Pathology · single question
A 62-year-old female with a buccal exostosis — radiographically identified as a hard smooth painless mass. What is this finding?
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Correct answer: D. Buccal exostosis
A hard, smooth, painless mass on the buccal gingiva of the maxillary premolar area with corresponding radiodensity is a BUCCAL EXOSTOSIS. Exostoses are benign outgrowths of cortical bone that occur on the facial (buccal) aspect of the jaws. They are dense on radiograph. The clinical presentation (hard, non-tender, smooth buccal mass) combined with the radiographic finding confirms buccal exostosis.
- A. INCORRECT. Periapical cemento-osseous dysplasia appears as periapical radiolucencies/mixed lesions in association with VITAL TEETH — not as a surface bony hard mass.
- B. INCORRECT. Compound odontoma consists of multiple small tooth-like structures — it appears as multiple radiodense structures resembling teeth in a radiograph.
- C. INCORRECT. Dense bony island (idiopathic osteosclerosis) appears as a radiopacity within the medullary bone — not as a surface/buccal hard mass.
- D. CORRECT. Buccal exostosis is a benign overgrowth of cortical bone on the buccal/facial surface of the jaw. It is hard, smooth, non-tender, and appears as a radiopacity on X-ray. It is the correct diagnosis for this clinical presentation.