Differential Diagnosis for a Lesion in the Lower Buccal Sulcus
- Single most likely diagnosis:
- Mucocele: This is a common, benign lesion that occurs in the oral cavity, often resulting from the rupture of a salivary gland duct and subsequent accumulation of mucin in the soft tissues. The lower buccal sulcus is a typical location for mucoceles due to the presence of minor salivary glands.
- Other Likely diagnoses:
- Irritation fibroma: A benign growth that can occur in response to chronic irritation, such as from a denture or sharp tooth edge. The lower buccal sulcus is a possible location due to its susceptibility to mechanical irritation.
- Pyogenic granuloma: A benign vascular lesion that can appear in the oral cavity, often in response to irritation or trauma. Although more common on the gingiva, it can also occur in other areas like the buccal sulcus.
- Traumatic ulcer: An ulceration that can occur due to mechanical trauma, such as from a sharp tooth edge, denture, or accidental bite. The lower buccal sulcus can be susceptible to such injuries.
- Do Not Miss diagnoses:
- Squamous cell carcinoma: Although less common, this malignant tumor can present in the lower buccal sulcus, especially in individuals with risk factors like tobacco use. Early detection is crucial for effective treatment.
- Salivary gland tumor: Both benign and malignant tumors of the salivary glands can occur in the lower buccal sulcus. Given the potential for malignancy, these lesions should not be overlooked.
- Rare diagnoses:
- Granulomatosis with polyangiitis (formerly known as Wegener's granulomatosis): A rare autoimmune disorder that can affect various parts of the body, including the oral cavity, and present with ulcers or other lesions.
- Langerhans cell histiocytosis: A rare disorder in which the body accumulates too many immature Langerhans cells, leading to tumors or damage in various organs, including the oral cavity.
- Sarcoidosis: A condition characterized by the growth of granulomas (inflammatory cells) in various parts of the body, including the oral cavity, which can present with lesions or ulcers in rare cases.