A Bleeding Oral Mass in a Pregnant Woman

Abstract

A 24-year-old gravida 1, para 0 woman at 26 weeks' gestation presented for a routine prenatal visit with a soft-tissue mass on her upper maxillary gingiva. She reported that the mass had been present for 2 to 3 weeks and was increasing in size. It was not painful but bled when she brushed her teeth or ate sharp foods, which made it difficult to eat. There was no discharge from the area. She had no fevers, no trauma to the area, and no history of a similar condition.Vital signs included a temperature of 36.4°C, blood pressure of 106/57 mm Hg, and heart rate of 93/min. Physical examination revealed a 3 × 5-cm soft, compressible, nodular mass on the upper right gum line adjacent to the lateral incisors (Figure). The mass was friable, pedunculated, and covered with a thin white film. There was some gingival erythema near the adjacent teeth but no lymphadenopathy. The examination results were otherwise unremarkable. Figure. Oral examination of the patient. WHAT WOULD YOU DO NEXT? A. Prescribe a course of prednisone B. Perform a needle biopsy C. Refer to an oral surgeon for excision D. Recommend watchful waiting Clinical Review & Education

A Pink Nodule on a Boy's Left Cheek

“…Cryotherapy and pulsed dye laser therapy can be used in pyogenic granulomas, but pyogenic granulomas predominantly occur in the second decade of life, mostly in young adult females. 1 Amelanotic malignant melanomas rarely occur in young children and are usually ulcerated and asymmetrical. There are different types of Spitz nevi, which cannot be completely differentiated clinically; therefore, a skin biopsy for hematoxylin-eosin stain is needed to confirm the diagnosis.…”

“…A biopsy for fungal culture is needed to diagnose sporotrichosis, but sporotrichosis typically has a granulomatous appearance and erosions or ulcerations with purulent drainage can be seen on the surface. Cryotherapy and pulsed dye laser therapy can be used in pyogenic granulomas, but pyogenic granulomas predominantly occur in the second decade of life, mostly in young adult females . Amelanotic malignant melanomas rarely occur in young children and are usually ulcerated and asymmetrical.…”