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A Blue-Grey Lesion of the Palate

Case Challenge Number: 52

Diagnostic Information

Medical History

The patient has a positive history of tobacco use. He denies risk factors for HIV. The patient has reported a recent history of epistaxis on the right side. He does not note any swelling or pain in the mouth.

Dental History

Additional clinical findings: The lesion feels slightly elevated and spongy upon palpation. No bruit or pulsation was detected.

Laboratory Data

None reported.

Radiographic Findings

The lesion is present in the maxillary bone and soft tissues of the palate. Please see CT scan image (Figure 1).

Diagnostic Information - figure 1

Figure 1. Representative serial coronal CT sections demonstrate erosion of maxillary bone with a thickening of the overlying palatal soft tissues.

Surgical Findings

Incisional biopsy of the area was uneventful.

Histopathology

An incisional biopsy of the oral mucosa was procured. The specimen is surfaced by stratified squamous epithelium with a regular pattern of maturation. The connective tissue is remarkable for several large, dilated vascular channels lined by thin, widely-spaced, flattened endothelial cells. Some blood and clear-filled fluid is identified within the lumina, and small capillaries are present in the area.  Mature adipose tissue is seen throughout the deep portion of the specimen.

fig02-biopsy

Figure 2. Incisional biopsy of the oral mucosa the overlying palatal soft tissues.