Pathology · single question
A patient presents with a blackish, tattoo-like appearance in the posterior maxillary region. What is the most likely diagnosis?
Show answer and explanation
Correct answer: A. Amalgam Tattoo (Foreign Body)
Amalgam Tattoo / Foreign Body (A) is the most likely diagnosis. An amalgam tattoo is the most common pigmented oral lesion — it appears as a flat, blue-gray to black macule, typically near restored teeth in posterior regions (common in maxillary area near old amalgam restorations). It is asymptomatic and does NOT change over time.
• Nevus (B): benign melanocytic lesion, usually well-circumscribed and lighter — less common in oral mucosa.
• Melanoma (C): oral melanoma is rare, aggressive, and typically shows irregular borders, color variation, ulceration, and growth. This would be alarming if present — biopsy mandatory.
• Fibroma (D): reactive fibrous growth — typically pink/flesh-colored and raised, NOT pigmented/black.
• Key: POSTERIOR MAXILLA + tattoo-like = think amalgam tattoo first.
• Nevus (B): benign melanocytic lesion, usually well-circumscribed and lighter — less common in oral mucosa.
• Melanoma (C): oral melanoma is rare, aggressive, and typically shows irregular borders, color variation, ulceration, and growth. This would be alarming if present — biopsy mandatory.
• Fibroma (D): reactive fibrous growth — typically pink/flesh-colored and raised, NOT pigmented/black.
• Key: POSTERIOR MAXILLA + tattoo-like = think amalgam tattoo first.