Sialolipoma of the hard palate

Sialolipoma is a new variant of salivary gland lipoma, which was first proposed by Nagao et al. (Histopathology 2001; 38: 30) in 2001. We report this rare case of sialolipoma in the hard palate. A 60-year-old Japanese woman was referred to our department complaining of a painless swelling on the right side of the hard palate. Intra-oral examination revealed a soft, elastic, dome-shaped mass with 1 cm in diameter located in the posterior part of the hard palate. Magnetic resonance imaging examination revealed high intensity on T(1)-weighted image and isointensity on T(2)-weighted image. Incisional biopsy revealed that the tumor was encapsulated by fibrous tissue, consisted of adipose tissue, and also contained normal salivary gland tissue peripherally. First diagnosed as an ordinary lipoma of the hard palate, the tumor was excised. According to the recent criteria of histologic findings of sialolipoma, we rediagnosed the tumor as sialolipoma of the hard palate.     

Plasmacytoma of the hard palate

Multiple myeloma is a systemic malignant disease and is associated with a poor prognosis. It is characterized by neoplastic proliferation of plasma cells involved in the production and secretion of monoclonal immunoglobulins (M proteins). It is generally a disseminated disease involving many bones. Systemic symptoms include bone pain, pathologic fracture, renal failure, hypercalcemia, weight loss, anemia, thrombocytopenia, and neutropenia. This condition may occur as a solitary lesion (solitary plasmacytoma), which in some patients eventually progresses to plasma cell myeloma. Extramedullary plasmacytoma is defined as neoplastic proliferation of plasma cells in the soft tissue. It usually occurs in the upper respiratory tract, such as the nasal cavity or posterior oropharynx. The authors present a rare plasmacytoma case with maxilla involvement.     

Renal cell carcinoma metastasis to the hard palate

A case of histologically proven renal cell carcinoma metastasis to the hard palate is presented. The role of cerebral angiography and computed tomography during the diagnostic evaluation of the patient is described. Due to the highly vascular nature of the tumor and the overall poor prognosis, cryotherapy was used for palliative treatment.     

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颏神经、颊神经及鼻腭神经都是周围神经的一部分。周围神经损伤的并发症是指各种因素对周围神经组织的损伤所引起的一系列神经症状或疾病。颊神经及鼻腭神经损伤可以迅速恢复,一般不产生影响;但颏神经损伤导致的感觉功能异常是很严重的并发症,会对患者的工作和生活造成严重影响。本文就拔牙导致周围感觉神经损伤的诊断、处理方法,以及颏、颊及鼻腭神经损伤的原因、临床表现、诊断、处理方法、防治措施做一阐述。     

Ultrastructure of intra-epithelial nerve endings in the hard palate of the rat, Rattus norvegicus

The ultrastructure is described of lanceolate and free nerve endings within the epithelium of the papillae of the intermolar palatal rugae, located either between the basement membranes and the bases of the epithelial cells, or suprabasally in the intercellular spaces of the epithelium. Cytoplasmic processes of epithelial cells invaginated the Schwann cells of the nerve endings; junctions between, or fusion of, the cell membranes of the epithelial cells and the Schwann cells were not found. The neurites of the nervous structures were characterized by numerous mitochondria, clear-cored vesicles and an axoplasmic reticulum. In lanceolate endings, asymmetric membrane densities existed between the neurite and its Schwann cell, the Schwann cell showing signs of pinocytotic activity at all sides of its plasma membrane. The basal lamina of the Schwann cell covering of the nerve endings appeared to be continuous with the basal lamina of the epithelium.     

Warthin's tumor of the hard palate

Warthin's Tumor (WT) or papillary cystadenoma lymphomatosum is typically located in parotid gland. Extraparotid localization of WTs (EPWT) was rarely described in ectopic salivary tissue in the latero-cervical and para-parotid lymph nodes. Localization in the hard palate is exceptional. This paper describes pre-surgical diagnostic work up and surgical management of a solitary WT localized in the hard palate as found in a 27-year-old Caucasian woman. With consideration of uncertain pre-surgical diagnosis obtained with FNAC, intraoperative histologic examination of frozen sections was planned. Conservative surgical approach was performed. After WT was diagnosed with histology, a local bone curettage was made. Clinical and radiographic follow-up at 12th month was negative for relapse.     

Epithelioid myoepithelioma of the hard palate

Background

Myoepithelioma, a generally benign tumor comprised of myoepithelial cells, is an uncommon salivary gland tumor. Among four morphologic variants of myoepithelioma, epithelioid type has not been reported in the oral and maxillofacial region.

Case report

A 61-year-old man first noticed the mass 3 years previously. The oral examination revealed a firm, non-tender, and well-circumscribed mass in the middle of the hard palate. A magnetic resonance imaging scan showed a well-circumscribed mass with low signal intensity (T₁-weighted image) or increased signal intensity (T₂-weighted image).

Discussion

Immunohistochemically, the tumor cells in the present case reacted to the epithelial (CK HMW and CAM5.2) and the mesenchymal (vimentin) markers. However, myoepithelial markers (S-100 protein, α-smooth muscle actin, glial fibrillary acidic protein, and calponin), except p63, were not expressed in the tumor cells. These results indicated that the epithelial myoepithelioma cells differentiated into epithelial cells rather than myoepithelial cells. We believe that epithelioid myoepithelioma of the palate is a distinctive subtype of myoepithelioma that should be included in the differential diagnosis of tumors of the palate.     

Chloroquine-induced hyperpigmentation of the hard palate

This article reports a rare case of extensive palatal pigmentation secondary to long-term chloroquine treatment. Chloroquine was originally used as an antimalarial agent, but it is now widely used as an adjunct in the treatment of autoimmune diseases. Adverse effects of chloroquine usually include skin changes such as bullous pemphigoid, exacerbation of psoriasis, and pigmentation of the skin and mucous membranes as well as retinopathy, gastrointestinal alterations, and neuromuscular disorders. Extensive oral pigmentation is an uncommon feature of an adverse drug effect, and diagnosis should be based on clinicopathological findings.     

Synovial sarcoma of the hard palate

Synovial sarcoma is a rare soft tissue tumour of uncertain histogenesis and intraorally they occur mainly in young adults. We present a case of synovial sarcoma of the hard palate in a 68-year-old woman. To our knowledge, there is no previously reported instance of this tumour at this site.