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A Guide to Clinical Differential Diagnosis of Oral Mucosal Lesions

Course Number: 110

Table 6. Benign Mesenchymal Tumors

Overlying mucosa is normal unless traumatized; usually well-circumscribed, asymptomatic, slowly growing.
Irritation fibromaFirm or compressible
Epulis fissuratum (inflammatory fibrous hyperplasia)Located adjacent to flange of removable denture; firm or compressible
Peripheral ossifying fibromaOccursonly on gingiva; firm; sometimes ulcerated; sometimes vascular; may move teeth
LeiomyomaFirm; sometimes vascular.
RhabdomyomaFirm; located in areas of skeletal muscle
Peripheral giant cell granulomaOccurs only on gingiva or attached alveolar mucosa; vascular
HemangiomaCongenital; compressible; vascular; circumscribed or diffuse
LymphangiomaCongenital; compressible; usually diffuse; not vascular
Pyogenic granulomaVascular; compressible; frequently has rapid growth, ulcerated, bleeds easily
LipomaEncapsulated; compressible; sometimes yellow
Neuroma (traumatic or amputation neuroma)Firm; usually tender to palpation; size of lesion is dependent upon size of involved nerve
NeurofibromaFirm or compressible; non-tender; circumscribed or diffuse; may occur with neurofibromatosis
Schwannoma (neurilemoma)Encapsulated; firm; non-tender;
Granular cell tumorFirm; sometimes overlying surface is rough
Congenital epulisFirm; congenital; occurs only on attached alveolar mucosa