Case #832: 4-year-old boy with oral lesion   
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Our appreciation is extended to Dr. Juan Yepes, Indiana University School of Dentistry Department of Pediatric Dentistry and Riley Hospital for Children, for contributing this case.

History: A 4-year-old boy presented to the pediatric dentist referred by a family dentist because of an unusual and small lesion lingual to the lateral right primary mandibular incisor. The parents were not aware of the lesion until the family dentist noted it during the clinical exam.

The boy’s past medical history was unremarkable. There was no history of trauma.

The extraoral exam was within the range of normal. The intraoral exam revealed a small soft-tissue lesion measuring 3 mm x 2 mm, slightly raised, smooth, pink in color, with no ulceration at the lingual aspect of the primary lateral right incisor. Click the image to enlarge it.

What is the most likely preliminary diagnosis?
Traumatic fibroma
Squamous papilloma
Lymph epidermoid cyst
All of the above are potential differential diagnosis