Pleomorphic Adenoma of the Hard Palate: A Multidisciplinary Approach

Pleomorphic adenoma is the most common salivary gland tumor accounting for 80% of all major salivary gland tumors. It is a benign salivary gland neoplasm that constitutes 3% to 10% of the neoplasms in the head and neck region.1 Salivary gland neoplasms represents less than 1% of all tumors. This article is being showcased as a special case due to the fact it was done at a Taluk Hospital and also because ENT and oromaxillofacial surgeons were involved during the surgery.

NECROTIZING SIALOMETAPLASIA OF PALATE A RARE CASE REPORT

Necrotizing sialometaplasia (NS) is a rare benign reactive necrotizing in?ammatory process that affects the minor salivary gland and frequently mimics cancer on both a clinical and histopathological level. Case Study : We report the case of a 21-year-old healthy man who had throat pain and non-healing ulcer over soft palate for the past one month, with pain during swallowing.Histopathological analysis and an incisional biopsy were performed on the patient. Necrotizing sialometaplasia was the histologically determined diagnosis. Necrotizing sialometaplasia is a self-limiting disorder of salivary glands mostly affecting the hard palate.The duration of the healing process is usually related to the size of the lesion.The recurrence rate of Necrotizing Sialometaplasia is low.Even a full thickness palatal lesion heals completely within 6 months.

Case report on adenoid cystic carcinoma of palate with review of literature

Adenoid cystic carcinoma (ACC) is a malignant tumor of minor salivary glands of the oral cavity, particularly the palate which accounts for about 5–10%. These tumors are slow growing with a high incidence of local recurrence, perineural invasion, and distant metastasis. Here, we report the case of a 69-year-old female who presented with swelling over the hard palate. Computerized tomography shows enhancing lesion along the undersurface of the left side of the hard palate, abutting the maxillary alveolus in the region of the second premolar and first two molars. There was no erosion of the inner cortex of the maxillary alveolus and no extension into the nasal cavity. Following the biopsy, she underwent a left hard palatectomy with upper alveolar resection. The final histopathological report confirmed ACC with no perineural invasion. Following she received adjuvant radiotherapy using an intensity-modulated radiotherapy technique. Now at 6 months of follow-up, there was no evidence of recurrence. Thus, our patient requires long-term follow-up to assess the benefit and survival outcome.

Hiperplasia Adenomatoide en Reborde Alveolar Maxilar: Una Presentación Inusual

RESUMEN: La hiperplasia adenomatoide (HA) se considera una patología no neoplásica de etiología desconocida asociada principalmente a trauma como principal factor causal, con localización frecuente en paladar duro y blando. El presente caso muestra el primer caso de HA en reborde alveolar asociado a prótesis removible mal adaptada. Hombre de 81 años con diabetes mellitus y HTA controlada presentaba un aumento de volumen nodular en reborde alveolar maxilar del color de la mucosa, de consistencia firme y márgenes definidos que medía 1,5 x 0,7 cm de diámetro, asintomático y asociada a falta de diente 1.3 protésico reportando 6 años de evolución. Se realizó biopsia excisional y estudio histopatológic o con hiperplasia de acinos glandulares. El 80 % de los casos se observa en paladar seguida de la mucosa oral, lengua y zona retromolar, pero sin reportes en encía o reborde alveolar. El factor causal mayormente asociado es el trauma crónico principalmente asociado a prótesis mal adaptadas, aunque existen estudios de un cromosoma aberrante con un rol desconocido tanto en su patogénesis como en su posible potencial maligno. En el caso actual, la lesión se asocia fuertemente a prótesis removible mal adaptada sugiriendo una lesión de aspecto reactivo. Por lo tanto, la HA se debe incluir como diagnóstico diferencial tanto a nivel palatino como en otras localizaciones incluyendo reborde alveolar. Además, se debe considerar cuando existe un factor etiológico traumático como prótesis removibles mal adaptadas, siendo necesario su confirmación mediante estudio histopatológico especialmente por su similitud con otras patologías.

