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JAMA Clinical Challenge

A Nodular Protuberance on the Hard Palate

Image of Two prominent protuberances at the bilateral maxillary tuberosities

Barry Ladizinski, MD
Kachiu C. Lee, MD, MPH

A 66-year-old man presents with a slowly enlarging growth in his mouth that appeared more than 20 years ago. He denies pain and discomfort but is concerned because the mass has increased in size during the past year. He does not wear dentures and denies trauma, use of tobacco products, poor nutrition, and risky sexual practices. Family history is noncontributory. Physical examination reveals a healthy appearing male with a nontender, symmetric, nodular bony protuberance on the midline of the hard palate. Two prominent protuberances are also noted at the bilateral maxillary tuberosities (Figure). The remainder of the examination is unremarkable.

See the full article for an explanation and discussion.

Author Affiliations: Dr Ladizinski (barryladizinski@gmail.com) is affiliated with the Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Dr Lee is affiliated with the Department of Dermatology, Brown University, Providence, Rhode Island.