Well-defined radiolucent lesion in the maxillary anterior region.

A case of nasopalatine duct cyst is described. Such cysts often remain asymptomatic for lengthy periods and may be discovered during routine radiography. The quiescent nature of this cyst underscores the importance of thorough clinical and radiographic examination before the fabrication of a prosthesis, as such cysts may give rise to acute infection, enlargement, and penetration through the overlying mucosa if not removed before denture insertion.

Large nonpainful swelling of the lower lip.

The lipomas are slow-growing benign neoplasms. They are characterized by a smooth-surfaced, sessile or pedunculated, yellow-to-pink submucosal mass that is usually asymptomatic. Superficially situated lesions show a telangiectatic vascular network. Deeper lesions may only be noticed as a subtle swelling, making them difficult to detect and treat. Despite its relative infrequency in the mouth, clinicians should be aware of the possibility of lipoma when diagnosing nonulcerated, soft-tissue masses of the mouth. Proper treatment consists of surgical excision, histologic examination, and patient follow-up.

A solitary cauliflower-like nodule on the mucosal surface of the lower lip.

The incidence of oral condylomata acuminata and simultaneous genital condylomata is not known. A review of the literature implies that the disease is rare, but it is more likely that it is only rarely reported. As the virus is autoinoculable and transmissible, the etiologic factor in this case of oral condylomata acuminatum is most likely orogenital contact. This case report serves as a reminder also that oroanogenital contact expands the anatomic range of sexually transmitted diseases.

Flattened papillary mass on the posterior hard palate.

An unusually large, asymptomatic, exophytic mass of the palate with a papillary surface architecture--characteristic of an oral squamous papilloma--has been presented. The cause of the squamous papilloma is unknown. Surgical excision, with microscopic examination of removed tissue, is the preferred treatment. Recurrence or malignant change, or both, are unusual.

Multiple, painful vesiculoulcerative lesions in the oral mucosa.

An example of pemphigus vulgaris with initial clinical manifestations confined to the mouth has been presented. Clinicians must recognize this serious disease and understand that probably more than half of the patients with pemphigus vulgaris will first experience oral lesions, and almost all will, at some time, have oral vesiculoulcerative lesions.

Well-defined radiolucent area involving the anterior maxilla.

An example of a large and symptomatic nasopalatine duct cyst is presented. This cyst is the most common type of developmental or fissural cyst occurring in the maxilla. Treatment for most patients is conservative surgical excision. The excised tissue should be submitted for histopathologic examination to establish a definitive diagnosis and to rule out the possibility of a more serious lesion.

Pemphigus vulgaris.

Pemphigus vulgaris is a rare, potentially fatal skin disease with lesions usually first appearing in the mouth. Histologic examination is the only reliable mechanism with which to establish an accurate diagnosis. An elderly patient with multiple oral and skin lesions was diagnosed, referred to the dermatology service, and successfully treated with corticosteroid therapy.