Pathology · single question

In the differential diagnosis of a soft tissue mass on the buccal mucosa, which of the following would be the EXCEPTION — i.e., a poor fit for this location?

  1. Schwannoma
  2. Fibroma
  3. Nicotinic (nicotine) stomatitis — which classically affects the HARD PALATE in habitual pipe/reverse smokers, not the buccal mucosa
  4. Lipoma
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Correct answer: C. Nicotinic (nicotine) stomatitis — which classically affects the HARD PALATE in habitual pipe/reverse smokers, not the buccal mucosa

Nicotine stomatitis specifically and classically affects the hard palate in habitual pipe smokers or reverse smokers (with the lit end inside the mouth), presenting as palatal keratosis with inflamed minor salivary gland duct openings — it does not typically present as a buccal mucosa mass, making it a poor fit for that differential diagnosis list. Schwannoma, fibroma, and lipoma are all plausible soft tissue masses that can present on the buccal mucosa.

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