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McDaniel CR, Hixson DR, Johnson TM, Inouye KAS. Gingival nodule at the site of a previous connective tissue graft. J Am Dent Assoc 2024:S0002-8177(24)00313-1. [PMID: 39023482 DOI: 10.1016/j.adaj.2024.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 05/07/2024] [Accepted: 06/10/2024] [Indexed: 07/20/2024]
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Dill Fuchs L, Borges Kirschnick L, de Farias Gabriel A, Martins Silveira F, Ajudarte Lopes M, Petersen Wagner V, Frenzel Schuch L, Domingues Martins M. Oral focal mucinosis: A systematic review. Br J Oral Maxillofac Surg 2024:S0266-4356(24)00148-7. [PMID: 39107146 DOI: 10.1016/j.bjoms.2024.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 05/30/2024] [Indexed: 08/09/2024]
Abstract
Oral focal mucinosis (OFM) is a rare lesion first described in 1974, but the aetiology remains unknown. Clinically, OFM presents as an asymptomatic nodular lesion and the similarity of clinical features to other soft tissue injuries makes the diagnosis difficult. The aim of this study was to integrate the demographic, clinical, and histopathological characteristics from previously published cases of OFM into a systematic review. Electronic searches without publication date restriction were performed in the following databases: Embase, PubMed, Medline, Web of Science, and Scopus. Case reports or case series of OFM published in English and presenting enough clinical and histopathological information were included. This systematic review identified 42 studies from 12 countries, comprising 113 cases of OFM. This lesion affected more females than males, usually in the fourth decade of life. The gingiva was the most common anatomical location, followed by the palate. Clinical presentation was most often an asymptomatic nodule. Imaging exams revealed that most cases did not have bone involvement. Surgical removal was the treatment of choice for most cases and only one recurrent case was reported. In conclusion, OFM is an uncommon pathology, and its diagnosis depends on histopathological analysis. The lesion could be included as a differential diagnosis of benign soft tissue lesions of the oral cavity, especially those affecting the gingiva.
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Affiliation(s)
- Larissa Dill Fuchs
- Department of Oral Pathology, Dental School, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Laura Borges Kirschnick
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Amanda de Farias Gabriel
- Department of Oral Pathology, Dental School, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Felipe Martins Silveira
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil; Department of Diagnosis in Pathology and Oral Medicine, Molecular Pathology Area, School of Dentistry, Universidad de la República (UDELAR), Montevideo, Uruguay
| | - Márcio Ajudarte Lopes
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Vivian Petersen Wagner
- Department of Dentistry, School of Dentistry, Universidade de São Paulo (FOUSP), São Paulo, Brazil
| | - Lauren Frenzel Schuch
- Department of Diagnosis in Pathology and Oral Medicine, Molecular Pathology Area, School of Dentistry, Universidad de la República (UDELAR), Montevideo, Uruguay
| | - Manoela Domingues Martins
- Department of Oral Pathology, Dental School, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil.
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Martínez-Ortega JI, Gómez-Torres RE. Oral Focal Mucinosis of the Tongue: A Rare Localization for a Rare Entity. Am J Dermatopathol 2023; 45:00000372-990000000-00218. [PMID: 37462208 DOI: 10.1097/dad.0000000000002490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
ABSTRACT Oral focal mucinosis (OFM) is a rare connective tissue disorder that is characterized by the excessive production of hyaluronic acid due to myxoid degeneration of submucosal connective tissue. The disorder typically presents as an asymptomatic nodule or mass in the gingiva or hard palate, and OFM of the tongue is even more unusual. In this report, we present a case of OFM on the tongue in a 72-year-old female patient who presented with a symptomatic lump that had been growing for 6 months on the dorsum of her tongue. The patient reported discomfort and pain while speaking and swallowing, and the lump was visually apparent on examination. OFM is a benign condition that does not have any specific clinical or radiographical features that distinguish it from other more common oral lesions, such as lipoma or fibroma. Therefore, histopathological examination is essential for a definitive diagnosis. The management of OFM typically involves surgical excision of the lesion. In this case, complete surgical removal of the lesion under general anesthesia was performed, and the patient was followed up for 10 months postoperatively. During the follow-up period, there was no evidence of recurrence, and the patient reported significant improvement in her symptoms. In conclusion, OFM is a rare connective tissue disorder that can occur in the oral cavity. Although OFM of the tongue is even rarer, it should be considered in the differential diagnosis of oral lesions. Histopathological examination is essential for definitive diagnosis, and surgical excision is typically the preferred treatment modality.
