Labial Mucosa Research Articles

Oral fibroepithelial polyps ("chewing granulomas") in 21 dogs: Histomorphology, immunohistochemical characterization, and clinical outcome.

Oral fibroepithelial polyps (FEPs) are common, benign, nonneoplastic lesions in humans that often develop slowly in sites of local irritation or trauma. This study analyzed 23 oral fibroepithelial polypoid lesions retrieved from 21 dogs (2014-2021). All lesions were pedunculated with usually an irregular/cauliflower-like or rarely smooth surface. FEPs most commonly arose under or lateral to the tongue; other sites included the labial and gingival mucosa, soft palate, and hard palate. All the lesions were characterized by a thick fibrovascular stalk consisting of bundles of fibrocytes and fibroblasts embedded in a collagenous matrix rich in blood vessels. The surface squamous epithelium, when evaluable, was hyperplastic (22/22; 100%) with frequent parakeratotic hyperkeratosis (12/22; 54.5%). Ulceration of variable extent was observed in 13/23 cases (56.5%). Inflammation was associated with 18/23 cases (78.3%), and was mostly lymphoplasmacytic. The connective tissue was consistently immunoreactive for vimentin and generally negative for smooth muscle actin and desmin. All FEPs in cases with available clinical outcome data did not recur after surgical excision. The presence of chronic inflammation and ulceration suggests a causative role of chronic irritation in the pathogenesis of canine oral FEPs. FEPs should be included among the differential diagnoses of proliferative lesions of the oral cavity in dogs.

Management of toxic epidermal necrolysis with oral involvement with candidiasis in stage III cervical carcinoma patients

Toxic epidermal necrolysis (TEN) is the most serious cutaneous adverse drug reaction characterized by extensive detachment of epidermis and erosions of oral mucosal. Early diagnosis and proper therapy are an essential for reduction the morbidity and mortality of this disease. This article is aimed to describe the management of TEN with oral involvement accompanied candi-diasis in patient with carcinoma cervix stage III. A 53-year-old female patient with carcinomacervix stage III and diagnosed of TEN was referred to Oral Medicine Clinic with complaint of painful throughout the oral mucosa, on the lips and during swal-lowing. The patient had a medication history after 25th radiotherapy i.e. cefixime and mefenamic acid. Erythema and erosive le- sion were seen at almost of the bodymainly in back, waist and belly except on palm hand and sole. Erosion also found on the lips with hemorrhagic crusts which bleed easily. Erosive lesion andcandidiasis were seen in the labial mucosa, dorsum and late-ral of tongue, and buccal mucosa. The patient was given NaCl 0.9% for lips compress, chlorhexidinedigluconate 0.12%, hya-ruronic acid mouthwash, vaseline album, whilst therapy for candidiasis was nystatin oral suspension 100,000 IU. The pa-tient was also given education to maintain oral hygiene. It was concluded that oral lesions and candidiasis were healed after 2 weeks of therapy and the patient had significant improvement on the oral mucosal. The appropriate pharmacological and non-pharmacological therapies given were successful on reducing the morbidity and mortality to the patient.

An evaluation of quality of life (OHIP-14) in facial adenocarcinoma patient with adjuvant therapy: case report

Adenocarcinoma is a type of carcinoma that begins from the glands. Impovement in management of head and neck cancer have resulted in decreased mortality, increased survival rates and patient’s quality of life. The World Health Organization defines quality of life are include three things, physical function, mentalstatus and ability to socially interact. It is reported a 19-year-old male with a history of right infraorbital adenocarcinoma who had undergone hemimaxillectomy,chemotherapy and radiotherapy. The patient complains painful swallowing and soreness in the oral cavity. Extraoral examination face and eyes was asymmetrical,there was keloid tissue in the right infraorbital and dry lips. Intraoral examination found white plaque on the upper labial mucosa, the left buccal mucosa had severalerythematous lesions and brownish macules. Yellowish white plaque on the anterior two-third of the tongue’s dorsum and there are fissures. Necrotic area on ​​right hard palate with yellowish margin. The teeth at first region are edentulous, whereas regions 2, 3 and 4 most of them are radix. The patient’s quality of life was assessed using the oral health impact profile (OHIP-14). Based on the assessment, the patient's quality of life at the first visit was poor with score 45, the next visit showed improvement with score 39, reduced in pain, improved physical and psychological abilities. It s concluded that oral and dental health is an important thing that can improve the quality of life of patients with infraorbital adenocarcinoma which is supported by good communication between doctors and patients.

