Home Dental Radiology A firm mass of the maxillary gingiva

A firm mass of the maxillary gingiva

by adminjay


A 57-year-old woman had a slow-growing mass affecting the maxillary right posterior
gingiva of 2 years’ duration. She denied initial trauma to the area and was asymptomatic.
Her medical history was significant for gastroesophageal reflux disorder and attention
deficit disorder. Surgical, family, and social histories were unremarkable. Medications
included ranitidine hydrochloride, dexlansoprazole, dexmethylphenidate hydrochloride,
lamotrigine, and citalopram hydrobromide. The patient reported no known drug allergies
and food allergies associated with broccoli, cauliflower, and red dye. The review
of systems was unremarkable. The extraoral examination revealed a well-nourished,
well-developed woman with no evidence of lymphadenopathy, salivary gland enlargement,
or thyromegaly. The intraoral examination revealed a pink-red, soft, nontender, 2-centimeter
mass on the buccal gingiva in the area of tooth no. 2 with an intact mucosal surface
(
Figure 1). Tooth no. 2 responded normally to thermal testing. A periapical radiograph of tooth
no. 2 (
Figure 2A) and a cone-beam computed tomographic scan (
Figure 2B) did not reveal dental or intrabony pathology in the area of the gingival lesion.
An excisional biopsy was performed, and the soft-tissue defect was closed with a local
mucoperiosteal advancement flap. The histopathologic examination revealed a soft-tissue
lesion composed of haphazardly arranged, plump, uniform fibroblasts in an immature
collagenous stroma with scattered metaplastic calcifications (
Figures 3 and
4).

Figure 1
Pink-red, soft, nontender, 2-centimeter mass on the buccal gingiva in the area of
tooth no. 2 with an intact mucosal surface.

Figure thumbnail gr2

Figure 2

A. Unremarkable periapical radiograph of tooth no. 2.
B. Unremarkable cone-beam computed tomographic scan.

Figure thumbnail gr3

Figure 3
Fibrotic mass with metaplastic bone (arrow) (hematoxylin and eosin, magnification
×20).

Figure thumbnail gr4

Figure 4
Scattered fibroblasts, collagen, and metaplastic bone (hematoxylin and eosin, magnification
×100).



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