ABSTRACT: Adenomatoid hyperplasia (AH) is considered a non-neoplastic pathology of unknown etiology but mainly associated with trauma as the main causal factor, with frequent localization on hard and soft palate. The present case shows the first case of AH on the alveolar ridge associated with a poorly adapted removable prosthesis. An 81-year-old man with diabetes mellitus and arterial hypertension controlled presents a nodular tumor in the maxillary alveolar ridge of the color of the mucosa, with a firm consistency and defined edges measuring 1.5 x 0.7 cm in diameter, asymptomatic and associated with a lack of a 1.3 prosthetic tooth reporting 6 years of evolution. Excisional biopsy and histopathological study were performed with glandular acini hyperplasia. The AH is observed in 80 % of cases on the palate followed by the oral mucosa, tongue and retromolar area, but without reports on the gingiva or alveolar ridge. The most associated causal factor is chronic trauma, mainly associated with poorly adapted prostheses, although there are studies of an aberrant chromosome with an unknown role both in his pathogenesis and possible malignant potential. In the current case, the lesion is strongly associated with a poorly adapted removable prosthesis, suggesting a lesion with a reactive appearance. Therefore, AH should be included as a differential diagnosis both at the palatal level and in other locations including the alveolar ridge. In addition, it should be considered when there is a traumatic etiological factor such as poorly adapted removable prostheses, It's confirmation by histopathological study being necessary, especially due to its similarity with other pathologies.

Mucocèle de la lèvre inférieure: rapport de cas et revue de la littérature / Lower lip mucocele: case report and review of literature

A mucocele is a mucus-filled, variable-sized, cavity that can appear as a nodule in the oral mucosa. It's a very common exophytic lesion resulting from a salivary accumulation, due to an alteration of the minor salivary gland.They can be categorized according to their etiology: they may occur from extravasation or retention of the secretion.The main one is the extravasation mucocele caused by traumatic rupture of the gland's epithelium spilling out the mucus in the extra-glandular space. The mechanical trauma can be caused by lip biting habits or by a cutting tooth in constant contact with the lip. [1] The collection then triggers an immune reaction in the mucosa with swelling, leading to the formation of granulation tissue with inflammatory cells. At this point, there is a pseudo capsule with no epithelialized lining defining a pseudocyst. [2] However, the retention cyst is a true cyst due to an epithelial proliferation of the exit ducts that generates an obstruction of the salivary flow. [2] Treatment options for mucoceles involve surgical resection, marsupialization, cryosurgery, steroid injection. The surgical excision remains the gold standard therapy for this lesion, but relapse might happen (8.8% on the labial/buccal mucosa). [3]

Desafío diagnóstico y terapéutico de carcinoma mucoepidermoide palatino: reporte de un caso

Resumen Las neoplasias en glándulas salivales son infrecuentes, representando menos del 3% de los tumores de cabeza y cuello. El carcinoma mucoepidermoide es el tumor maligno más común en glándulas salivales, siendo su principal ubicación la parótida. Clínicamente se asemeja a otras lesiones de mucosa oral, por lo cual, es importante realizar un correcto diagnóstico diferencial. Su comportamiento biológico se relaciona con el grado histológico tumoral, factor relevante en el pronóstico y tratamiento de esta neoplasia. Presentamos el caso de un paciente hombre de 75 años afectado con un tumor en paladar con diagnóstico de carcinoma mucoepidermoide de bajo grado. Como tratamiento se realizó una maxilectomía parcial y una placa obturadora en base a una prótesis removible y posterior reconstrucción con un colgajo libre microvascularizado. Actualmente el paciente se encuentra en controles periódicos, libre de enfermedad. Los tumores de glándulas salivales son un desafío diagnóstico, requieren de exámenes imagenológicos y del estudio histopatológico. Cuando existen dudas en el diagnóstico, se debe considerar repetir la toma de la muestra o la obtención de biopsias de más de una zona representativa que permita el diagnóstico de la lesión.

