Oral varices are dilated veins that presumably develop due to loss of connective tissue tone of the vascular wall. They generally begin developing after 40 years of age and are found commonly in older adults. They are not associated with hypertension or cardiopulmonary diseases.
Most commonly found on the ventral tongue in two thirds of adults over 60 years of age and present as multiple, soft, well-circumscribed bluish-purple papules.
A solitary varix is also fairly common, affecting the lips and buccal mucosa, and presenting as a nontender, bluish-purple papule or nodule. Thrombus formation is often seen in these lesions due to the sluggish vascular flow, and the resultant mild enlargement and firmness may bring the lesion to the patient's attention.
Oral varices - Oral Mucosal Lesion
Alerts and Notices
Synopsis
Codes
ICD10CM:
I86.8 – Varicose veins of other specified sites
SNOMEDCT:
702792005 – Oral varices
I86.8 – Varicose veins of other specified sites
SNOMEDCT:
702792005 – Oral varices
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Mucocele – This will have a history of sudden onset, perhaps with subsequent "swelling and popping." It may have bluish to clear color but generally occurs in a much younger age group.
- Hematoma – This is a hemorrhage due to blunt trauma, most often affecting the labial or buccal mucosa. It appears as a flat or elevated zone that varies from red or purple to blue or bluish-black. It is less well-defined, and because it is extravasated blood, it will not blanch when pressure is applied with a glass slide (diascopy).
- Oral hemangioma
- Lobular capillary hemangioma (pyogenic granuloma)
- Peripheral giant cell granuloma
- Mucoepidermoid carcinoma – This will be firmer to palpation and less well circumscribed.
- Kaposi sarcoma – This presents on palatal mucosa or attached gingiva most often and is generally seen in a somewhat younger age range.
- Granulomatosis with polyangiitis
Best Tests
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Therapy
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References
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Last Updated:10/30/2017
Oral varices - Oral Mucosal Lesion