Lower Lip Fibroma — ORE Part 1 MCQ

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EasyOral PathologyLower Lip FibromaORE Part 1

A 60-year-old patient presents with a lump on the lower lip that has been present for 6 months. It is firm, dome-shaped, 8 mm in diameter, with an intact mucosal surface. It does not transilluminate and has no colour change. What is the most likely diagnosis?

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Correct answer: D — Fibroma (irritation fibroma)

Explanation lettering: D = shown as A · A = shown as D

The correct answer is A (Fibroma/Irritation Fibroma). This lesion fits the classic presentation of an irritation fibroma: firm consistency, absence of transillumination (excludes mucocele and haemangioma), no colour change, intact mucosal surface (excludes SCC), slow 6-month growth, appropriate age (third–sixth decade), and characteristic location on the lip. Irritation fibromas are benign reactive hyperplasias of connective tissue responding to chronic local trauma or irritation. They are the most common acquired soft tissue lesion in the oral cavity. Option B (mucocele) is excluded because mucoceles transilluminate when fluid-filled and are fluctuant rather than firm. Option E (haemangioma) is excluded by the absence of colour change or visible vascularity. Options C (SCC) and D (pleomorphic adenoma) are implausible given the intact smooth surface and slow growth pattern.

Reference: Mucocele and fibroma: treatment and clinical features for differential diagnosis. Braz Dent J. 2013;24(5):537–41. https://pubmed.ncbi.nlm.nih.gov/24474300/ [Supported by NHS Yorkshire Oral Medicine Referral Guide 2017]