History of the present illness

This is a 57-year-old white male with a slowly and progressively enlarging gingival swelling lingual of teeth #s 29-30 and the posterior edentulous mandible.  A similar, but smaller lesion was removed six years ago from the same area.  This swelling is of one and a half years’ duration and has been growing slowly.  It is reddish-purple in color and is ulcerated but not painful.  The patient frequently bites the lesion as it interferes with chewing.  It is described clinically to be hemorrhagic (bleeds easily), fungating and in excess of 2.5 x 3.5 cm in size.  Tooth #30 is significantly displaced and the edentulous alveolar ridge is superficially resorbed, leading to the so-called “saucerization” of the alveolar bone (Figure 2). 

Figure 1 Photograph is taken at clinical presentation demonstrating a large, exophytic, reddish gingival mass on the lingual area of teeth #s 29 & 30 and extending posteriorly to involve the edentulous alveolar ridge.

Figure 2 Panoramic radiograph taken at clinical presentation. It shows superficial and smooth-bordered resorption of the edentulous alveolar ridge.