Soft-tissue lesions in children

Fibroma is a mass of collagenous connective tissue that typically presents as an exophytic, domeshaped, smooth-surfaced, sessile or pedunculated nodule (Fig. 1A) on the buccal mucosa [1]. The most common cause is irritation, especially from chronic chewing of the area. Occasionally, it may represent a true benign neoplasm of fibrous connective tissue origin. Fibroma can affect patients of any age, including children, but it is more common in adults around 30 years of age and has no sex predilection [1]. It occurs anywhere in the oral cavity but most commonly on the buccal mucosa along the plane of the occlusal line, lips, lateral tongue, and gingiva. It can be pink, white, or red (if ulcerated) in color [1–3]. In individuals with dark skin, it can be gray or brown. Sizes range from a few millimeters to several centimeters in diameter, averaging 1 to 2 cm. Unless they are ulcerated, fibromas are usually asymptomatic. Histologically, fibromas are made up of a nodule of connective tissue, usually collagenous (Fig. 1B). The surface epithelium ranges from thin to thick and is usually covered by parakeratin or orthokeratin (Fig. 1B). Conservative surgical removal, whether conventional or laser, and cessation of the chewing habit qualify as appropriate treatment [1,2]. The likelihood of recurrence depends on whether the habit of cheek chewing continues. The differential diagnosis of fibromas of the buccal mucosa and lips should include salivary gland neoplasms.