engleski

Palatal mucoepidermoid carcinoma misdiagnosed as odontogenic infection

Mucoepidermoid carcinoma (MEC) constituting less than 10% of all salivary gland tumors, account for approximately 30% of all malignant salivary gland 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 moderate responsiveness to radiotherapy, initial wide local excision appears to be appropriate for low-grade, plus neck dissection if the nodes are clinically suspicious in intermediate-grade and for high-grade a neck dissection is combined with wide block excision. Differential diagnosis on the hard palate includes all 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 mucocoele 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 has not been cured. Eight months after the beginning of the treatment, the patient has been sent to our Department. The cytology diagnosis we made 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.

mucoepidermoid carcinoma ; odontogenic infection ; salivary gland tumor

Oral Case Presentation