Pathology · patient case question
The bony hard midline swelling of the hard palate is best identified radiographically as:
Patient case: White and Pigmented Oral Lesions
demo: 58-year-old male
chief: Routine examination; several mucosal findings noted.
history: Smokes one pack per day for 30 years. Occasional alcohol.
meds: None
findings: Finding 1: a small white plaque on the soft palate that does not wipe off. Finding 2: a white plaque on the lateral tongue border, 3 mm, non-wiping. Finding 3: a flat blue-grey macule in the buccal mucosa adjacent to a large amalgam restoration. Finding 4: irregular erythematous patches with white serpiginous borders on the dorsal tongue that shift location between visits. Finding 5: a bony hard midline swelling of the hard palate.
Show answer and explanation
Correct answer: C. Torus palatinus, appearing as a well-defined midline radiopacity
- A. Ossifying fibroma is a well-circumscribed intrabony lesion with mixed density, typically in the posterior mandible.
- B. A nasopalatine duct cyst is a radiolucent heart-shaped lesion between the roots of the maxillary central incisors, not a bony hard surface swelling.
- C. Correct. Torus palatinus is a developmental exostosis of the midline hard palate — bony hard, covered by normal mucosa, and seen as a well-defined radiopacity superimposed on an occlusal film. No treatment is needed unless it interferes with a prosthesis.
- D. A compound odontoma is a collection of tooth-like structures within bone, not a surface exostosis.