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Q. I have recurrent swelling in the hard palate. Is it some oral malignancy?

Answered by
Dr. Beryl Fredrick
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 25, 2021 and last reviewed on: Jul 03, 2021

Hi doctor,

About two months ago, I realized that my hard palate in the anterior region was very swollen. Out of panic, I pushed it down with my finger. It did not feel solid or firm. Instead, there was a pus discharge. Afterward, my anterior palate near the incisive papilla went down a bit. This has kept happening three to four times during the past few weeks. I thought it would solve on its own, but since it is recurrent, I am scared it might be some oral malignancy or something.

Recently, I pushed down my incisive papilla with my finger once again and took a picture. I have sent it for your reference. It seems swollen and does not get fixed. It constantly gets swollen, full of pus for no reason. It is completely painless.

There is no history of cancer in my family. I am not a smoker nor a drinker. I have not had intercourse. Please help me.

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Hello,

Welcome to icliniq.com.

I have gone through your query and all your pictures (attachment removed to protect the patient's identity). From the images, the swollen mass at the center of your hard palate could be a torus palatinus. And the supposed swelling of your incisive papilla region with pus could mean a simple gingival abscess or an infected torus palatinus. It can also be a gingival abcess or odontogenic abcess. A possible root canal-treated tooth with the missing crown was also seen from the pictures (upper left first molar).

You will need a complete clinical and radiographic examination to diagnose this. Once diagnosed, this can be treated appropriately. First, take an OPG (orthopantomogram) or CBCT (cone-beam computed tomography).

A complete dental examination and biopsy are required to confirm if this is going to any benign or malignant mass or swelling.

I hope this helps you. If you have further queries, do let me know.


Hi doctor,

Thank you.

I was specifically wondering about the swelling around my incisive papilla. Can an abscess be painless and recurring?

I am extremely worried about this being some malignancy, do malignancies of the mouth or incisive papilla present like this?

Update on how it looks today. I have attached the pictures.

Furthermore, I was reading on nasopalatine cysts. Please guide me.

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Hello,

Welcome back to icliniq.com.

Yes, an abscess can reoccur and be painless if untreated. From the pictures (attachments removed to protect the patient's identity), no distinctive sign of incisive papillary infection or inflammation was noted. But this pus drainage, where exactly do you get? Between the upper central incisors or between the upper left central and lateral incisors?

Please get back for further information.

Hi doctor,

Thank you.

The pus is exactly coming out of where a nasopalatine cyst would be located, that is, the backside of the upper central incisors. However, this only happened a couple of times in the past. My posterior incisive papilla around this area would get very swollen. When I pushed it down, pus would come out, and the area would return to its normal size. It is swollen a little now, as seen in the attached picture.

Also, I am extremely worried about this being some malignancy. Does malignancies of the mouth or the incisive papilla present like this? Please guide me.

#

Hello,

Welcome back to icliniq.com.

A nasopalatine cyst is one of the most commonly occurring developmental cysts of this region. However, any cystic lesion or swelling of this region, as seen in the picture (attachments removed to protect the patient's identity), shows similar clinical symptoms like painlessness in nature with drainage. Therefore, a provisional diagnosis can be derived only after clinical examination of the swelling, vitality status check of the anterior teeth, and radiological study.

Once the presence of a cystic lesion and its origin (odontogenic or developmental) is confirmed by surgical excision or enucleation, it can be planned for follow-up by confirmatory biopsy, which gives a definitive diagnosis.

Considering the given history, the chances of it being malignant are less. But since you mentioned that it is recurrent now in the past few weeks, I suggest you get this checked right away. Given its purulent nature and its position, it is not safe to postpone diagnosis and treatment.

I hope this helps. For further queries, please get back to me.


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