Pleomorphic adenoma of the palate. Case report

Report on a huge pleomorphic adenoma (diameter 6 cm) of the right palate extending into the posterior part of the oral cavity. The dimension of the tumour and anatomical relations were documented with the use of nuclear magnetic resonance.     

Myxoid angiomyoma of the hard palate: a case report.

Angiomyomas are found with some frequency in the female genital tract. They can also appear in both sexes in the gastrointestinal tract and in the skin. The oral cavity is an unusual site for an angiomyoma. In this article, we describe the case of a 74-year-old woman who came to us with a nodule at the palatal midline. Following surgical excision of the growth and stent placement over the wound site, a biopsy analysis was performed. Histology of the removed tissue revealed an unusual variant of an angiomyoma: a myxoid angiomyoma.     

Monomorphic adenoma of the hard palate: report of a case.

A rare case of monomorphic adenoma of the hard palate in a 69-year-old female is presented. Her complaints were a slowly growing mass and occasional pain of the palate. The tumor was located in the posterior region of the hard palate, and it was approximately 1.5 x 1.5 cm in size. Under general anesthesia, the tumor was excised with a wide margin of normal tissue. The palatal bone was intact. Histological diagnosis was monomorphic adenoma, basal cell type.     

Acquired glottic web formation in a 3-year-old girl: Case report and literature review

Pediatric glottic webs are most commonly congenital in origin. Acquired webs in children are typically traumatic in nature, primarily from external trauma or intubation. We report a unique variation of this post-traumatic etiology: a web centered at the junction of the anterior one-third and posterior two-thirds of the vocal folds, possibly formed after phonotraumatic stress from severe coughing. Our case suggests that careful attention should be paid to persistent voice changes after acute illness, as this may be a sign of laryngeal web in the setting of phonotraumatic stress.     

Vallecular acinic cell carcinoma in a 9-year-old girl: report of an unusual case

An unusual case of acinic cell tumour of the vallecula is presented. Acinic cell carcinoma occurs usually in the major salivary glands. Minor salivary gland location is unusual and vallecular origin exceptional. This peculiar histologic tumour should now be classified as an low grade carcinoma and adequate treatment has to be initiated. The patient, a 9-year-old girl, had undergone a suprahyoid access for total tumor removal with a bilateral neck exploration. Postsurgical radiotherapy has to be done in case with perineural invasion, invaded margins, node invasion or high grade tumor. The clinical and histopathological findings are discussed in the light of the literature.     

Schwannoma of the hard palate

Schwannoma or neurilemmomas are benign, slow-growing, usually solitary, encapsulated tumors. They originate from the schwann cells of the nerve sheath. Approximately 30–40% of head and neck tumors are schwannomas. Intraoral schwannomas constitute a mere 1%. Tongue is the commonest site of schwannomas intraorally. Here we report a rare case of a hard palate swelling which was histopathologically diagnosed as schwannoma. The lesion was completely excised intraorally.     

Melanoma of the hard palate

Oral melanomas are extremely rare and occur most often on the palate and gingiva. Its prognosis is poor. Surgical management remains the preferred treatment, sometimes in combination with chemotherapy. We report the case of a 72 years old woman with a malignant melanoma of the hard palate who developed three years later a gingival nevi and 5 years later metastatic cervical lymph nodes. Our treatment has been only radical surgery all times.     

Ameloblastoma in an 11-year-old child

The authors report a case of ameloblastoma occurring at the unusual age of 11 years. The surgical management is conservative. Complete and careful tumorectomy was performed without reconstruction. Complete spontaneous restitution was seen one year after the operation. No recurrence was seen and the patient may new be considered as cured, with a 6 year follow-up.     

Osteomyelitis of the hard palate secondary to actinomycosis: a case report

Osteomyelitis of the hard palate is a rare and difficult-to-eradicate sequela of actinomycosis. In this case report, we illustrate the necessity of aggressive surgical management of actinomycotic infection of the hard palate. The patient was initially treated with multiple local debridements supplemented with oral and then parenteral antibiotics, but his disease progressively worsened. His condition eventually resolved only after a partial palatectomy was performed to remove all the necrotic bone, followed by a prolonged course of intravenous and oral antibiotic treatment.     

Considerations for free-flap reconstruction of the hard palate.

OBJECTIVE: To evaluate the use of microvascular free-tissue transfers in the reconstruction of hard palate defects. DESIGN: Retrospective review of a case series. SETTING: Two tertiary referral centers. PATIENTS: Thirty patients had hard palatal defects that resulted from ablative oncologic surgery: 10 total or subtotal palatal defects, 14 hemipalatal defects, and 6 anterior arch defects. INTERVENTION: Nine fibular, 11 rectus abdominus, 3 scapular, 6 radial forearm, and 1 latissimus dorsi free flaps were used to reconstruct these defects. MAIN OUTCOME MEASURES: Separation of the oral cavity from the nasal and sinus cavities, complications, oral diet, speech intelligibility, and overall quality of life. RESULTS: No flap failures occurred, and all palatal defects were ultimately sealed. Nineteen patients eat a regular diet, while the remainder maintain a soft diet. Twelve patients use a conventional dental prosthesis; 8 of the dental prostheses are supported by implants. Of 23 patients examined for speech, 18 have no disorders, 3 exhibit hyponasal speech, and 2 have hypernasal speech. Overall University of Washington, Seattle, quality of life scores were fair in 2 patients, good in 6, and excellent in 12. CONCLUSIONS: Free-flap reconstruction of the palate provides reliable permanent separation of the oral and sinonasal cavities in one stage. In addition, the potential for dental rehabilitation with the restoration of masticatory function and normal phonation exists. Flap choice is tailored to specific palatal defects as well as patient needs.     

