A Guide to Clinical Differential Diagnosis of Oral Mucosal Lesions
Table 6. Benign Mesenchymal Tumors

Course Author(s): Author: Michael W. Finkelstein, DDS, MS; Emily Lanzel, DDS, MS; John W. Hellstein, DDS, MS

Table 6. Benign Mesenchymal Tumors

Overlying mucosa is normal unless traumatized; usually well-circumscribed, asymptomatic, slowly growing.
Irritation fibroma Firm or compressible
Epulis fissuratum (inflammatory fibrous hyperplasia) Located adjacent to flange of removable denture; firm or compressible
Peripheral ossifying fibroma Occursonly on gingiva; firm; sometimes ulcerated; sometimes vascular; may move teeth
Leiomyoma Firm; sometimes vascular.
Rhabdomyoma Firm; located in areas of skeletal muscle
Peripheral giant cell granuloma Occurs only on gingiva or attached alveolar mucosa; vascular
Hemangioma Congenital; compressible; vascular; circumscribed or diffuse
Lymphangioma Congenital; compressible; usually diffuse; not vascular
Pyogenic granuloma Vascular; compressible; frequently has rapid growth, ulcerated, bleeds easily
Lipoma Encapsulated; compressible; sometimes yellow
Neuroma (traumatic or amputation neuroma) Firm; usually tender to palpation; size of lesion is dependent upon size of involved nerve
Neurofibroma Firm or compressible; non-tender; circumscribed or diffuse; may occur with neurofibromatosis
Schwannoma (neurilemoma) Encapsulated; firm; non-tender;
Granular cell tumor Firm; sometimes overlying surface is rough
Congenital epulis Firm; congenital; occurs only on attached alveolar mucosa