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Affiliation(s)
| | - Rosa E Gómez-Torres
- Research Institute in Dentistry, Center of Health Sciences, University of Guadalajara, Guadalajara, México
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Tonkaboni A, Hafezi Motlagh K, Derakhshan S. Oral focal mucinosis in an adolescent: A rare entity. Clin Case Rep 2022; 10:e6594. [DOI: 10.1002/ccr3.6594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 10/14/2022] [Accepted: 10/25/2022] [Indexed: 11/20/2022] Open
Affiliation(s)
- Arghavan Tonkaboni
- Department of Oral Medicine, School of Dentistry Tehran University of Medical Sciences Tehran Iran
- Grupo de Investigacion en Patologia Oral Medico Quirurgica Universidad de Santiago de Compostela Santiago Spain
| | - Kimia Hafezi Motlagh
- Department of Oral Medicine, School of Dentistry Tehran University of Medical Sciences Tehran Iran
| | - Samira Derakhshan
- Oral and Maxillofacial Pathology Department, School of Dentistry Tehran University of Medical Sciences Tehran Iran
- Cancer Preclinical Imaging Group, Preclinical Core Facility Tehran University of Medical Sciences Tehran Iran
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Miyahara GI, de Castro TF, Araújo WAF, Tomo S, Biasoli ER, Santos-Silva AR, Xavier-Júnior JCC, Crivelini MM, Bernabé DG. A submucous yellow nodule of the fornix. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:124-127. [PMID: 35210203 DOI: 10.1016/j.oooo.2021.12.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 11/23/2021] [Accepted: 12/02/2021] [Indexed: 10/19/2022]
Affiliation(s)
- Glauco Issamu Miyahara
- Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Aracatuba, São Paulo, Brazil; Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Aracatuba, São Paulo, Brazil.
| | - Tamara Fernandes de Castro
- Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Aracatuba, São Paulo, Brazil; Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Aracatuba, São Paulo, Brazil
| | - Winícius Arildo Ferreira Araújo
- Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Aracatuba, São Paulo, Brazil; Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Aracatuba, São Paulo, Brazil
| | - Saygo Tomo
- Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Aracatuba, São Paulo, Brazil; Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Aracatuba, São Paulo, Brazil
| | - Eder Ricardo Biasoli
- Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Aracatuba, São Paulo, Brazil; Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Aracatuba, São Paulo, Brazil
| | - Alan Roger Santos-Silva
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, São Paulo, Brazil
| | - José Cândido Caldeira Xavier-Júnior
- Pathology Institute of Araçatuba, Araçatuba, São Paulo, Brazil; School of Medicine, Centro Universitário Católico Unisalesiano Auxilium, Araçatuba, São Paulo, Brazil
| | - Marcelo Macedo Crivelini
- Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Aracatuba, São Paulo, Brazil
| | - Daniel Galera Bernabé
- Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Aracatuba, São Paulo, Brazil; Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Aracatuba, São Paulo, Brazil
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Silva Cunha JL, Leite AA, de Castro Abrantes T, Vervloet LP, de Lima Morais TM, de Oliveira Paiva Neto G, Kimura TNL, Ferreira SMS, de Albuquerque-Júnior RLC, Abrahão AC, Romañach MJ, Benevenuto de Andrade BA, de Almeida OP, Soares CD. Oral focal mucinosis: A multi-institutional study and literature review. J Cutan Pathol 2020; 48:24-33. [PMID: 33410541 DOI: 10.1111/cup.13813] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 07/05/2020] [Accepted: 07/15/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Oral focal mucinosis (OFM) is a rare benign condition of unknown etiology, considered the oral counterpart of cutaneous focal mucinosis. We report the clinicopathologic features of 21 cases of OFM in conjunction with a review of the literature. METHODS Clinical data were collected from the records of five oral and maxillofacial pathology services. All cases were evaluated by hematoxylin and eosin staining, histochemistry, and immunohistochemistry (vimentin, S-100, α-SMA, CD34, and mast cell). RESULTS The series comprised 14 females (66.7%) and seven males (33.3%), with a mean age of 48.2 ± 20.7 years (range: 8-77 years) and a 2:1 female-to-male ratio. Most of the lesions affected the gingiva (n = 6, 28.6%) and presented clinically as asymptomatic sessile or pedunculated nodules with fibrous or hyperplasic appearance. All cases were negative for S-100 protein, CD34, and α-SMA and positive for Alcian blue staining. Conservative surgical excision was the treatment in all cases, and there was only one recurrence. CONCLUSION OFM is a rare benign disorder that is often clinically misdiagnosed as reactive lesions or benign proliferative processes. Dermatologists and pathologists should consider OFM in the differential diagnosis of soft tissue lesions in the oral cavity, mainly located in the gingiva.
