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Clinicopathologic Conference
A radiolucency in the posterior mandible
A 36-year-old female patient was referred to a private clinic presenting an asymptomatic, intraosseous lesion in the posterior right mandible. The lesion was found incidentally during a routine radiographic examination (Figure 1). The patient's past medical and dental histories were unremarkable, and she denied any use of medications or harmful habits. The intraoral examination did not reveal any significant alteration in the oral mucosa; no swelling relative to the intraosseous lesion (i.e., in the mandibular molar area) could be noted during local palpation.Intraoral mass, extraoral suppuration, and jaw lesions
A 77-year-old African American man with a 1-year history of an asymptomatic intraoral mass and facial edema was referred by his physician for specialized oral medicine evaluation at our department. His medical condition pointed to systemic arterial hypertension controlled with medications. His blood test results indicated elevated creatinine and urea (1.64 mg/dL and 80 mg/dL, respectively). Additionally, the patient's medical history did not indicate any antiresorptive or other drug that could alter bone remodeling, as well as radiotherapy in the head and neck region.A nodule in the palatal mucosa
A 67-year-old male patient was referred to our service with a complaint of an asymptomatic nodule in the hard palate; the nodule had evolved over 12 months and displayed slow growth. The patient did not report any alcoholism or smoking, and his past medical history was noncontributory. Upon general examination, the patient appeared well oriented, and there were no signs of any systemic illnesses or lymphadenopathy. The intraoral examination revealed a dome-shaped nodule with a smooth surface, exhibiting normal-colored overlying mucosa.A nodule in the temporomandibular joint area
A 66-year-old woman with a chief complaint of swelling of 3 months’ duration in the right preauricular area was referred by her head and neck surgeon to our department. The patient's past medical and dental histories were unremarkable, and she denied any use of medications. She reported a facial trauma that had occurred approximately 1 year ago and denied previous temporomandibular joint (TMJ) complaints. Clinical examination revealed a painless, normal-colored, well-limited smooth nodule in the right TMJ area (Figure 1).A sessile nodule in the dorsum of the tongue
In June 2017, a 52-year-old male patient was referred by his nephrologist to the Dental Service of the Clinics Hospital of the Federal University of Minas Gerais (HC-UFMG) for evaluation of an asymptomatic swelling in the tongue. The patient reported rapid enlargement of a swelling on the posterior region of his tongue; the swelling had started a few days ago. The patient denied any pain or discomfort. He had a medical history significant for end-stage renal disease (ESRD) caused by focal segmental glomerulosclerosis diagnosed 20 years ago.An ulcer on the ventral tip of tongue
A 55-year-old male patient was referred to our department with the chief complaint of a painful and nonhealing ulcer of 1-month duration in the ventral tip of the tongue. He also complained of difficulty chewing and swallowing. The patient smoked 20 cigarettes per day for 15 years. The patient reported unintentional weight loss of 4 lb during the last 2 months and presented an unproductive cough lasting for 5 years, considered a complication of his smoking habit. Additional past medical and surgical histories were unremarkable.A mixed image in the maxillary sinus
A 19-year-old male patient complaining of a diffuse swelling of 4 months' duration on the right side of his face was referred to our department. No palpable cervical lymph node was found, and patient's past medical history was noncontributory. Intraoral examination did not reveal any significant visual alteration in the right maxillary mucosa; however, a slight swelling in the maxilla, extending from the first to the third molars, could be noted during local palpation, demonstrating a hard consistency suggestive of bone cortical expansion (Figure 1A).