Abstract Salivary gland neoplasms are infrequent lesions representing less than 3% of head and neck tumors. Mucoepidermoid carcinoma is the most common malignant tumor in salivary glands, being the parotid the most usual location. Clinically, it resembles other oral mucosa lesions, therefore, it is important to make a correct differential diagnosis. Its biological behavior is related to the tumor histological grade, a relevant factor in the prognosis and treatment of this neoplasm. We reported a case of a 75-year-old-man, with a tumor in the palate, diagnosed as low-grade mucoepidermoid carcinoma. A partial maxillectomy and an obturator plate were performed based on a removable prosthesis and subsequent reconstruction with a microvascularized free flap. The patient is currently undergoing regular checkups, maintaining disease free. Salivary gland tumors are a diagnostic challenge, requiring imaging tests and histopathological study. In case of doubts with the diagnosis, it should be considered to biopsy more than area or to repeat the biopsy in order to obtain a representative sample that allows the diagnosis of the lesion.

Adenoma pleomorfo mimetizando lipoma oral / Adenoma pleomórfico que mimetiza el lipoma oral / Pleomorphic adenoma mimicking oral lipoma

Introdução: O adenoma pleomorfo é a neoplasia benigna de glândula salivar mais comum, podendo acometer glândulas salivares maiores e menores. Essa neoplasia ocorre em uma ampla faixa etária, e se caracteriza por uma ampla variabilidade clinico-patológica e por altas taxas de recorrência. Objetivo: Relatar um caso de um adenoma pleomorfo, com enfoque nos aspectos clinico-patológicos, diagnóstico diferencial e manejo clínico. Relato de caso: Paciente do sexo masculino, 72 anos, exibiu lesão nodular, bem delimitada, localizada em fundo de sulco maxilar esquerdo, com tempo de evolução de quatro anos. A biópsia excisional foi realizada, e as hipóteses diagnósticas de hiperplasia linfoide, adenoma pleomorfo e lipoma foram consideradas, sendo esta última reforçada pelo fato de ter flutuado em formol. Sob análise microscópica, observou-se uma proliferação de células epiteliais e mioepiteliais em meio a um estroma variável. Com isso, o diagnóstico histopatológico de adenoma pleomorfo foi emitido. Conclusão: O presente estudo enaltece a importância da realização de análise histopatológica criteriosa para exclusão de outras hipóteses diagnósticas e neoplasias malignas. Dessa forma, a partir da associação dos achados clínicos e microscópicos, é possível obter um diagnóstico correto, guiando, consequentemente, na adoção de uma conduta terapêutica adequada(AU)

Introducción: El adenoma pleomórfico es la neoplasia benigna de glándulas salivales más común, que puede afectar a las glándulas salivales mayores y menores. Esta neoplasia se presenta en un amplio grupo de edad y se caracteriza por una amplia variabilidad clínica y patológica y altas tasas de recurrencia. Objetivo: Describir un caso de adenoma pleomórfico, con énfasis en aspectos clínicos y patológicos, diagnóstico diferencial y manejo clínico. Caso clínico: Paciente masculino, de 72 años, que presentó una lesión nodular bien definida ubicada en la parte inferior del surco maxilar izquierdo, con un tiempo de evolución de cuatro años. Se realizó una biopsia escisional. Se consideraron las hipótesis diagnósticas de hiperplasia linfoide, adenoma pleomórfico y lipoma, con mayor atención este último por el hecho de que flotaba en formaldehído. Bajo análisis microscópico, se observó una proliferación de células epiteliales y mioepiteliales en medio de un estroma variable. Por lo tanto, se emitió el diagnóstico histopatológico de adenoma pleomorfo. Conclusión: El presente estudio destaca la importancia de llevar a cabo un cuidadoso análisis histopatológico para excluir otras hipótesis diagnósticas y neoplasias malignas. Luego, con base en la asociación de hallazgos clínicos y microscópicos, es posible obtener un diagnóstico correcto, imprescindible en la adopción de un enfoque terapéutico apropiado(AU)

