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Clinically Unusual Pigmented Lesion of the Buccal Mucosa: A Case Report

We present a rare clinical case of a 64-year-old patient with a pigmented lesion localized in the left buccal mucosa. Subjective complaints of slight pain and discomfort in the process of eating and increased sensitivity when consuming hot food were reported. According to the information provided by...

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Autores principales: Yankov, Yanko G, Nenova-Nogalcheva, Anna K, Dimanov, Simeon N, Stoev, Lyuben L, Konstantinova, Desislava A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10566642/
https://www.ncbi.nlm.nih.gov/pubmed/37829959
http://dx.doi.org/10.7759/cureus.45050
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author Yankov, Yanko G
Nenova-Nogalcheva, Anna K
Dimanov, Simeon N
Stoev, Lyuben L
Konstantinova, Desislava A
author_facet Yankov, Yanko G
Nenova-Nogalcheva, Anna K
Dimanov, Simeon N
Stoev, Lyuben L
Konstantinova, Desislava A
author_sort Yankov, Yanko G
collection PubMed
description We present a rare clinical case of a 64-year-old patient with a pigmented lesion localized in the left buccal mucosa. Subjective complaints of slight pain and discomfort in the process of eating and increased sensitivity when consuming hot food were reported. According to the information provided by the patient, the lesion had progressively increased in size. A history of previous dental manipulations was reported, namely, the extraction of teeth with amalgam obturations in the left half of the maxilla as per relevant indications. During the intraoral examination, a flat, black-colored lesion, 0.4 cm in diameter, with well-defined borders was observed in the buccal mucosa. Teeth 25, 26, and 27 were previously extracted five to seven years ago. An orthopantomography was performed as a routine procedure. It did not show any presence of X-ray contrast areas that could explain the symptoms of the patient. The symptomatic nature of the lesion as well as the negative radiological findings prompted surgical treatment and excisional biopsy with subsequent histological evaluation to rule out oral malignancy. An excision was performed. During the follow-up examination in the next eight days, all the symptoms of the patient were gone. The conclusion of the pathology report was "histological findings and clinical data consistent with amalgam tattoo". The amalgam tattoo is the most frequent iatrogenic pigmented lesion of the oral mucosa, which results from the implantation of amalgam particles in the soft tissues and it is usually asymptomatic. In this case, no surgical treatment is needed. However, in some rare cases, like the one we are presenting, some symptoms can occur and complicate the diagnostic process. In these cases, the complete excision of the lesion is to be performed with subsequent histological evaluation. The atraumatic intervention of teeth, obturated with definitive amalgam fillings, is a main factor for preventing this kind of pigmentation of the oral mucosa.
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spelling pubmed-105666422023-10-12 Clinically Unusual Pigmented Lesion of the Buccal Mucosa: A Case Report Yankov, Yanko G Nenova-Nogalcheva, Anna K Dimanov, Simeon N Stoev, Lyuben L Konstantinova, Desislava A Cureus Pathology We present a rare clinical case of a 64-year-old patient with a pigmented lesion localized in the left buccal mucosa. Subjective complaints of slight pain and discomfort in the process of eating and increased sensitivity when consuming hot food were reported. According to the information provided by the patient, the lesion had progressively increased in size. A history of previous dental manipulations was reported, namely, the extraction of teeth with amalgam obturations in the left half of the maxilla as per relevant indications. During the intraoral examination, a flat, black-colored lesion, 0.4 cm in diameter, with well-defined borders was observed in the buccal mucosa. Teeth 25, 26, and 27 were previously extracted five to seven years ago. An orthopantomography was performed as a routine procedure. It did not show any presence of X-ray contrast areas that could explain the symptoms of the patient. The symptomatic nature of the lesion as well as the negative radiological findings prompted surgical treatment and excisional biopsy with subsequent histological evaluation to rule out oral malignancy. An excision was performed. During the follow-up examination in the next eight days, all the symptoms of the patient were gone. The conclusion of the pathology report was "histological findings and clinical data consistent with amalgam tattoo". The amalgam tattoo is the most frequent iatrogenic pigmented lesion of the oral mucosa, which results from the implantation of amalgam particles in the soft tissues and it is usually asymptomatic. In this case, no surgical treatment is needed. However, in some rare cases, like the one we are presenting, some symptoms can occur and complicate the diagnostic process. In these cases, the complete excision of the lesion is to be performed with subsequent histological evaluation. The atraumatic intervention of teeth, obturated with definitive amalgam fillings, is a main factor for preventing this kind of pigmentation of the oral mucosa. Cureus 2023-09-11 /pmc/articles/PMC10566642/ /pubmed/37829959 http://dx.doi.org/10.7759/cureus.45050 Text en Copyright © 2023, Yankov et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Pathology
Yankov, Yanko G
Nenova-Nogalcheva, Anna K
Dimanov, Simeon N
Stoev, Lyuben L
Konstantinova, Desislava A
Clinically Unusual Pigmented Lesion of the Buccal Mucosa: A Case Report
title Clinically Unusual Pigmented Lesion of the Buccal Mucosa: A Case Report
title_full Clinically Unusual Pigmented Lesion of the Buccal Mucosa: A Case Report
title_fullStr Clinically Unusual Pigmented Lesion of the Buccal Mucosa: A Case Report
title_full_unstemmed Clinically Unusual Pigmented Lesion of the Buccal Mucosa: A Case Report
title_short Clinically Unusual Pigmented Lesion of the Buccal Mucosa: A Case Report
title_sort clinically unusual pigmented lesion of the buccal mucosa: a case report
topic Pathology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10566642/
https://www.ncbi.nlm.nih.gov/pubmed/37829959
http://dx.doi.org/10.7759/cureus.45050
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