A Rare Case of Carcinoma Ex Pleomorphic Adenoma of the Palate with Cervical Lymph Node Metastasis

Carcinoma ex pleomorphic adenoma (CEPA), a rare, aggressive malignant secondary carcinoma developing in pre-existing pleomorphic adenoma usually occurs in the salivary glands. Capsular invasion has an oppressive prognosis. We report a rare case of CEPA of the palate originating in a minor salivary gland with cervical lymph node metastasis. A 63-year-old woman with a 6-month history of several enlarging cervical masses had a painless non-growing palate mass for the last 20 years. Preoperative histological findings partially supported malignancy and histological lymph node diagnosis indicated adenocarcinoma motastatis necessitating complete oral tumor resection and modified radical neck dissection. Histological findings of oral tumor carcinoma were scattered through the pathologically benign pleomorphic adenoma tumor. Despite the absence of capsular invasion, this case featured high-grade malignancy with multiple cervical lymph node metastases. Histological and clinical discrepancies made it difficult to diagnose preoperatively.