Introduction: Pleomorphic adenoma is the most common benign salivary gland neoplasm. It may affect major and minor salivary glands. It presents at a broad age range and is characterized by great clinical and pathological variability and high recurrence rates. Objective: Describe a case of pleomorphic adenoma, with emphasis on clinical and pathological aspects, differential diagnosis and clinical management. Case report: A male 72-year-old patient presents with a well-defined nodular lesion in the lower section of the left maxillary groove with a time of evolution of four years. Excisional biopsy was performed. The diagnostic hypotheses considered were lymphoid hyperplasia, pleomorphic adenoma and lipoma, with greater attention to the latter, due to the fact that it floated in formaldehyde. Microscopic examination revealed proliferation of epithelial and myoepithelial cells amidst a variable stroma. Thus, a histopathological diagnosis of pleomorphic adenoma was issued. Conclusion: The present study highlights the importance of careful histopathological examination to rule out other diagnostic hypotheses and malignant neoplasms. Next, clinical and microscopic findings will lead to an accurate diagnosis indispensable to adopt an appropriate therapeutic approach(AU)

Clear cell-rich salivary duct carcinoma involving the palate / Carcinoma do ducto salivar rico em células claras envolvendo o palato

ABSTRACT Salivary duct carcinoma (SDC) is a rare and aggressive neoplasm arising from salivary glands. SDC occurs most frequently in major salivary glands, with isolated cases arising from the minor salivary glands. The occurrence of clear cells in salivary gland tumors is uncommon and is rarer in SDC cases. We report the case of a 51-year-old male diagnosed with a clear cell variant of SDC in the minor salivary gland, involving the left hard palate. Immunohistochemical analysis revealed positivity for HER2/neu and GATA-3. The patient was submitted to radical surgical excision, neck dissection, and radiotherapy. Unfortunately, he died 14 months after the cancer diagnosis.

RESUMEN El carcinoma ductal de las glándulas salivales (CDS) es un tumor raro y agresivo que surge de las glándulas salivales. El CDS ocurre con mayor frecuencia en las glándulas salivales mayores, sin embargo, existen casos aislados de afectación en las glándulas salivales menores. La aparición de células claras en los tumores de las glándulas salivales es infrecuente y más rara en los casos de CDS. Presentamos el caso de un varón de 51 años al que se le diagnosticó la variante de células claras del CDS en la glándula salival menor, que afecta al paladar duro izquierdo. El análisis inmunohistoquímica reveló positividad para HER2/neu y GATA-3. El paciente fue sometido a escisión local quirúrgica radical, disección del cuello y la radioterapia. Desafortunadamente, murió 14 meses después del diagnóstico de cáncer.

RESUMO O carcinoma do ducto salivar (CDS) é um tumor raro e agressivo que se origina nas glândulas salivares. O CDS ocorre mais frequentemente nas glândulas salivares maiores, porém, há casos isolados de acometimento nas glândulas salivares menores. A ocorrência de células claras em tumores de glândulas salivares é incomum, sendo ainda mais rara nos casos de CDS. Relatamos o caso de um homem de 51 anos de idade que foi diagnosticado com a variante de células claras de CDS em glândula salivar menor, envolvendo o palato duro do lado esquerdo. A análise imuno-histoquímica revelou positividade para HER2/neu, GATA-3. O paciente foi submetido a excisão cirúrgica radical, esvaziamento cervical e radioterapia. Entretanto, ele faleceu 14 meses após o diagnóstico do câncer.

Pleomorphic Adenoma of the Cheek. Case Report with Review / Adenoma Pleomórfico de Mejilla. Reporte de Caso con Revisión

ABSTRACT: Pleomorphic adenoma (PA), also called benign mixed tumor, is the most common tumor of the salivary glands. About 70 % of these tumors occur in the parotid gland and an uncommon site are the minor salivary glands. The most common sites of PA of the minor salivary glands are the palate followed by lips and cheek. Other rare reported sites include the fauces, floor of the mouth, tongue, tonsil, pharynx, retromolar area and nasal cavity. Here we report a case of pleomorphic adenoma of minor salivary glands of the cheek in a 22-year-old male. The mass was removed by wide local excision with adequate margins, and the patient was followed for 1-year post operatively with no recurrence.

