History of Present Illness

The patient is a 62-year-old white male who presented to the University of Washington emergency room complaining of mouth pain and limited ability to swallow his medications. He also complained of shortness of breath which decreased when he sat down. A large mass was noted to be growing out of the socket of an extracted lower left molar tooth (Fig 1). The tooth had been extracted recently in Alaska. The patient reported increased pain in the area and that the molar tooth had been “abscessed” for approximately one year prior to the extraction. He has a history of smoking one to two packs of cigarettes per day for forty years. He does not consume alcohol.

Figure 1. The left posterior mandibular alveolar ridge demonstrates a large, exophytic purplish-red mass extending downward into the floor of mouth growing in an area of non-healing tooth socket.