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 2 A. Unremarkable periapical radiograph of tooth no. 2. B. Unremarkable cone-beam computed tomographic scan.
Figure 3 Fibrotic mass with metaplastic bone (arrow) (hematoxylin and eosin, magnification ×20).
Figure 4 Scattered fibroblasts, collagen, and metaplastic bone (hematoxylin and eosin, magnification ×100).