Management of Lingual Traumatic Fibroma in An Epileptic Patient Using Diode Laser

Traumatic fibroma is a benign exophytic and reactive oral lesion that develops secondary to repetitive trauma or irritation. Most commonly affected sites are tongue, buccal mucosa, and lower labial mucosa. These are well demarcated, smooth, pedunculated or sessile, exophytic lesions which are similar to the surrounding mucosa in color. Generally, it is non-tender but local irritation may lead to painful ulceration. Treatment plan includes complete excision and removal of the cause of irritation. Excision can be done by scalpel, electrocautery or Laser. The excision of the fibroma with diode laser is a safe procedure, with minimum postoperative discomfort and complications. Recurrences are rare but may occur due to repetitive trauma at the same site.

Oral lichen planus and related lesions. What should we accept based on the available evidence?

Recent new terminologies have been proposed for lesions in the sphere of oral lichen planus (OLP) that theoretically present unique aetiological, clinical, prognostic or management characteristics different from those of the so-called typical forms of OLP. We aimed to critically analyse what concepts and terminologies related to OLP should we accept based on the available evidence. A review of the literature was carried out in order to critically analyse the concepts and terminologies related to OLP. New concepts and terminologies include oral lichenoid lesions; contact lichenoid reactions, drug lichenoid reactions or those in the context of graft-versus-host disease; chronic ulcerative stomatitis; lichen planus pemphigoid; and some lesions that are difficult to categorise, such as OLP with features of proliferative verrucous leukoplakia and lichenoid lesions of the upper labial mucosa. A multidisciplinary, multicontinent working group has recently published a guideline with recommendations for modifying definitions and terminologies associated with a disease, among which a reasoned, evidence-based justification for the proposed change is considered essential. An in-depth analysis of the newly proposed terms for OLP-related lesions shows that many of them are not justified. In this paper, we set out our position on the basis of the existing evidence on the appropriateness of the use of these new terms.

Traumatic Fibroma of Tongue

Traumatic or irritational fibroma is a common benign exophytic and reactive oral lesion that develops secondary to injury. Fibroma is a result of a chronic repair process that includes granulation tissue and scar formation resulting in a fibrous submucosal mass. The most common sites of traumatic fibroma are the tongue, buccal mucosa and lower labial mucosa. This article presents the case of a 35-year-old female patient with 2 months-long proliferation on the tip of the tongue. Here, electrocautery was used for the complete excision of the lesion. The main advantages of using it is effective hemostasis that can be achieved in a short span, is less invasive, and better postoperative phase

PHARMACOLOGICAL MANAGEMENT OF ORAL LESIONS IN ADENOID CYSTIC CARCINOMA PATIENTS UNDERGOING RADIOTHERAPY

Objective: This case report aimed to describe the pharmacological management of oral lesions in adenoid cystic submental carcinoma patients undergoing radiotherapy.
 Methods: A 48 y old female undergoing radiotherapy complained of difficulty eating, swallowing, and speaking due to severe pain in her oral cavity for three weeks. Intra-oral examination revealed painful yellowish-white plaques that could not be scrapped on the tongue, maxillary and mandibular anterior gingiva, left and right buccal mucosa, and palate, diagnosed with oral candidiasis. We also found multiple shallow ulcers on the left buccal mucosa and upper labial mucosa that can be seen as oral mucositis.
 Results: The patient was given nystatin oral suspension for oral candidiasis, benzydamine hydrochloride for the complaint of pain when swallowing, and saline for promoting wound healing and keeping the oral mucosa moist. These lesions healed in a week and she could eat solid food without pain.
 Conclusion: Appropriate pharmacological management of oral lesions in a patient undergoing radiotherapy provides significant healing to better quality of life.

Development of a coaxial DCF-GRIN fiberoptic Raman probe for enhancing in vivo epithelial tissue Raman measurements.

We report on the development of a novel, to the best of our knowledge, coaxial double-clad-fiber (DCF) and graded-index (GRIN) fiberoptic Raman probe for enhancing epithelial tissue Raman measurements in vivo. The ultra-thin (140 µm outer diameter) DCF-GRIN fiberoptic Raman probe is designed and fabricated with an efficient coaxial optical configuration, whereby a GRIN fiber is spliced onto the DCF to enhance both the excitation/collection efficiency and depth-resolved selectivity. We demonstrate that the DCF-GRIN Raman probe can be used to acquire high-quality in vivo Raman spectra from various oral tissues (e.g., buccal mucosa, labial mucosa, gingiva, mouth floor, palate, and tongue) covering both the fingerprint (800-1800 cm-1) and high-wavenumber (2800-3600 cm-1) regions within sub-seconds. The subtle biochemical differences between different epithelial tissues in the oral cavity can also be detected with high sensitivity, suggesting the potential of the DCF-GRIN fiberoptic Raman probe for in vivo diagnosis and characterization in epithelial tissue.