RESUMEN: El adenoma pleomórfico (AP), conocido también como tumor mixto benigno, es el tumor más común de las glándulas salivales. Alrededor del 70 % de estos tumores ocurren en la glándula parótida y con menor frecuencia en las otras glándulas salivales. Los lugares más comunes de AP en las glándulas salivales son el paladar, seguido de labios y mejillas. Otros sitios poco frecuentes reportados, incluyen las fauces, el piso de la boca, la lengua, las tonsilas palatinas, la faringe, el área retromolar y la cavidad nasal. En este estudio se presenta un caso de adenoma pleomórfico de las glándulas salivales menores de la mejilla en un hombre de 22 años. Se extirpó la masa mediante escisión local amplia con márgenes adecuados, con un seguimiento del paciente durante un año después de la operación sin recurrencia.

Interpretación de la biopsia de glándula salival menor en el síndrome de Sjögren. Correlación clínico-patológica / Interpretation of minor salivary gland biopsy in Sjögren's syndrome. Clinical-pathological correlation

RESUMEN La biopsia de glándula salival menor (BGSM) es uno de los principales criterios (no el único) para el diagnóstico del síndrome de Sjögren, y esto tiene que ir en conjunto con la clínica y los niveles de anticuerpos. Diferentes clasificaciones se han desarrollado para evaluar la interpretación de los hallazgos observados en la BGSM y poder categorizar / diagnosticar el síndrome de Sjögren. Esto ha causado que los patólogos y los clínicos tengan una inadecuada interpretación de la BGSM debido a que existe confusión por las diferentes escalas de puntuación que se han implementado a lo largo del tiempo. El presente artículo de revisión tiene como objetivo ilustrar a la comunidad científica, especialmente reumatólogos, cirujanos orales, internistas y patólogos, entre otros, sobre los hallazgos a considerar en la BGSM al momento del reporte por parte del patólogo.

ABSTRACT The minor salivary gland biopsy (MSBG) is one of the main criteria (not the only one) for the diagnosis of Sjögren's syndrome, and has to be taken in conjunction with the clinic parameters and the antibodies levels. Different classifications have been developed to evaluate the interpretation of the findings observed in the MSBG and to be able to categorise / diagnose Sjögren's syndrome. This has meant pathologists and clinicians have had an unsuitable interpretation of the MSBG due to the existence of confusion due to the different scoring scales that have been implemented over time. This review article aims to illustrate to the scientific community, especially rheumatologists, oral surgeons, internists, and pathologists, among others, on the findings to be considered in the MSBG when reported by the pathologist.

Unusual treatment of pleomorphic adenoma of soft palate in adult / Tratamiento inusual del adenoma pleomórfico del paladar blando en adulto

Pleomorphic adenoma is the most common benign neoplasia of the salivary glands and affects mostly the parotid gland, less frequently the minor salivary glands. Minor salivary gland tumors have a higher risk of malignancy compared to tumors of the major salivary glands, so appropriate diagnostic evaluation should be prompt. In this case report, we present a case of an extensive pleomorphic adenoma of soft palate in an adult patient. After preoperative investigation using Fine Needle Aspiration (FNA) and imaging tests, the patient was successfully treated by surgical resection under general anesthesia. There was no recurrence seen after a follow-up period of 1 year.

El adenoma pleomórfico es la neoplasia benigna más común de las glándulas salivales y afecta principalmente la glándula parótida, con menos frecuencia en las glándulas salivales menores. Los tumores de las glándulas salivales menores tienen un mayor riesgo de malignidad en comparación con los tumores de las glándulas salivales mayores, por lo que la evaluación diagnóstica apropiada debe ser rápida. En este reporte de caso, presentamos un caso de un extenso adenoma pleomórfico de paladar blando en un paciente adulto. Después de la investigación preoperatoria utilizando aspiración con aguja fina y pruebas de imagen, el paciente fue tratado con éxito con la resección quirúrgica bajo anestesia general. No se observó recurrencia después de un período de seguimiento de 1 año.