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Affiliation(s)
- John Lennon Silva Cunha
- Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Amanda Almeida Leite
- Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Thamiris de Castro Abrantes
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Lorena Passoni Vervloet
- Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Thayná Melo de Lima Morais
- Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | | | | | | | | | - Aline Corrêa Abrahão
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Mario José Romañach
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | | | - Oslei Paes de Almeida
- Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Ciro Dantas Soares
- Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
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Cho JJ, Shupak RP, Michaels C. Oral focal mucinosis of the mandible in an adolescent patient. BMJ Case Rep 2019; 12:12/12/e232671. [PMID: 31852693 DOI: 10.1136/bcr-2019-232671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Oral focal mucinosis (OFM) is the rare oral manifestation of cutaneous focal mucinosis. It is a diagnosis made histopathologically, as OFM remains clinically similar to other more common oral lesions, and radiographs do not provide any diagnostic information. This case is a report of a teenage female with left mandibular involvement of an elevated, rounded, asymptomatic, mucosa-coloured lesion in the facial and lingual gingiva between her left first and second mandibular molars. The cause was unclear, although the patient stated that she may have sustained a laceration in that area several months prior. An incisional biopsy revealed histopathological findings consistent with OFM, and complete surgical excision of the lesion was performed under a general anaesthetic, with no signs of recurrence for 2 months. The histological, clinical and accepted treatment methods on OFM will be discussed. Clinicians, including those serving paediatric populations, should consider OFM in their differential diagnoses when evaluating gingival lesions.
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Affiliation(s)
- Jason J Cho
- Department of Oral and Maxillofacial Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Raymond P Shupak
- Department of Oral and Maxillofacial Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Caroline Michaels
- Department of Oral and Maxillofacial Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
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Higuchi Y, Tsushima F, Sumikura K, Sato Y, Harada H, Kayamori K, Ikeda T. Diagnosis and treatment of oral focal mucinosis: a case series. J Med Case Rep 2019; 13:108. [PMID: 31023388 PMCID: PMC6485166 DOI: 10.1186/s13256-019-2033-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 02/27/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Oral focal mucinosis, the oral counterpart of cutaneous focal mucinosis, is a rare disease. As it has no characteristic clinical or radiological features, diagnosis is established by histopathological and immunohistological examination. We present three cases of oral focal mucinosis occurring in the retromolar (which is extremely rare) and gingival regions. CASE PRESENTATION Case 1 involved a 26-year-old Japanese man with radiolucency in the right retromolar region on panoramic radiograph and computed tomography; no obvious protrusion was observed in the region. This finding was clinically diagnosed as a tumor of the retromolar region. Case 2 involved a 60-year-old Japanese woman. A tumor-like mass of tissue was identified on the buccal gingiva at the maxillary right canine and first premolar region. The lesion measured 7 × 6 mm and exhibited elastic hardness and healthy-colored mucosa. The lesion was diagnosed as an epulis. Case 3 involved a 47-year-old Japanese woman. A tumor-like mass of tissue was identified on the buccal gingiva at the maxillary right canine and first premolar region. The lesion measured 10 × 10 mm and exhibited elastic hardness and redness of the surface mucosa. This lesion was also diagnosed as an epulis. Resection was performed in all three cases, and the lesions were histopathologically diagnosed as oral focal mucinosis. Postoperative courses were uneventful and, thus far, there have been no recurrences. CONCLUSIONS Although it is difficult to diagnose oral focal mucinosis based on clinical symptoms and imaging findings, the disease should be considered a possibility when diagnosing benign oral tumors. We believe that an emphasis on histopathologic study is essential to confirm the clinical suspicion.
