Squamous Papilloma — ORE Part 1 MCQ

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EasyOral PathologySquamous PapillomaORE Part 1

A 30-year-old woman presents with a painless, soft, pedunculated mass on the tip of her tongue. It is pink, lobulated, and approximately 5 mm in diameter. It has been present for 6 months with no rapid change. What is the most likely diagnosis?

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Correct answer: D — Squamous papilloma

Squamous papilloma is the correct answer. This is a benign, painless, exophytic, pedunculated lesion with characteristic pink, lobulated morphology on the tongue in a 30-year-old patient—a classic presentation. Squamous papillomas are among the most common benign oral epithelial lesions, solitary, grow slowly to ~0.5 cm, and have no malignant potential. Option E (fibroma) lacks the specific pedunculated, lobulated, exophytic morphology typical of papilloma. Option C (verruca vulgaris) is primarily a cutaneous lesion and not the standard diagnosis for this intraoral presentation. Option A (SCC) is excluded by the painless, non-aggressive 6-month course, small size, and pink colour; SCC typically presents with more aggressive features, pain, or ulceration. Option B (granular cell tumour) is rare and not consistent with this clinical picture.

Reference: An Atypical Squamous Papilloma of the Uvula, PubMed Central, 2024. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11087670/ and Management of an Oral Squamous Cell Papilloma in an Unusual Maxillofacial Location, PubMed Central, 2024. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12883488/