Uncommon plasmacytoid myoepithelioma originating from ectopic minor salivary gland in neck: a rare case with rare site presentation

The aim of this case report is to present as case of plasmacytoid at ectopic minor salivary gland in the neck which is a rare neoplasm with uncommon presentation of site. Usually it is a tumor of major salivary gland and more common in parotid gland and less common in the minor salivary gland of the oral cavity predominantly in palate. Here authors are discussing a case of 10-year-old female who presented in our institute with complain of swelling over right mid cervical region which was clinically suspected as reactive cervical lymph node. Patient was evaluated further and cytologically diagnosed as a case of plasmacytoid myoepithelioma. It was also confirmed as a case of plasmacytoid myoepithelioma after histopathology and immunohistochemistry studies. Plasmacytoid myoepithelioma at ectopic minor salivary gland site in the neck is uncommon presentation and only a limited number of cases have been reported in literature.

Acinic cell carcinoma of the posterior buccal mucosa: A rare case report

Acinic cell carcinoma (ACC) is a low-grade malignant salivary gland neoplasm that comprises approximately 17% of primary salivary gland malignancies or about 6% of all salivary gland neoplasms. The most common intraoral sites are the buccal mucosa, lips, and palate. The diagnosis of ACC frequently presents difficulties, owing to its great radiological and cytological similarity with benign tumors and with normal acinar component of the salivary gland, respectively. The management of ACC consists of complete surgical excision. Here, we report a case of ACC on the left retromolar trigone, a rare location in a 44-year-old female

Mucocele de glándulas de Blandin Nuhn. Caso inusual y revisión de la literatura / Mucocele da glândula Blandin Nuhn. Caso incomum e revisão da literatura / Mucocele of Blandin Nuhn glands. Unusual case and review of the literature

El mucocele asociado a las glándulas de Blandin Nuhn es un fenómeno de extravasación mucosa que ocurre en las glándulas salivales localizadas en la superficie ventral anterior de la lengua, son de tipo mixto, no encapsuladas, que forman parte del complejo de glándulas salivales menores de cavidad bucal. Objetivo: Se presenta el caso clínico de un paciente masculino que cursa la segunda década de vida con características clínicas peculiares de un mucocele de Blandin Nuhn. Caso clínico: Adolescente masculino de 14 años de edad presenta aumento de volumen localizado en superficie ventral de lengua, forma cilíndrica, de 3 meses de evolución y asintomático. Se realiza biopsia excisional para estudio histopatológico, el cual reporta fenómeno de extravasación mucosa y se establece la correlación clínico histopatológica. Conclusiones: Se debe fundamentar un diagnóstico correcto para proporcionar un tratamiento oportuno y evitar complicaciones en el paciente que afecten su calidad de vida.

Mucoceles of the glands of BlandinNuhn consist in a mucus extravasation phenomenon that occurs in the salivary glands located in the anterior ventral surface of the tongue. They are mixed, not encapsulated, and part of the complex of minor salivary glands of the oral cavity. Objective: This paper presents the clinical case of a male patient in his second decade of life with peculiar clinical characteristics of a mucocele of the glands of Blandin-Nuhn. Clinical case: A 14-year-old male adolescent has an increase in volume located on the ventral surface of the tongue, of cylindrical shape, with three months of evolution and is asymptomatic. An excisional biopsy is performed for histopathological study, which reports mucosal extravasation phenomenon and a histopathological clinical correlation is established. Conclusions: A correct diagnosis should have a solid foundation in order to provide timely treatment and avoid complications for the patient that may affect quality of life

A mucocele associada às glândulas de Blandin Nuhn é um fenômeno de extravasamento de mucosa que ocorre nas glândulas salivares localizadas na superfície ventral anterior da língua, do tipo misto, não encapsuladas, que fazem parte do complexo de glândulas salivares menores da cavidade oral. Objetivo: É apresentado o caso clínico de um paciente do sexo masculino na segunda década de vida com características clínicas peculiares de uma mucocele de Blandin Nuhn. Caso clínico: Adolescente de 14 anos apresenta aumento de volume localizado na superfície ventral da língua, formato cilíndrico, evolução de 3 meses e assintomático. A biópsia excisional é realizada para estudo histopatológico, que relata o fenômeno do extravasamento da mucosa e a correlação clínica histopatológica é estabelecida. Conclusões: Um diagnóstico correto deve ser baseado para fornecer tratamento oportuno e evitar complicações no paciente que afetem sua qualidade de vida

