1

Irritation Fibroma
Soft Tissue Abscess
Lipoma
Mucocele
Hyperplastic Lymph Node
Hemangioma
Neurofibroma
Salivary Gland Tumors
◦ Pleomorphic Adenoma
◦ Mucoepidermoid Carcinoma
Koplik’s Spots

Question 2

Soft Tissue Abscess

Answer 2

Upper lip&raquo_space; Lower lip
Due to odontogenic infection that has extends to lip
Can be caused by foreign body entrapment
Review trauma history, always take soft tissue film if laceration present
If not trauma related, consider foreign body or dental source
TX: Debride area/wound, remove foreign body, Incise and drain if needed

Question 3

Lipoma

Answer 3

Well circumscribed submucosal lesion
Soft and movable with digital manipulation, painless
Yellowish in color with slow growth
Benign fat cell tumor
Buccal mucosa, floor of mouth and tongue are common sites
TX: Surgical excision with rare reoccurrence

Question 4

Hyperplastic Lymph Node

Answer 4

Increase in the number of normal cells (lymphocytes) that are
contained in lymph nodes
◦ Lymphoid hyperplasia
Occurs typically with bacterial or viral infection
Commonly referred to as lymphadenopathy
Will typically resolve once bacterial or viral infection has
resolved
If lymph node is unable to drain fluid, it may swell and have
same clinical appearance

Question 5

Neurofibroma

Answer 5

Uncommon benign lesion of the oral cavity that originate from
cells of the nerve sheath
Firm, slowly growing, fairly well circumscribed
Can occur as a single lesion or multiple lesions
Closely associated with individuals that have neurofibromatosis
Treatment is best via excision

Question 6

Neurofibromatosis (NF)

Answer 6

Multiple café-au-lait macules and pigmented neurofibromas
Genetically acquired (inherited or spontaneous mutation)
◦ One of the most common nervous system disorders
Various types exist
◦ NF1 – Earlier onset
◦ NF2 – Later onset
◦ Schwannomatosis
NF1 – Normal life expectancy, cosmetic concerns with tumors, possible
tumors to cause nerve compression and ocular damage (Optic pathway
gliomas)
NF2 – Possible hearing loss cataracts, balance issues due to bilateral acoustic neuromas

Question 7

Traumatic Neuroma

Answer 7

Reactive lesion that may be tender
Caused by local reaction to trauma
Resembles a fibroma in clinical appearance, but is tender to touch (Sometimes)
Smooth surface nodule, soft nonulcerated
TX: Excisional biopsy, may lead to paresthesia of associated nerve

Question 8

Multiple Endocrine Neoplasia, Type 2b

Answer 8

Autosomal dominant
Resembles person with Marfan Syndrome
◦ Marfanoid Body – Narrow face, Long lips
Mucosal neuromas of lips, tongue, buccal mucosa and gingiva
Prone to medullary carcinoma of the thyroid, especially in
infancy
Pheochromocytoma – tumor of adrenal gland
Appear before 10 years of age
TX: Biopsy to confirm clinical diagnosis, early evaluation of
thyroid is needed

Question 9

Koplik’s Spots – Measles (RUBEOLA)

Answer 9

Oral manifestation of measles (rubeola)
Occur at onset and initial stages of the virus
Commonly on buccal mucosa and soft palate
◦ Buccal mucosa – White specks
◦ Soft Palate – Small red dots/macules
Multiple, tiny white, macules that wipe off (Grain of salt or sand
appearance)
Tx: Refer to pediatrician immediately due to contagious nature
Diff Dx: Pseudomembranous candidiasis, mucosal burn, mucosal
sloughing