Karakteristik Lesi dan Faktor-Faktor Pemicu Penderita Stomatitis Aftosa Rekuren pada Mahasiswa Profesi Kedokteran Gigi USU Tahun 2019-2020

Recurrent Aphthous Stomatitis (RAS) is ulcer in the oral mucosa that occur repeatedly with unknown etiologic factors but varied trigger factors and lesion characteristics. The prevalence of RAS still high in community, however pain and the recurrence impact the quality of life both in oral activities and daily activities such as: avoided brushing teeth that it causes poor oral conditions, impaired mastication, swallowing, speaking, feeling uncomfortable, difficulty sleeping and reducing social interaction. The purpose of this study was to determine the frequency distribution of lesion characteristics and the triggering factors for patients with recurrent aphthous stomatitis in USU dental professional students in 2019-2020. This research is a survey study with a cross sectional design. The population is students of the dental profession at the University of North Sumatra in 2019-2020 with a total sample of 62 respondents who were used as research subjects. Measurement of SAR variables using the Recurrent Aphthous Stomatitis Diagnosis (RASDX) questionnaire. The research data was obtained by distributing online questionnaires in the form of a google form. Students who were most affected by SAR were female at 87.1%. The most common type of SAR found was minor at 95.2%, was in the labial mucosa by 72.6%, single ulcers of 95.2%), history of ulcer duration suffered by respondents was around 7-14 days 54.8%, multifactorial triggering factors are genetic, trauma and stress (30,6%) with the most common triggering factor was stress at 93.5%. The characteristics RAS in this research were minor type on the labial mucosa, a single of number and duration of 7-14 days. Based on the trigger factors, it can be concluded that the most common group of 3 multifactor (genetic, trauma and stress) which stress is the most common factors.

A Clinicohistopathological Characterization of Oral Lichen Planus: A Cross-Sectional Study.

Based on the modified diagnostic criteria for oral lichen planus (OLP) proposed by Van der Meij and Van der Waal, the objective of the current investigation was to demonstrate a clinicohistopathological association in the diagnosis of OLP. Data were retrieved from 250 individuals who visited the Department of Oral Medicine and Radiology and were diagnosed with OLP between September 2018 and December 2021. Upon completion of the histopathological analysis, the precise diagnosis of OLP was made. Repeat biopsies were performed in the cases suspecting malignant transformation during the follow-up phase. The data were analyzed using SPSS software. The Fisher's exact test and chi-square test of association were used to establish the significant differences between the variables at a 5% significance level. Of the 250 patients, 48% and 52% were males and females, respectively. The two clinical manifestations observed were reticular (n=145, 58%) and erosive types (n=105, 42%). The most frequently impacted locations were the buccal mucosa (n=150, 60%) and labial mucosa (n=100, 40%). Fourteen individuals (two with reticular form and 12 with erosive form) later during follow-up showed dysplasia, with moderate (n=2) to mild (n=12) dysplastic alterations. Koilocytes were reported in 84 cases (34%), which included 35 (24%) reticular cases and 49 (47%) erosive lesions. The histopathological features such as acanthosis, epithelial atrophy, hyperkeratosis, presence of neutrophils, koilocytes, and epithelial dysplasia were shown to be statistically significant between the clinical forms (p<0.001). The results of the current study highlight the concordance of histopathological and clinical diagnoses, especially for early definitive diagnosis of OLP. More research studies are warranted to validate the trend of epithelial dysplasia in OLP associated with human papillomavirus (HPV) and to explore the course of the lesions that might be affected by this trait.

Real-time delineation of basement membrane in human oral and esophageal mucosa with micro-optical coherence tomography

Basement membrane is a thin, extracellular matrix-like structure, separating the epithelium from the stroma and having a vital role in determining cancer progression. Identification of this diagnostically important structure with histology is invasive and labor-intensive. Micro-optical coherence tomography (µOCT) which has the capability to recognize subcellular-level microstructures underneath the surface offers the possibility to resolve basement membrane noninvasively in situ and in vivo. In this study, we conducted numerical analysis of the back-scattering intensity of basement membrane and experimental µOCT imaging of human labial mucosa in vivo and esophageal mucosa ex vivo, in an attempt to characterize the basement membrane underlying stratified squamous epithelial tissues. The results disclose that the layered structure of mucosa could be clearly delineated and the basement membrane presented as a steep, low-scattering linear structure in between the relatively high-scattering epithelium and stroma. Besides, according to the knowledges on its ultrastructure, we assume the low-scattering signal is collectively determined by basal lamina and reticular lamina since the former alone is extremely thin to be recognized by µOCT. This study clarifies the scattering features of basement membrane and the capability of real-time delineation of basement membrane which will help to determine the progression of epithelial cancers without the need of resection and histology.