Sialolithiasis of minor salivary gland in labial mucosa: a clinical finding / Sialolitíase de glândula salivar menor na mucosa labial: um achado clínico

Introduction: sialolithiasis is the most common form of obstructive sialadenitis caused by a mixture of different calcium phosphates and an organic matrix. It is one of the most common salivary gland diseases, often attributed to the submandibular gland, with no relation to age or gender. However, it is rarely reported in the minor salivary glands. Objective: the present study aims to report auncommon clinical finding case of a sialolithiasisof minor salivary gland in labial mucosa. Case report: a 43-year-old female patient presented with a single, yellow and asymptomatic nodule in the labial mucosa at clinical examination. The clinical hypotheses were lipoma and fibrous hyperplasia. The lesion was biopsied, and the histopathological analysis showed a mineralized tissue. The final diagnosis was sialolithiasis and the patient remained under follow-up (8 months) without relapse. Conclusion: this case shows that sialolithiasis should be included in the diagnostic hypotheses when occur in a minor salivary glands area and emphasizes the importance of a complete clinical examination since it was not complaint of the patient.(AU)

Introdução: a sialolitíase é a forma mais comum de sialadenite obstrutiva causada por um composto de diferentes produtos, como fosfato de cálcio e matriz orgânica. É uma das doenças mais comuns das glândulas salivares, geralmente atribuídas à glândula submandibular, sem relação com idade ou sexo. No entanto, raramente é relatada nas glândulas salivares menores. Objetivo: reportar um achado clínico incomum de sialolitíase em glândula oral menor na mucosa labial. Relato de caso: uma paciente do sexo feminino, de 43 anos, apresentou nódulo único, amarelo e assintomático na mucosa labial durante o exame clínico. As hipóteses clínicas foram lipoma e hiperplasia fibrosa. A lesão foi encaminhada para biópsia e a análise histopatológica mostrou um tecido mineralizado. O diagnóstico final foi de sialolitíase e o paciente permaneceu em acompanhamento por 8 meses sem recidiva. Conclusão: este caso mostra que a sialolitíase deve ser incluída nas hipóteses diagnósticas de lesões em áreas de glândulas salivares menores e enfatiza a importância de um exame clínico completo, pois não se tratava da queixa principal da paciente.(AU)

Extensive Basal Cell Adenocarcinoma Involving Minor Salivary Gland of the Hard Palate: A Rare Entity

@#Basal cell adenocarcinoma (BCAC) is a very rare slow-growing malignant basaloid tumour of the minor salivary gland. We reported a case of BCAC of the minor salivary gland of the hard palate occurring in a 56-year-old man. BCAC shares overlapping histopathological features with the other oral basaloid cell neoplasms which carries different prognosis and treatment modality. We emphasised on the histomorphologic features and the role of immunohistochemistry panel in the differential diagnosis of BCAC in incisional biopsies.

Hyalinizing Clear Cell Carcinoma of the Soft Palate - A Case Report

@#Hyalinizing clear cell carcinoma presents as a painless submucosal mass commonly located at the palate and base of tongue. It is a rare tumour and has often been misdiagnosed for other more common tumours with clear cytoplasm, such as acinic cell carcinoma, clear cell oncocytoma or mucoepidermoid carcinoma. HCCC has been reported as a low grade malignant tumour with a high rate of cervical metastases. Due to its rarity, there is no treatment protocol. However, the treatment of choice is wide local excision and the neck disease is treated with neck dissection or radiotherapy or both with no conclusive outcome as incidence is too low or underreported with no long term follow up. Our case highlights the diagnosis difficulties in such rare cases, and the need for longer follow up post excision to determine outcome and recurrence rates.

