Polymorphous low grade adenocarcinoma of palate: A case report with review and differential diagnosis

9^th International Conference on Clinical & Medical Case Reports

September 27-28, 2018 | Amsterdam, Netherlands

Junaid Ahmed,Nandita Shenoy

Manipal Academy of Higher Education, India

Scientific Tracks Abstracts: J Clin Case Rep

Abstract :

Introduction: Minor salivary gland neoplasms constitute up to approximately 25% of all salivary gland tumors. The most commonly affected gland in these cases is parotid. However, cases of involvement of minor salivary glands have also been reported. Here, we are presenting a case of a 47-year-old man who was diagnosed with adenocarcinoma of minor salivary glands in the hard palate. Case Report: The case report begins with a 47-year-old man referred to the Department of Oral Medicine with a history of soft tissue growth in the palate for the past two months. The growth was sudden in onset, growing rapidly in size within the next two months and localized to the palate. The patient reported of no pain during the onset of growth. However, for the past one week, the patient reported of mild pain. On clinical examination, there was a diffuse, proliferative soft tissue swelling of the maxilla extending from the marginal gingiva in the palatal aspect of the anterior tooth and involving the entire surface of hard palate up to the level of the junction between hard and soft palate. Previously, a private practitioner had advised an orthopantomograph which was inconclusive and revealed severe generalized periodontitis. The patient was then advised for a CBCT to the Department of Oral Medicine which revealed moth-eaten appearance of palate with involvement of nasopalatine canal anteriorly and external resorption of roots in relation to all the teeth present within the vicinity of the swelling. Based on CBCT and clinical findings, a preliminary diagnosis of intra-osseous malignancy was made. The patient was then scheduled for surgery and total maxillectomy up to the floor of orbit was performed. The tissue sample was sent for histopathologic exam which revealed an unencapsulated tumor within the connective tissue extending close to the surface epithelium, with the tumor cells arranged in diverse patterns and lined by one to two layers of oval/cuboidal cells along with a peripheral layer of flat cells suggestive of polymorphous low grade adenocarcinoma of palate. The patient is currently hospitalized and under observation. Conclusion: Adenocarcinoma of the palate is a rare occurrence and the present case report highlights the relevance of including salivary gland malignancies in the differential diagnosis of soft tissue swellings involving the hard palate.

Biography :

Junaid Ahmed is presently working as Professor and Head of the Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), India. He has obtained his Master’s (MDS) in the specialty of Oral Medicine and Radiology. With a cumulative experience of more than 20 years, he has actively involved himself in various dental associations and forums and is presently an Executive Committee Member of Karnataka State Indian Dental Association and Vice Chairman of Ethics Review Committee (ERC) of Indian Academy of Oral Biology (IAOB). He has also worked in the capacity of Member, Ethical Committee, Indian Academy of Oral Medicine and Radiology and as Reviewer and Editorial Board Member in various national and international journals. He has delivered more than 25 guest lectures in the field of both Oral Medicine and Maxillofacial Radiology at national and international conferences and has more than 90 national and international indexed publications to his credit. He has undergone training for Ethical Committee Certification by Boston University and CBCT Imaging training at Planmeca, Helsinki, Finland. His research interest is in Oral Medicine and Maxillofacial Radiology.

E-mail: junaid.ahmed@manipal.edu