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A firm soft tissue nodule of the palate with grey-blue color should make a clinician think of leiomyoma or angiomyoma (vascular leiomyoma). The age and gender in this case is supportive of leiomyoma. The histology is also supportive of leiomyoma.
Leiomyoma is a benign neoplasm of smooth muscle origin. Uncommon in the oral cavity, it mainly occurs in the G.I. tract, uterus and skin. In the oral cavity, it most likely originates from the vascular smooth muscle. Vascular leiomyoma, also known as angiomyoma, accounts for 75% of oral leiomyomas. Patients tend to be over 30 years of age and are predominantly males. It is most common on the posterior tongue, palate, cheeks and lips. It is a slow growing, painless, pedunculated, smooth-surfaced, normal color or slightly bluish nodule. Intra-osseous leiomyomas have been reported, but very rarely. Histopathologically, this neoplasm is made up of a well-circumscribed to encapsulated nodule composed of bundles of smooth muscle cells, with some surrounding blood vessels in cases of angiomyoma. Simple and conservative excision is the treatment of choice.
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