An unusual white lesion in a 10 month old child

Abstract

Introduction: Oral lesions commonly diagnosed in neonatesinclude Epstein’s pearls, Bohn’s nodules, dental lamina cysts,natal teeth and congenital epulis. Nevertheless, intriguing caseswhich have rarely been reported in the literature are sometimesencountered by clinicians. We report a case of an unusual whitelesion in a 10-month old male infant. Clinical management: The infant’s mother had noticed a smallwhite swelling in the anterior region of the maxilla in the morningwhich increased in size by the late afternoon. Hence, she wasurged by the paediatrician to seek dental advice. Intra-oralexamination revealed a white mass (approximately 5 mm indiameter) in the maxillary right central incisor region, firm inconsistency and adherent to the mucosa. Radiographic examina-tion indicated that the white mass was radiolucent. The parentswere reassured and advised to monitor the lesion. The parentsreturned 3 weeks later reporting that the white mass had, thatday, shed spontaneously. It had a uniform hemispherical outlineand measured 10 mm · 5 mm in diameter. Histopathologicalexamination reported the mass to be acellular and amorphous;as it did not resemble any known bodily tissues, it was diagnosedas a Ôforeign bodyÕ.Conclusion: Infants tend to explore things with their mouths; hencethey put anything they can hold into their oral cavity to determinethe size and texture. This case serves to illustrate that theunexpected can occur and that in children the differential diagnosisshould include a Ôforeign bodyÕ.