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JAMA Clinical Challenge
July 18, 2017

A Bleeding Oral Mass in a Pregnant Woman

Author Affiliations
  • 1Banner University Medical Center, University of Arizona, Tucson
JAMA. 2017;318(3):293-294. doi:10.1001/jama.2017.6901

A 24-year-old gravida 1, para 0 woman at 26 weeks’ gestation presented for a routine prenatal visit with a soft-tissue mass on her upper maxillary gingiva. She reported that the mass had been present for 2 to 3 weeks and was increasing in size. It was not painful but bled when she brushed her teeth or ate sharp foods, which made it difficult to eat. There was no discharge from the area. She had no fevers, no trauma to the area, and no history of a similar condition.

Vital signs included a temperature of 36.4°C, blood pressure of 106/57 mm Hg, and heart rate of 93/min. Physical examination revealed a 3 × 5–cm soft, compressible, nodular mass on the upper right gum line adjacent to the lateral incisors (Figure). The mass was friable, pedunculated, and covered with a thin white film. There was some gingival erythema near the adjacent teeth but no lymphadenopathy. The examination results were otherwise unremarkable.