Comparative Clinicopathological Analysis of 39 Cases of Oral Focal Mucinosis with Published Cases in the Literature

Abstract

Oral focal mucinosis (OFM) is a soft tissue swelling characterised by a localised myxoid area of stromal connective tissue. Due to its rare occurrence and nonspecific clinical presentation, OFM is frequently misdiagnosed and underreported. Objective of the study was to describe the clinical and histopathological features of 39 cases of OFM and to compare the clinical findings with those reported in existing literature to enhance diagnostic accuracy. This retrospective case series analysed 39 histologically diagnosed cases of OFM at the Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya over 25 years. Data on patient demographics, lesion site, size, clinical diagnosis, and histopathological features were evaluated. A literature review was conducted revealing 113 previously reported cases in literature. Statistical analysis was performed with Chi-squared test and the t test considering p < 0.05 as significant. Our case series comprised of 20 females (51.28%) and 19 males (48.71%), with a mean age of 43.86 ± 15.80 and a 1.05:1 female-to-male ratio. The lesion size averaged at 2.15 ± 1.36cm. The most common anatomical location was the gingiva (56.41%), followed by the alveolar ridge mucosa (20.51%) and palate (17.95%). The average duration of lesions prior to diagnosis was 21.25 ± 27.75 months. Clinically, most lesions were diagnosed as reactive lesions (74.19%). Histologically, all cases showed myxoid stroma. Literature demonstrated a statistically significant female predominance, with 70.80% of cases reported in females and a female-to-male ratio of 2.42:1 compared to only 56.41% of females in our series (p = 0.027). Comparison with literature revealed no significant differences in other clinicopathological characteristics. A single case of recurrence was observed, aligning with previously reported findings in the literature. In conclusion, OFM predominantly affects adults in their fourth decade of life, with a slight female predilection. Notably, 9.68% of cases in the present series were clinically suspected to be malignant, highlighting the importance of histopathological confirmation for accurate diagnosis and appropriate treatment.