LIP-PRINTS – EVIDENCE LOST TO IMPERTINENCE

Objective: Identity means determination of individuality of a person beyond doubt, based on physical characteristics unique to an individual. Article-6 of the Universal Declaration of Human Rights states that everyone has a right to identity as a person. The wrinkles and grooves on labial mucosa called form a characteristic pattern and the study of these is referred to as cheiloscopy. These are unique to an individual just like the fingerprints thus, hold the potential for identification purpose. This study was designed to evaluate lip-prints as a tool of forensic identification. Methods: The study was done in North Haryana on 1000 subjects aged between 15 and 25 years over a period of 2 years. Purposive sampling was done and subjects were asked to produce lip prints on bond paper, which were examined based on Suzuki and Tsuchihashi classification. Data obtained were analyzed using Student’s t-test. Results: It was found that no two individuals had similar lip prints. Type I pattern was most common followed by Type II whereas Type V was least common. Conclusion: However, till date, no reliable system with repeatability has been developed for studying lip-prints especially to remove observer bias. Nor any comprehensive studies are available comparing lip-prints in live and dead subjects to authenticate their forensic identification potential, raising question at forethought and purpose of practical application of research in the field of cheiloscopy.

Demographics, Clinicopathological Profile of Oral Lichen Planus of South Kerala Population: A Cross-Sectional Study.

Oral lichen planus (OLP) is a chronic mucocutaneous inflammatory lesion of unknown cause. The buccal mucosa is the most frequently affected anatomic site and the lesion is bilateral. The objective of this retrospective study was to investigate the epidemiological and clinical characteristics of 250 OLP patients in South Kerala. This was done by figuring out these patients' epidemiological and clinical characteristics. Materials and methods:In the present study,patients who reported between September 2018 and December 2021were selected employing the diagnostic criteria consistent with the WHO classification of OLP. Data of all the patient's characteristic featureswere collected and evaluated using the Statistical Package for the Social Sciences (SPSS) software for statistical analysis. Out of 250 patients, 52% were females and 48% were males. Reticular (n = 145, 58%) and erosive forms (n = 105, 42%) were the two clinical presentations of the lesions that were most consistently observed. The age group of 25-34 years reported the highest number of cases (n = 71, 28.4%). According to the chi-square test, there were statistically highly significant differences between the hyperpigmentation, age, and type of OLP. While 43.2% (n = 108) of cases reported a burning sensation, pain, or soreness, 56.8% (n = 142) of cases were asymptomatic. There were statistically significant differences between the type of OLP and the reported symptoms (p = 0.001). Mild to moderate dysplastic changes were documented in 5.6% during the follow-up period. A successful treatment outcome with topical steroid administration was recorded in the study sample. It was apparent that patients typically have bilateral lesions involving the buccal and labial mucosa, manifesting with varying degrees of oral discomfort. Although patients frequently have more than one variant of OLP, the lesions are typically reticular or erosive in nature. A meticulous follow-up is crucial to determine its malignant change.

COMPLETE UNILATERAL MAXILLECTOMY IN A COHORT OF FIVE COLOMBIAN BOAS (BOA IMPERATOR).

Five unrelated adult Colombian boas (Boa imperator) presented with a 1- to 3-mon history of unilateral rostral swelling of the maxilla associated with a chronic rubbing against the enclosure's walls. Moderate to severe gingival inflammation and ulceration of the labial mucosa were present at the level of the swelling with tenderness to the touch. Radiography revealed osteolytic or proliferative lesions of the maxillary bone. Chronic maxillary osteomyelitis was diagnosed. Unilateral maxillectomy was performed on each animal under general anesthesia. Local anesthesia was also achieved by infiltrating lidocaine along the medial and lateral aspect of the maxillary gingiva and at the level of the maxillo-ectopterygoid joint. Using a lateral gingival approach, the maxillo-prefrontal, maxillary-palatine, and maxillo-ectopterygoid attachments were transected, and the maxillary bone removed. Histologic examination revealed pyogranulomatous stomatitis and osteomyelitis in all snakes, and presence of intralesional bacteria (n = 3 snakes). Gram-negative bacteria (Chryseobacterium indologenes and Proteus mirabilis) were cultured from the resected tissue of two snakes. One snake suffered from wound dehiscence 5 d postoperatively. All snakes were fed 15 d postoperatively and ingested dead mice without apparent difficulties. One snake was examined 2 mon and 1 yr after surgery, with no evidence of soft tissue or osseous infection and only minor facial scaring; all other snakes were lost to follow-up 15 d after surgery. Unilateral maxillectomy was performed in a cohort of five Colombian boas suffering from maxillary osteomyelitis. This surgical technique should be considered as an alternative to medical treatment in boid snakes.

