BENIGN ORAL CAVITY TUMORS

1. Oral squamous papilloma – fourth most common oral mucosal mass

 Commonly associated with HPV 6 and 11
 Low virulence – not contagious
 FEATURES:
> Painless white or pink exophytic growth with numerous, small finger-like
projections that looks like a roughened, verrucous or ‘cauliflower like’ surface.
> Usually it is a well circumscribed pedunculated tumor but can also be sessile.
> Most commonly found on the tongue, lips, buccal mucosa, gingiva and palate
(adjacent to the uvula)
> Size: usually only in millimeters but can grow to several centimeter
2. Squamous acanthoma – uncommon
 May occur at any site on the oral mucosa
 Usually in older adults
 FEATURE:
> Small flat or elevated, white, sessile or pedunculated lesion on the mucosa
 HISTOLOGY:
> Well-demarcated elevated and umbilicated epithelial proliferation with a
markedly thickened layer of orthokeratin and underlying spinous layer of cells
 According to Tomich and Shafer, it is caused by trauma then epithelial alteration took
place beginning with pseudoepitheliomatous hyperplasia
 No recurrence after excision
3. Keratoacanthoma – clinically and pathologically resembles SCC (variant of invasive SCC)
 Aka: self-healing carcinoma, molluscum pseudocarcinomatosum, molluscum ebaceum,
verrucoma
 Common low grade malignancy
 Origin: pilosebaceous glands
 Etiologic factors: sunlight, chemical carcinogens (ex. Pitch and Tar), trauma, HPV, genetic
factors, immunocompromised
 Epidemiology:
> All group age; incidence increase with age
> Male > Female
> Fairer skin > dark skin
> Common sites: face, neck, and dorsum of the upper extremities
 FEATURES:
> Painful solitary lesions that begin as firm, round, skin-colored or reddish papules
> After 4-8 wks it becomes a dome-shaped nodule with smooth shiny surface
> Has a central crateriform ulceration or keratin plug that projects like a horn
> Regional lymphadenopathy may be present
> Undergoes spontaneous regression over the next 6-8 week period by:
- Expulsion of the keratin core
- Resorption of mass
 TREATMENT: surgical excision
4. Oral Nevi – hamartomas
 Intramucosal nevus – most common mucosal type
 Blue nevus – second most common
> More common on mouth than skin
> rarely undergo malignant transformation
 More predominant in female than male
 Most common location: hard palate; 2nd most common: buccal
5. Pleomorphic adenoma – most common salivary gland tumor
 Particularly common site is the parotid gland (lower pole of the superficial lobe)
 Rare in sublingual gland
 Palate – most common site of minor salivary gland involvement
 Average occurrence in patients is at 43y/o, but have known to occur in children
 FEATURES
> Small, painless, quiescent nodule that slowly increase in size
> Irregular, nodular and firm with well-defined borders
> Can cause facial paralysis
> Pleomorphic intraoral accessory gland
- 1–2 cm in diameter
- Can have difficulties in mastication, talking and breathing
6. Myoepithelioma – uncommon
 Common site: parotid gland
7. Monomorphic adenoma
 Group of salivary neoplasm with microscopic features that are different from
pleomorphic adenoma
 Canalicular adenoma, basal cell adenoma, oncocytoma
8. Papillary cystadenoma lymphomatous – 2nd most common tumor of salivary glands
 Aka: Warthin’s tumor, adenolymphoma
 Common site: Parotid (almost exclusively), submaxillary
 Arises from entrapped salivary gland tissue within paraparotid and intraparotid lymph
nodes during embryogenesis
 Risk factor: smoking, 60-70 y/o (ave 62 y/o)
 Features:
> Painless, firm, superficial, under or protruding the parotid capsule
> Does not exceed 3-4cm
9. Sebaceous adenoma
 More common in men
 Mean age: 58 y/o (22-90 y/o)
 Encapsulated or sharply circumscribed that can be grayish-white to pinkish white to
yellow or yellow gray
 Composed of sebaceous nests with minimal atypia and pleomorphism