An isolated phlebolith found in buccal soft tissue: a rare case report

Abstract

The presence of an isolated phlebolith in oral soft tissue is a rare entity. This case presents the finding of a tender calcified mass situated in the buccal sulcus, adjacent to where the lower wisdom tooth was situated 5 years prior. Histological diagnosis of the lesion confirmed a phlebolith; to the best of our knowledge this is the first reported case of an isolated oral phlebolith, with no associated vascular malformation, arising after the surgical extraction of a wisdom tooth. Here, we discuss the case of a 27 year old female complaining of soreness in the right posterior buccal mucosa, adjacent to where the lower right wisdom tooth (LR8) was extracted 5 years ago. Clinical examination revealed a small, mobile firm lump within the buccal soft tissue. Radiographically, a well‐defined round lesion of mixed radiodensity was detected, indicating a calcified lesion. This was excised and histology confirmed it to be a phlebolith. This may have been caused by trauma from the surgical extraction of the LR8 or long‐buccal infiltration, as it presented in that specific location. Oral phleboliths rarely occur without associated vascular malformations; there have only been four other similar lesions reported in the literature to date. This is a rare but interesting complication that likely arose from the uneventful surgical procedure 5 years previously, and should be included in a differential diagnosis for calcified lesions in buccal soft tissue.