Palatal Exostoses — ORE Part 1 MCQ

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EasyOral PathologyPalatal ExostosesORE Part 1

A patient presents with bilateral palatal swellings that are firm, non-tender, and covered with normal mucosa. They are located lateral to the midline in the premolar/molar region. The patient is asymptomatic. What is the most likely diagnosis?

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Correct answer: D — Palatal exostoses

Palatal exostoses are benign bony overgrowths located laterally on the hard palate, typically in the premolar/molar region. The key distinguishing feature is their **lateral-to-midline location**, which differentiates them from torus palatinus (which arises exclusively along the midline). The firm consistency, normal mucosa covering, bilateral presentation, and asymptomatic nature are typical of benign bony lesions. Pleomorphic adenomas are soft tissue salivary tumours (usually solitary, rarely bilateral) with different consistency; abscesses present with pain, tenderness, and signs of infection; necrotising sialometaplasia causes ulceration and inflammation. The anatomy and clinical presentation here are diagnostic of palatal exostoses.

Reference: Jainkittivong A, Langlais RP. Buccal and palatal exostoses: Prevalence and concurrence with tori. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;90(1):48–53. https://pubmed.ncbi.nlm.nih.gov/10884635/; supported by García-García et al., Alveolar bone exostoses following orthodontic treatment. Diagnostic considerations and clinical management (2023). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9992487/