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Affiliation(s)
- Yusuke Higuchi
- Oral and Maxillofacial Surgery, Department of Oral Restitution, Division of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510 Japan
| | - Fumihiko Tsushima
- Oral and Maxillofacial Surgery, Department of Oral Restitution, Division of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510 Japan
| | - Kanako Sumikura
- Oral and Maxillofacial Surgery, Department of Oral Restitution, Division of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510 Japan
| | - Yuriko Sato
- Oral and Maxillofacial Surgery, Department of Oral Restitution, Division of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510 Japan
| | - Hiroyuki Harada
- Oral and Maxillofacial Surgery, Department of Oral Restitution, Division of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510 Japan
| | - Kou Kayamori
- Oral Pathology, Department of Oral Restitution, Division of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510 Japan
| | - Tohru Ikeda
- Oral Pathology, Department of Oral Restitution, Division of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510 Japan
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Tobouti PL, Horikawa FK, Matuck BF, de Sousa SCOM, Alves FA. Oral focal mucinosis of the hard palate and gingiva. AUTOPSY AND CASE REPORTS 2018; 8:e2018044. [PMID: 30775321 PMCID: PMC6360821 DOI: 10.4322/acr.2018.044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 08/28/2018] [Indexed: 11/23/2022] Open
Abstract
Oral focal mucinosis (OFM) is an uncommon, asymptomatic, submucosal, slow-growing nodule representing a counterpart of the cutaneous focal mucinosis (CFM). OFM has a female predilection with the highest prevalence in the fifth decade of life. About 68% of OFMs occur in the gingiva and 14% in the palate. We present the case of a 41-year-old woman presenting a progressively growing mass on the palate, since the last 8 months. The diagnostic workup led to the diagnosis of an unusual OFM with the clinical presentation involving the gingiva and hard palate. This case report discusses the clinical and histopathological differential diagnosis.
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Affiliation(s)
- Priscila Lie Tobouti
- Universidade de São Paulo, School of Dentistry, Stomatology Department. São Paulo, SP, Brazil.,Universidade de São Paulo, School of Dentistry, Oral Pathology. São Paulo, SP, Brazil
| | - Fernando Kendi Horikawa
- Universidade de São Paulo, School of Dentistry, Stomatology Department. São Paulo, SP, Brazil
| | - Bruno Fernandes Matuck
- Universidade de São Paulo, School of Dentistry, Stomatology Department. São Paulo, SP, Brazil
| | | | - Fábio Abreu Alves
- Universidade de São Paulo, School of Dentistry, Stomatology Department. São Paulo, SP, Brazil.,A.C. Camargo Cancer Center, Stomatology Department. São Paulo, SP, Brazil
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Gonzaga AKG, de Oliveira DHIP, Lopes MLDS, Filho TJS, Queiroz LMG, da Silveira ÉJD. Clinicopathological study of oral focal mucinosis: a retrospective case series. Med Oral Patol Oral Cir Bucal 2018; 23:e401-e405. [PMID: 29924755 PMCID: PMC6051680 DOI: 10.4317/medoral.22291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 05/22/2018] [Indexed: 11/10/2022] Open
Abstract
Background Oral focal mucinosis (OFM) is a rare soft tissue lesion of unknown etiology that exhibits tumor-like growth. It is considered the oral counterpart of cutaneous focal mucinosis or cutaneous myxoid cyst. This is a retrospective study of oral OFM diagnosed over a period of 42 years at an oral pathology service. Material and Methods Clinical, histopathological and immunohistochemical data were analyzed. Alcian blue staining and S-100 immunohistochemistry were performed. Results Eleven cases were retrieved (4:1 female-to-male ratio). The mean age was 44 years. The gingiva was the most affected site. The main clinical presentation was sessile or pedunculated lesions of fibrous or hyperplasic appearance, most of them asymptomatic. Positive Alcian blue staining and absence of S-100 protein were observed in all specimens, which supported the histological diagnosis of OFM. Surgical excision was the treatment of choice. Conclusions Although rare, this study supports the inclusion of OFM in the differential diagnosis of intraoral myxoid lesions. Key words:Oral focal mucinosis, myxomatous lesion, connective tissue diseases, diagnosis.
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Affiliation(s)
- A-K-G Gonzaga
- Departamento de Odontologia, Universidade Federal do Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, CEP 59056-000 Natal, RN, Brasil,
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