History of Present Illness
Ms. Thomas is a 32-year-old gravid white female who presents with a complaint of, “I have this bump in my cheek that I need checked out.” She was advised by her obstetrician to have it evaluated by a dentist. She relates first noticing it when she bit her cheek while eating about 8 months ago. It felt better in a few days and has not bothered her since. She has not been to a dentist during the past 15 months.
Extraoral examination is within normal limits. Intraoral examination reveals an intact dentition with good oral hygiene and mild gingivitis. A 3 x 1.5 cm lobulated submucosal mass is noted in the lower left buccal mucosa adjacent to #18/19 and inferior to the occlusal plane. The lesion is feely moveable and the patient notes some discomfort when it is squeezed. In consultation with her obstetrician and with the consent of the patient, the lesion was excised and submitted for histopathologic assessment.
The biopsy shows a circumscribed submucosal mass composed of lobules of mature adipose tissue. The round adipocytes display clear cytoplasm and peripheral small bland basophilic nuclei. The lobules are separated by bands of densely collagenous fibrovascular connective tissue. The specimen is surfaced by acanthotic parakeratinized stratified squamous epithelium.