Palatal Minor Salivary Tumour — ORE Part 1 MCQ

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ModerateOral PathologyPalatal Minor Salivary TumourORE Part 1

A patient presents with a painless, slow-growing swelling of the posterior hard palate. It is firm, non-tender, dome-shaped, and covered with intact mucosa. It is not in the midline. What is the most likely diagnosis?

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Correct answer: E — Pleomorphic adenoma of a minor salivary gland

Pleomorphic adenoma (option A) is the most likely diagnosis. The key discriminating feature is the non-midline location: torus palatinus (option B) occurs invariably at the midline and is a bony exostosis, not soft tissue. Pleomorphic adenoma, the most common minor salivary gland tumour, typically arises on the posterolateral hard palate where minor salivary glands are concentrated, presenting as a painless, firm, slow-growing submucosal mass with intact mucosa—exactly matching the clinical presentation. Palatal abscess (option C) would show inflammatory signs (pain, tenderness, swelling); necrotising sialometaplasia (option D) is acute, often post-procedural, and self-limiting with ulceration; SCC (option E) typically presents with ulceration and rapid growth. The intact mucosa and chronic non-inflammatory course exclude these alternatives.

Reference: Pleomorphic adenoma of the soft palate: major tumor in a minor gland. NCBI/PMC. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4765339/ (2015)