Pathology · single question
A tongue lesion is suspected. All of the following are differential diagnoses for a pedunculated mass on the tongue EXCEPT one. Which is the EXCEPTION?
Show answer and explanation
Correct answer: A. Verruca vulgaris
Schwannoma, granular cell tumor, and fibroma can all present as pedunculated (or sessile) masses on the tongue. Verruca vulgaris (common wart — HPV) typically occurs on the lips, perioral skin, and keratinized mucosa but is much less commonly found on the tongue proper. For a pedunculated soft tissue mass on the tongue, fibroma (traumatic), granular cell tumor, and schwannoma are all appropriate differentials.
- A. CORRECT (this is the EXCEPTION). Verruca vulgaris (HPV warts) typically occurs on keratinized or semi-keratinized surfaces such as the lips, perioral skin, hard palate, and gingiva — NOT characteristically on the tongue proper. It is the least likely of the four options to be a differential for a tongue pedunculated mass.
- B. INCORRECT (IS a differential). Fibroma (traumatic fibroma) is the most common benign oral soft tissue tumor and frequently presents as a smooth-surfaced nodule on the tongue, buccal mucosa, or lip.
- C. INCORRECT (IS a differential). Granular cell tumor commonly occurs on the tongue — it is actually one of the most frequent benign tongue tumors.
- D. INCORRECT (IS a differential). Schwannoma is a benign nerve sheath tumor that can arise anywhere on the tongue — it is a valid differential for a tongue mass.