A 38-year-old man came to the Oral and Maxillofacial Surgery Department with a complaint of a painless lump on his palate. The patient had a good health status with no significant medical background. During the oral examination, a 1cm well-defined, firm, smooth lump that was not connected to the underlying tissue was found. Radiographic (orthopentamograph) analysis confirmed that there was no bone involvement or invasion (panel A). Under local anesthesia, by using a laser diode 980nm, 1.7W, ablation of the mass was done successfully, and the wound was left to heal by secondary intension. Histopathological examination showed nodular pattern growth of plasmacytoid and spindle-shaped myoepithelial cells in between fibrosis with few ducts lying by benign cuboidal cells admixed with chronic cell infiltration, immunohistochemical expression of cytokeratin showed negative expression and confirmed the diagnosis of pleomorphic adenoma of minor salivary gland (panels B and C). Pleomorphic adenoma is the most frequent benign tumor of the salivary glands, with the parotid gland being the most common site, followed by minor salivary glands, which account for about 7% of cases, and the palate being the most common site for intraoral pleomorphic adenoma. It is crucial to conduct a comprehensive clinical, imaging, and histopathological examination to determine whether the lesion is benign or malignant before surgery. About 1 month later, the patient was pleased with the cosmetic and functional results (panel D).
Khalil et al. (Wed,) studied this question.