The Pathological Spectrum Of Lesions Presenting As Oral Submucosal Masses

Objective: Retrospective analysis of lesions presenting as oral submucosal masses Materials and Methods: The study included all submucosal masses diagnosed between 2009-2011. Clinico-pathological analysis was performed and the correlation between the clinical diagnosis and final microscopic diagnosis investigated. Lesions with a microscopic diagnosis of mucocele, irritaion fibroma and hemangioma were excluded. Results: The survey included 32 patients, 17 males, 15 females, 5-92 years old (mean=54). The lesions were located in buccal mucosa (15), lip (10), palate (3) and other sites (4). The size ranged between 0.4-3 cm in diameter. The most frequent group of lesions (n=10, 31.25%) were of salivary gland origin, of which 2 were malignant (polymorphous low grade adenocarcinoma and carcinoma in pleomprphic adenoma) and 5 benign (3 pleomorphic adenomas, 2 canalicular adenomas and 1 basal cell adenoma). Salivary duct cyst was diagnosed in 2 patients. Lipomas and fibrolipomas were diagnosed in 9 (28.1%) cases. Five (15.6 %) cases were diagnosed as neuro-vascular hamartomas and 2 as epidermoid cysts. Three (9.3%) cases were lesions of neural origin (2 schwanommas, 1 neurofibroma). Lymphoma was diagnosed in 2 (6.25%) patients, and intravascular fasciitis in one case. Conclusions: Although relatively small and non-ulceratred, 12.5% of the submucosal masses were malignant. In addition, the survey included 21.9% tumors rarely reported in the oral mucosa, such as intra-vascular fasciitis, neuro-vascular hamartoma and basal cell adenoma in minor salivary glands. Thus, in 34.4% of the cases the final microscopic diagnosis was unexpected and was not included in the clinical differential diagnosis.