Large pleomorphic adenoma of hard palate
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The following case has been published in the Annals of Maxillofacial Surgery.

A 56-year-old female presented with a 30-year history of swelling in her mouth which was small initially and gradually increased in size. She also complained of change in voice and difficulty in swallowing.

Intraoral examination revealed a solitary well-defined dome-shaped growth on the palate, measuring 3 cm × 4 cm in size with smooth surface. Swelling extended anteriorly up to palatal aspect of maxillary central incisors, posterior extent of tumor could not be observed, and inferiorly the growth extended up to the dorsum of the tongue and laterally extended into the edentulous space with relation to 26.

The occlusal radiograph showed a diffuse radiolucency in relation to 25, 26, and 27 region, measuring approximately 2 cm × 1 cm in size extending up to the midline. CT scan revealed homogenous hyperdense area present in left half of maxilla arising from the alveolar process, lifting the floor of left maxillary sinus, and also involving the left half of nasal cavity.

Based on the clinical examination and investigations, a provisional diagnosis of benign salivary gland tumor was made and surgery planned. Through external approach, the tumor was excised with 1-cm clinical margins, and an acrylic obturator was placed to cover the oral defect. The size of the obturator was gradually reduced according to the healing of the defect.

Follow-up examination was done every month and the defect completely healed at the end of 6 months. There was no recurrence after 2 years of follow-up. On gross examination, the excised tumor was pinkish, lobulated and had focally glistening cut surface.

The excised tumor was sent for the histopathological examination which showed an admixture of epithelial and stromal components. Ducts lined by inner epithelial and outer myoepithelial cells were seen surrounded by a chondromyxoid stroma consistent with PA.

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