Pathology · single question
A 25-year-old patient presents with a firm, non-tender 1 cm elevated lesion on the buccal mucosa with a central 1 cm ulceration on its surface. The MOST likely diagnosis is:
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Correct answer: D. Nodule
A nodule is a solid elevated lesion >5mm in diameter. When a nodule has surface ulceration (as described here), it warrants biopsy to rule out malignancy. The clinical description — firm, elevated, non-tender buccal lesion with central ulceration — is classic for a nodule. Management: incisional biopsy to establish diagnosis.
- A. ❌ A fibroma is typically firm and sessile/pedunculated but does not characteristically present with central ulceration.
- B. ❌ A ranula is a large mucocele on the floor of the mouth with a characteristic bluish, fluctuant appearance.
- C. ❌ A mucocele is fluid-filled, fluctuant, and bluish — not firm with ulceration.
- D. ✅ CORRECT – A nodule is a solid elevated lesion >5mm. Central ulceration on a nodule raises concern and warrants incisional biopsy.