Painless Oral Swelling Or Mass Differential Diagnosis Table

Painless Oral Swelling Or Mass
Differential Diagnosis Table:

Swelling is an enlargement present anywhere on the body that arises due to a variety of reasons, such as inflammation, infection, injury, or the accumulation of mucus, fluid, or pus. Swelling can be present in any location in varying colors, shapes, or sizes. Sometimes, it can be painful, and patients present with intolerable pain, usually keeping them up at night; in other instances, it is painless, and the only sign is the presence of an abnormal bulge.
Swelling in the oral cavity is a common occurrence. Usually, the swelling or mass inside the oral cavity heals within 4 weeks. Any swelling lasting more than 4 weeks is suspected of malignancy and checked by biopsy. It is hard to tell whether the mass is benign or malignant just by looking at it. The only way is to perform a biopsy.

How To Recognize Which Disease Is Causing the Painless Oral Swelling or Mass

How to Recognize if Mucocele Is Causing the Painless Oral Swelling or Mass

Mucocele of the oral cavity is a benign mass that usually arises as a result of trauma, which obstructs the normal drainage of mucous, resulting in mucous accumulation under the tissue. Mucocele is usually painless and heals on its own. Mucoceles can be present anywhere inside the oral cavity on the floor of the mouth, lower lip, palate, and buccal mucosa. The most common location is the lower lip, where the incidence of trauma as a result of lip biting is the most common.
The most common presentation is a soft-textured, 1 to 2 cm wide mass, which is filled with fluid, giving it a fluctuant appearance. It is mostly painless and gives a bluish tinge.

How to Recognize if Lipoma Is Causing the Painless Oral Swelling or Mass

Lipoma is a soft tissue tumor that occurs as a result of fat accumulation between the oral mucosa and muscle. Oral cavity lipomas are a rare occurrence and are found anywhere inside the oral cavity, including the salivary glands, lip, buccal mucosa, gingiva, floor of the mouth, and palate.
They appear yellow in color, well-circumscribed, and soft upon palpation. They are painless and usually do not produce any symptoms. If they enlarge, they produce discomfort upon chewing and speaking.

How to Recognize if Hemangioma Is Causing the Painless Oral Swelling or Mass

Hemangioma is a mass that is produced as a result of blood vessel accumulation under the skin. In the oral cavity, oral hemangiomas are mainly caused by endothelial proliferation and are considered benign tumors. Hemangiomas can be present on the lips, palate, the floor of the mouth, the buccal mucosa, and the salivary glands.
They are soft, a few mm to cm wide, and may blanch on pressure. They are asymptomatic and may interfere with mastication if large. They appear as a well-circumscribed red-blue mass.

How to Recognize if Salivary Gland Tumor Is Causing the Painless Oral Swelling or Mass

Salivary gland tumors can be benign or malignant. They can occur in any of the major salivary glands, namely parotid, submandibular, and sublingual glands. Most commonly, a salivary gland tumor is benign and occurs in the parotid gland. They can be unilateral or bilateral.
For benign tumors, a mass can be seen extra-orally and can be palpated. They are well-circumscribed and are asymptomatic. Malignant tumors are usually not circumscribed and feel fixed to the adjacent structures. They are also painless and produce paresthesia of the face.

How to Recognize if Lymphoma Is Causing the Painless Oral Swelling or Mass

Lymphoma is a tumor associated with lymph nodes. Lymphoma is among the most common cancers of the body. Lymphoma produces symptoms such as fever, unexplained weight loss, sweating at night, loss of appetite, and swollen lymph nodes. Rarely, lymphoma produces symptoms inside the oral cavity.
Oral lymphoma produces an asymptomatic soft oral mass or swelling that can be ulcerated. Mobile teeth and swollen gums that can bleed easily. These lesions can also produce oral paresthesia.

How to Recognize if Schwannoma Is Causing the Painless Oral Swelling or Mass

Schwannoma is a benign tumor of nerve covering or sheath. It is a slowly growing tumor and can affect the head and neck. When it grows, it can produce pain and paralysis of the associated nerve.
In the oral cavity, it is present as an asymptomatic, slowly growing mass with a soft and smooth texture. The swelling is firm, and the mass can be palpable. It can sometimes produce pain and paresthesia. The most common site is the tongue, and it can be present in regions like the palate, the floor of the mouth, the buccal mucosa, and the gingiva.

Common Red Flags with Painless Oral Swelling Or Mass

Painless oral swelling and mass can be due to a number of reasons, as discussed above, and in most cases, it’s benign. Most of these masses need to be removed surgically to improve the quality of life, as pain is not an issue owing to their asymptomatic nature.
Mucocele can be distinguished from the others by a bluish tinge and fluctuant swelling. Lipomas usually appear yellow in color because they are composed of fat. Hemangiomas are usually reddish in color because they are composed of blood vessels and can blanch when pressure is applied. Salivary gland tumors are usually present in the area where the salivary glands are located and can be easily spotted. Other than that, some tumors produce facial paralysis. Lymphomas, being a cancer, usually produce extra-oral symptoms, mainly night sweats, weight loss, and lymph node swelling.
Any kind of oral mass should be referred for biopsy if they persist for more than 4 weeks. Only a biopsy can confirm the diagnosis and detect malignancy early. Other warning signs are oral paresthesia and a mass fixed to adjacent structures. Whenever such signs are present, a biopsy should be rushed.