Main complaint and medical history
A 30 year otherwise healthy presented to the oral medicine clinic to evaluate a painless swelling affecting the back part of her right palate. The growth was painless and only noticed after a friend asked her about it a few weeks prior. The lesion has not affected her speech or comfort when eating. She assumed the lesion was a result of a decaying tooth.
Clinical examination:
No abnormalities were detected extra-orally and she reported no lesions elsewhere.
Intra-oral examination revealed caries at molar teeth and a severely decayed non-vital tooth
- Lesion presented as a discrete dome shaped soft tissue mass with diffuse non indurated margins affecting the right side of the soft palate immediately posterior to posterior border of the hard palate. The lesion did not appear to cross the midline; however the midline border appeared to be more defined. The surface epithelium displayed no signs of inflammation although prominent vascularization was noted. Palpation elicited no pain or discomfort, felt rubbery in consistency and no blanching or mobility was detected. The remaining soft tissues were in good health although improvements in oral hygiene were necessary.
Differential diagnosis:
- Benign or malignant minor salivary gland neoplasia
Figure 1: Intra-oral presentation as described
Management:
The patient was immediately referred for Fine need aspiration biopsy and radiographic examination. The report indicated that a salivary neoplasm was detected and that a pleomorphic adenoma was suspected. The patient was then immediately referred to ENT for excision.
