Minor Salivary Gland Tumour — MFDS Part 1 MCQ

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ModerateOral PathologyMinor Salivary Gland TumourMFDS Part 1

A 48-year-old patient has a 2-year history of a slowly enlarging, painless swelling on the posterolateral hard palate. Examination shows a smooth, well-circumscribed, firm submucosal mass with intact, normal-coloured overlying mucosa. It is not bony hard. What is the most likely diagnosis?

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

Pleomorphic adenoma is the best answer. Intraoral pleomorphic adenomas most often arise from minor salivary glands of the palate and classically present as slowly enlarging, painless, firm submucosal masses with intact mucosa. The posterolateral location and non-bony consistency distinguish this lesion from a torus palatinus, which is a midline bony exostosis. Squamous cell carcinoma is more likely to show mucosal alteration, ulceration or irregular induration. Oral Kaposi sarcoma is usually red, brown or violaceous, often in an immunocompromised patient. A fibrous epulis arises from gingival tissue rather than the palate. Clinical features establish only the most likely diagnosis; histopathological examination is required because benign and malignant minor salivary gland tumours can overlap clinically.

Reference: AlWatban Z et al. Pleomorphic Adenoma of the Oral Cavity: Systematic Review. Indian Journal of Otolaryngology and Head & Neck Surgery. 2023;75(4):3288-3304. https://pubmed.ncbi.nlm.nih.gov/37974882/