Mucoepidermoid carcinoma of the retromolar region: case report / Carcinoma mucoepidermoide em região retromolar: relato de caso

ABSTRACT The present study aimed to report a case of mucoepidermoid carcinoma (MEC), focusing on its clinical-pathological characteristics. At intraoral clinical examination, a nodular lesion was observed in the right pterygomandibular raphe region, with three years of evolution. An incisional biopsy was performed, and the diagnostic hypotheses of salivary gland injury and sialadenitis were considered. Histopathologically, a malignant neoplastic process characterized by the proliferation of epidermoid, intermediate and mucosal cells was observed. The histopathological diagnosis of MEC was emitted. The present case praises the importance of early diagnosis and correct management of this disease, providing a better prognosis for these patients.

RESUMEN Reportamos un caso de carcinoma mucoepidermoide (CME) con enfoque en sus rasgos clinicopatológicos. En la exploración clínica intraoral, se observó una lesión de aspecto nodular en región del rafe pterigomandibular derecho, con tiempo de evolución de tres años. Se realizó una biopsia por incisión, considerándose las hipótesis diagnósticas de lesión de glándula salival y sialadenitis. Histopatológicamente, se observó un proceso neoplásico maligno caracterizado por la proliferación de células epidermoides, intermedias y mucosas. El diagnóstico histopatológico fue de CME. El presente caso destaca la importancia del diagnóstico temprano y del manejo correcto de esa enfermedad, ofreciendo un mejor pronóstico para los pacientes portadores de CME.

RESUMO Relatamos um caso de carcinoma mucoepidermoide (CME) com enfoque em suas características clinicopatológicas. No exame clínico intraoral, observou-se lesão de aspecto nodular em região de rafe pterigomandibular direita, com tempo de evolução de três anos. Biópsia incisional foi realizada, e as hipóteses diagnósticas de lesão de glândula salivar e sialadenite foram consideradas. Histopatologicamente, observou-se um processo neoplásico maligno caracterizado pela proliferação de células epidermoides, intermediárias e mucosas. O diagnóstico histopatológico de CME foi emitido. O presente caso enaltece a importância do diagnóstico precoce e do correto manejo dessa patologia, proporcionado um melhor prognóstico para os pacientes portadores de CME.

Pleomorphic Adenoma of a Minor Salivary Gland of the Hard Palate Report of a Case

The pleomorphic adenoma is the most common benign tumor of the minor salivary glands and is comprised of epithelial and mesenchymal tissues. The majority of the salivary gland tumors occur in the second decadeof life with a slight predilection for females. Clinically it presents as a firm or rubbery submucosal mass without ulceration or surrounding inflammation. Diagnosis is established on the clinical examination and histopathology, supplemented with plane radiographs, computerized tomography, and magnetic resonance imaging when necessary. Here, we report a case of pleomorphic adenoma of the hard palate in a 21-year-old female patient with a painless swelling in the left palatal region of nine months duration.

Fine needle aspiration cytology of minor salivary gland tumors: A retrospective 5-year study of 42 cases in a tertiary care hospital

Background: Minor salivary gland tumors (MSGTs) are less common than major salivary glands and involve only 15–20% of all salivary gland tumors. Most of the cases originate at intra- and peri-oral region. Minor salivary gland lesion cytology has been studied rarely in India. Aims: This present study was performed to evaluate the role of fine needle aspiration cytology (FNAC) in diagnosis of MSGTs and to explore the cases of cytohistological discrepancies in the study. Materials and Methods: This retrospective study was conducted over a 5-year period on 42 cases of MSGTs. In all the cases, cytology was correlated with histology and cytohistological discrepancies were searched. Sensitivity, specificity, and diagnostic efficacy were calculated using histopathology as gold standard. Results: We diagnosed 27 malignant (64.28%) and 15 benign (35.71%) MSGTs in cytological evaluation. We found two false negative and one false positive case in cytology. Sensitivity, specificity, and diagnostic accuracy of the study were 92.59%, 93.33%, and 92.85%, respectively. Conclusion: FNAC is a minimally invasive and cost-effective procedure with high accuracy (92.85%) in the assessment of MSGTs and helps in the management of benign and malignant tumors.