Mandibular Tori — ORE Part 1 MCQ

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EasyOral PathologyMandibular ToriORE Part 1

A 30-year-old man presents with a 3 cm bony-hard swelling on the lingual aspect of the mandible in the premolar region bilaterally. It is asymptomatic and covered with normal mucosa. What is the most likely diagnosis?

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Correct answer: B — Torus mandibularis

Explanation lettering: C = shown as A · A = shown as B · E = shown as C · B = shown as D · D = shown as E

The answer is A: Torus mandibularis. The clinical presentation is pathognomonic: bilateral asymptomatic bony protrusions on the lingual surface of the mandible in the premolar region with normal overlying mucosa. This represents the classic and most common presentation of torus mandibularis. Approximately 80–90% present as bilateral lesions in the premolar region and are incidental findings. Osteoma (B) is typically solitary and not characteristically bilateral in the exact anatomical pattern described. Exostosis (C) is a generic term for bony outgrowth; torus is the specific clinical diagnosis for this lingual mandibular presentation. Fibrous dysplasia (D) is a progressive fibro-osseous lesion with distinctive radiographic features (ground glass appearance, cortical expansion) and would not present as bilateral symmetric lesions in this location. Osteosarcoma (E) is malignant, typically painful and rapidly progressive, and incompatible with asymptomatic presentation and normal mucosa.

Reference: Torus mandibularis. PMC5847250 (2018); Torus mandibularis is a benign osseous overgrowth arising from the lingual surface of the mandible. Pubmed 33307982 (2020). https://pubmed.ncbi.nlm.nih.gov/33307982/