A non-cancerous (benign) swelling/tumour of the mouth is a growth that does not spread (metastasize) to other parts of the body. It is not usually life threatening.
The most common types of non-cancerous swellings of the oral cavity in the Indian population are:
MUCOCELE(FIG. 1 And 2): Mucocele are cavities filled in with mucus and lined by epithelium or covered by granulation tissue. Ranulae are considered as variants of mucocele that arise in the floor of the oral cavity. Mucoceles can be caused by extravasation of mucous followed by trauma to a ductal gland (extravasation cyst). Alternatively, they can be caused by retention of mucous due to ductal obstruction by sialolithiasis, invasive tumour or periductal scars. They normally present as smooth, painless swellings ranging from deep blue to the normal colour of the oral mucosa (pink). Discomfort, interference with speech, swallowing, mastication and external swelling may occur depending on the size and location of the mucocele. Traditional management of the lesion is excision along with the associated overlying mucosa. Recent studies also show promising results by a surgical approach with CO2 laser excising the lesion along with offending mucosal gland.
HEMANGIOMA(FIG. 3 & 4): Hemangioma is a benign tumour of dilated blood vessels. Hemangiomas of head and neck usually appear a few weeks after birth and they grow rapidly. It is known as port-wine stain, strawberry hemangioma and salmon patch. They are characterised by hyperplasia of blood vessels, usually veins and capillaries, in a focal area of submucosal connective tissue. It is almost never encapsulated. Clinically, they may manifest as warm, pulsatile, firm masses and the venous malformations manifest as soft and easily compressible. The treatment for benign vascular lesions are sclerotherapy, systemic corticosteroids, interferons, laser, embolisation, cryotherapy and surgery. Whether they should be followed-up or treated depends on the patient’s age, and on lesion site and size.
LIPOMA(FIG. 5): It is a benign lesion largely composed of fat tissue. It shows a male predilection and is usually seen in patients past the age of 40 years. They may occur anywhere in the oral cavity but the cheek is the most common site. They present as a smooth, asymptomatic and well circumscribed mass. Surgical excision is the only treatment recommended, and the prognosis is uniformly excellent.
FIBROMA(FIG. 6 & 7): They are known as the most common benign “tumour” of the oral cavity that are composed of fibrous or connective tissue. It is also known as Irritational Fibroma/ Traumatic Fibroma/ Focal Fibrous Hyperplasia as it is mainly seen arising as a reactive hyperplasia of fibrous connective tissue in response to a local irritation or trauma. Although it can arise anywhere, the most common location is the buccal mucosa along the bite line, presumably as a result of trauma from biting the cheek. The labial mucosa, tongue and gingiva are also common sites. The lesion typically presents as a smooth surfaced pink nodule that is similar in color to the surrounding mucosa. It usually has no symptoms unless secondary traumatic ulceration has occurred. The lesion is treated by excisional biopsy using the surgical enculeation technique which presents the advantage of complete removal of the entire lesion. Recurrence is fairly rare.
About the Author
This article has been contributed by the Department of Oral Pathology & Microbiology, Yenepoya Dental College under the Yenepoya (Deemed to be University) established in the year 1992, with its robust alumni of 3000 Under graduates and 67 Post graduates students and research scholars has many accolades and achievements to its credit. It strives to provide state of art Oral diagnostics and Molecular Pathology while excelling in research activities and instilling a holistic approach in dental education among students.
Department contributes its expertise in fostering inter-disciplinary collaboration and providing exemplary education and scientific research.
