CLINICAL PRESENTATION A 60-year-old Caucasian male was referred by his dentist for diagnosis and management of an asymptomatic lesion, incidentally discovered during a routine dental examination. According to the patient, this was his first dental visit after more than 5 years. His medical history was significant for iron deficiency anemia; he had been smoking 10 cigarettes per day for about 42 years. Clinical examination revealed a round, well-circumscribed, red, plaque-like lesion with a papillaryÀverrucous surface on the alveolar ridge distally to the decayed root of the mandibular right first premolar, measuring 0.8 £ 0.5 cm (Figure 1). It was nontender on palpation, and the patient did not report pain or other neurologic symptoms in the area. There were numerous dental and periodontal problems, but the rest of the oral mucosa was normal. Cone beam computed tomography (CBCT), requested by his dentist for the preoperative planning of oral implant rehabilitation, did not reveal any bone abnormality in the area of concern (Figure 2, arrow).