Premium
OC4
Palatal mucoepidermoid carcinoma misdiagnosed as odontogenic infection
Author(s) -
Brajdić D,
Virag M,
Manojlović S,
Macan D
Publication year - 2006
Publication title -
oral diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.953
H-Index - 87
eISSN - 1601-0825
pISSN - 1354-523X
DOI - 10.1111/j.1601-0825.2006.01308_4.x
Subject(s) - medicine , mucoepidermoid carcinoma , adenoid cystic carcinoma , hard palate , neck dissection , salivary gland , sialadenitis , pathology , adenocarcinoma , pleomorphic adenoma , differential diagnosis , carcinoma , surgery , cancer
Mucoepidermoid carcinoma (MEC) constituting less than 10% of all salivary gland tumors, account for approximately 30% of all malignant tumors, approximately 60% occur in the parotid and 30% in minor salivary glands. The palate is the most frequent localisation for those arising in minor salivary glands. Although the prognosis correlates with the histological grade, occasional low‐grade tumors behave unexpectedly aggressive. Because of only moderately responsive to radiotherapy, initial wide local excision appears to be appropriate for low‐grade, plus neck dissection if the neck nodes are clinically suspicious in intermediate‐grade and for high‐grade a neck dissection is combined with wide block excision. Differential diagnosis includes benign and malignant tumors of hard palate, mostly pleomorphic adenoma, polymorphous low‐grade adenocarcinoma, adenoid cystic carcinoma and squamous cell carcinoma. The chronic sialadenitis or mucocele as a histologically similar could be misdiagnosed with a low‐grade MEC, but also necrotising sialometaplasia. Odontogenic cyst, lymphoma, plasmacytoma, Langerhans cell histiocytosis or metastatic carcinoma could also be included. We report a case of a 33‐year‐old male patient with a MEC of a hard palate treated as an acute odontogenic infection, which after tooth endodontic treatments, repeated incisions and antibiotics have not been cured. He had a toothache on 26 and tumor of a hard palate. Eight months after, the patient has been sent to our Department. The cytology diagnosis was MEC, low‐grade malignant. Partial maxillectomy was performed. The diagnosis and the long‐term unsuccessful treatment have warned that the diagnosis and consequently the treatment should have been revised.