ORAL AND MAXILLOFACIAL PATHOLOGY CASE:
Papillary Lesion of the Posterior
Maxillary Gingiva
Moore MS, Goldfaden JS, Foronda AMS, Summersgill KF
AUTHORS
Mobolaji S. Moore, BDS, DDS, DPH Oral and Maxillofacial Pathology Resident Department of Diagnostic Sciences, School of Dental Medicine, University of Pittsburgh, G-132 Salk Hall, 3501 Terrace Street, Pittsburgh, PA, 15261, USA Phone:( 412) 383-7338 Email: mom230 @ pitt. edu
Joshua S. Goldfaden, DDS * Oral and Maxillofacial Pathology Resident Department of Diagnostic Sciences, School of Dental Medicine, University of Pittsburgh, G-132 Salk Hall, 3501 Terrace Street, Pittsburgh, PA, 15261, USA Phone:( 412) 383-7338 Email: jsg114 @ pitt. edu * Corresponding author
Amber M. S. Foronda, DMD Associate Periodontist Integrated Periodontics & Dental Implants 563 Epsilon Drive, # 300, Pittsburgh, PA, 15238, USA Phone:( 412) 963-1911 Email: amsforonda @ gmail. com
Kurt F. Summersgill, DDS, PhD Associate Professor Department of Diagnostic Sciences, School of Dental Medicine, University of Pittsburgh, G-134 Salk Hall, 3501 Terrace Street, Pittsburgh, PA, 15261, USA Phone:( 412) 648-8635 Email: kfs8 @ pitt. edu
CASE PRESENTATION An 86-year-old female was referred to a periodontics practice for evaluation and biopsy of a gingival growth distal to the maxillary right second molar( Fig. 1). The lesion was reported to be present for one month, without change in size. The lesion was of normal mucosal color, papillary in shape, and measured approximately one centimeter. The lesion was asymptomatic, although the patient reported being aware of its presence due to occasional discomfort when touched by her tongue.
Extraoral and intraoral examinations were otherwise unremarkable. The patient’ s medical history included breast cancer in 1984, recurring in 2003, but a review of systems revealed no current disease. CBCT imaging demonstrates bony involvement, with thinning of the maxillary cortex distal to tooth no. 2( Fig 2.). The clinical differential diagnosis included giant cell granuloma and fibroma. The lesion was excised and submitted for histopathologic examination. Hematoxylin and eosin( H & E) stains show a papillary mass( Fig. 3).
CAN YOU MAKE THE DIAGNOSIS? A. Squamous papilloma
B. Papillary squamous cell carcinoma C. Primary intraoral melanoma D. Metastatic breast carcinoma
Figure 1
Figure 3
Papillary, mucosal-colored, exophytic lesion of the right maxillary tuberosity, distal to tooth no. 2( image courtesy of Amber M. S. Foronda, DMD).
Figure 2
The lesion exhibits a papillary architecture at low power microscopically( hematoxylin & eosin( H & E), 20x).
Panoramic radiograph derived from a CBCT showing thinning of the maxillary cortex distal to tooth no. 2.
MAY / JUNE 2025 | PENNSYLVANIA DENTAL JOURNAL 29