MYOEPITHELIOMA VS ADENOID CYSTIC CARCINOMA OF PALATE: CHALLENGES IN DIFFERENTIAL DIAGNOSIS

Abstract

A 46-year-old male melanoderm patient presented hard palate swelling with 4-year history, pain, and sporadic bleeding, with a previous diagnosis of tubular epithelial neoplasia compatible with epithelioid myoepithelioma after immunohistochemical study. The patient was submitted to total surgical excision with margins. Histopathologic and immunohistochemical analysis of the removed lesion revealed an adenoid cystic carcinoma. Because of pT1 staging with no perineural and no angiolymphatic invasion, adjuvant treatment was not proposed. There are no signs of relapse after 5-month follow-up by the multidisciplinary medical/dental team. Diagnosis of salivary gland lesions is complex because of the various similarities between the various subtypes of neoplasms, including benign and malignant tumors. The divergence between incisional biopsy and postoperative diagnosis shows the clinical challenge for surgeons and pathologists. A 46-year-old male melanoderm patient presented hard palate swelling with 4-year history, pain, and sporadic bleeding, with a previous diagnosis of tubular epithelial neoplasia compatible with epithelioid myoepithelioma after immunohistochemical study. The patient was submitted to total surgical excision with margins. Histopathologic and immunohistochemical analysis of the removed lesion revealed an adenoid cystic carcinoma. Because of pT1 staging with no perineural and no angiolymphatic invasion, adjuvant treatment was not proposed. There are no signs of relapse after 5-month follow-up by the multidisciplinary medical/dental team. Diagnosis of salivary gland lesions is complex because of the various similarities between the various subtypes of neoplasms, including benign and malignant tumors. The divergence between incisional biopsy and postoperative diagnosis shows the clinical challenge for surgeons and pathologists.