Rapidly enlarging nodular lesion of the anterior maxilla

Abstract

A 25-year-old Hispanic male was referred to our hospital oral surgery clinic from a local correctional facility for the evaluation of an oral mass. The patient’s chief complaint was a painless, rapidly enlarging swelling of his gingiva of the right anterior maxilla. It was first noticed approximately 8 weeks prior and described by the patient as a small bump between the maxillary right canine and maxillary right lateral incisor teeth. Progressive mobility of his right maxillary anterior teeth and slight drainage were reported. Before referral for lesion evaluation, the patient was treated with oral clindamycin 300 mg, 3 times daily for 10 days by his dentist with no improvement. On presentation to the hospital oral surgery clinic, the patient’s medical and dental histories were obtained and a clinical examination was performed. He denied prior orofacial trauma. The patient’s past medical history was negative for illnesses, hospitalizations, or surgeries. His social history included occasional social alcohol use before his incarceration. He denied tobacco or recreational drug use. On head and neck examination, displacement of the right lip and right naris was evident. No cervical lymphadenopathy was apparent on physical examination. On oral examination, a 5 7-cm nodular lesion was visualized involving the right anterior maxillary buccal alveolus with extension to the vestibule (Fig. 1). The lesion extended from the region adjacent to the right central incisor to the first molar. The maxillary lateral incisor, canine, and premolar teeth were dis-