Mucocele of the hard palate in children

ObjectiveMucus retention cyst of the hard palate may result from obstruction of the ducts of the minor salivary glands, and it was defined as a mucocele. Although, the disease is not common in the hard palate, it was previously reported by many authors in the soft palate. The aim of our study was to present pediatric patients who were diagnosed to have mucocele of the hard palate, and to evaluate the outcome of the surgical excision of this lesion.MethodsThis is a case series study included 8 pediatric patients who presented with cystic lesions on the hard palate which were removed surgically, and were diagnosed as mucoceles. Preoperative data, surgical procedures, and postoperative outcome were presented. Follow up of patients was performed for at least one year.ResultsThe swelling was detected as a single isolated lesion, on the side of the hard palate, covered with healthy mucosa, not tender, oval or round in shape, and measuring 0.4 to 1.7 cm in its greatest dimension. Computed tomography showed a well defined cavity which was not invading the bone, and not disrupting the muscles of the palate. Histopathological examination confirmed that the lesion was a cavity that is lined with an epithelial layer with pseudoepitheliomatous hyperplasia. No patients developed intraoperative or postoperative complications, and no recurrence was detected in any patient.ConclusionsOral mucoceles can develop on the hard palate of the children, the lesions are mucus retention cysts. Complete surgical removal of the lesions with their cystic wall is a good treatment options, it carries no risk of recurrence.     

Cellular neurothekoma in an 11-year-old child

INTRODUCTION: Neurothekoma is a rare benign tumor which must be distinguished from certain malignant tumors such as fibrohistiocyte tumors or plexiform cell tumors, neurotropic melanomas and clear-cell sarcoma. CASE REPORT: An 11-year-old girl consulted for a recurrent subcutaneous tumor of the chin which had been operated 4 months earlier. The resection was incomplete. A wider revision resection successfully stopped recurrence. The histology study established the diagnosis of neurothekoma due to the presence of mitosis atypia, cellular nodules, and extension to the hypodermis. Immunohistochemistry confirmed the diagnosis. DISCUSSION: Neurothekoma is a benign tumor observed in young women, mainly on the face. It occurs as a dermal cohesive mass without infiltration of the epidermis. The typical immunohistochemical pattern enables differential diagnosis with myxoid neurothekoma, melanocytic and nervous system tumors. Surgical resection is indicated.     

Mucoepidermoid carcinoma of the hard palate

A case of mucoepidermoid carcinoma originating in the hard palate was presented. Histological diagnosis of the removed mass at the first operation was pleomorphic adenoma. Tumor recurred at the same site three years later. Subtotal maxillectomy was performed and recurrent tumor was histologically diagnosed as low grade malignant mucoepidermoid carcinoma. A two-year follow-up showed no evidence of recurrence. The low grade malignant mucoepidermoid carcinoma strongly resembles pleomorphic adenoma. The differential diagnosis is important for the better treatment and prognosis.     

Necrotizing sialometaplasia--a specific differential diagnosis of an ulcer of the hard palate

BACKGROUND: Ulcers of the hard palate are mostly caused by malignancies. In addition, rare diseases should be included in the differential diagnosis. Beside specific inflammations (lues, tuberculosis) necrotizing sialometaplasia belongs to these uncommon medical conditions. PATIENTS: A 51-year-old male was admitted to the hospital with an algetic ulcer of the hard palate. Malignancy was ruled out by pathohistological examination. Inflammation or infection was excluded by serological examination. A second biopsy was investigated by the pathologist suspecting necrotizing sialometaplasia and confirmed the suspicion. By applying local treatment and systemic antibiosis against bacterial superinfection the ulcer finally healed. CONCLUSIONS: Necrotizing sialometaplasia is a rare medical condition generated by local circulatory disorder. 128 cases were published so far. Typical patients are males aged 50 and above. Characteristics of this ulcer are a high rate of spontaneous healing and lacking malignancy. After excluding a malignant tumor this rare disease has to be considered when diagnosing an ulcer of the hard palate.     

Salivary gland tumor of the hard palate

BACKGROUND: Pleomorphic adenomas of the small salivary glands are very rare and usually arise from the hard palate. CASE REPORT: We present a female patient who was referred to our Department because of a bleeding enoral tumor, which persisted for 35 years. Histopathological examination after complete tumor excision showed a pleomorphic adenoma. CONCLUSION: Pleomorphic adenomas are an important differential diagnosis for tumors of the hard palatine. The therapy of choice is surgical excision.