Verruco-papillary dilemma for the oral diagnostician: A case series of two interesting cases

Oral Verrucous Lesions (OVL) comprise of Verrucous Hyperplasia (VH), Verrucous Keratosis, Proliferative Verrucous Leukoplakia (PVL) and Verrucous Carcinoma of Oral Cavity (VC) known as Ackermann’s Tumour. These predominantly emerge as slow proliferating, gray or white, warty, exophytic lesion with micro-nodular surface &amp; commonly seen on the buccal, labial mucosa, gingiva, tongue and palate. These are associated with consumption of tobacco in smoke and smokeless ways and in conjugation with alcohol and viral opportunists have known to be reported. Despite being delineated as benign lesions of minimum aggressive potential, these are difficult to tell apart from each other &amp; long-standing cases have shown transformation into squamous cell carcinoma. This case report, we discuss case scenarios of an 80 year old female and a 42 year old male patient presenting with a diagnostic dilemma of verruco-papillary lesions which was successfully managed by early intervention and surgical intervention and extensive chemo-prevention.

Primary Oral Myiasis of Anterior Maxilla in An Intellectually Disabled Female – A Case Report

“Myiasis” is a term used to represent invasion caused by fly larvae that affect organs and tissues of human beings and feeds on the host tissue. It is a rare and non-specific pathology that varies according to the species of fly larvae and the area of the body involved. Various factors like extraction wounds, uncontrolled diabetes, necrotic tissues, alcohol addiction, poor oral hygiene, immunocompromised conditions and people with special care needs like debilitated or mentally challenged individuals predispose to develop myiasis. We hereby report a case of oral myiasis of the maxillary anterior region of the palate and labial mucosa, in a 16-year-old female patient with special care needs who for her daily activities is dependent. The diagnosis was confirmed by the presence of pulsating larvae in the lesion and was managed by conservative suffocation therapy involving the turpentine oil topical application followed by the mechanical removal of larvae along with surgical debridement and post-operative antibiotics.

Uremic stomatitis in patients with chronic renal failure undergoing hemodialysis

Patients with end-stage renal disease with or without hemodialysis are at risk of experiencing a number of comorbidities inclu-ding hypertension, anemia, risk ofbleeding and have oral manifestations related to the disease itself or due to hemodialysis; for example uremic stomatitis. This article describes uremic stomatitis in end-stage renal disease patient undergoing hemodialysis. A 14-year-old girl with chronic kidney disease had already undergoing hemodialysis, came with weak, pale condition and pre-viously vomiting, complaining sore mouth and difficult to eat. Extra oral revealed anemic conjunctiva, dry lips, exfoliative, ero-sive with serosanguinolenta crusts, tend to bleed, multiple purpuras and petechiae on the lower lip. Intra oral showed white plaque cannot be scrapped off on theventral tongue. Painful erosive area and white pseudomembranes on the lower labial mu-cosa, multiple white plaques can be scrapped off leaving erythematous area on the right buccal mucosa, purpura on the left buc-cal mucosa. Laboratory examination supported the diagnosis as as uremic stomatitis and exfoliative cheilitis. To overcome the complaints and improve the oral condition, the patient was treated with 0.12% chlorhexidine digluconate 0.12%, 0.9% NaCl solution, a mixture of tranexamic acid vials and aqua bides, and vaseline album. It was concluded that uremic stomatitis is an oral manifestation of end-stage renal disease, and appropriate therapy will improve the quality of life of the patient.

Honey as a risk factor for erythema multiform: case report

Erythema multiform (EM) is an acute and recurrent hypersensitivity reaction that occurs on the skin and oral mucosa. EM's risk factors include viral infections,drugs, radiation, autoimmune diseases, foodstuffs, and chemicals. Various bee products such as propolis, honey, and bee pollen are believed to have therapeutic effects for various diseases but can trigger allergic reactions. A 31-year-old female patient came to the Oral Medicine clinic with swollen and bleeding lips 2 weeks ago. The patient initially felt her lips were dry and exfoliate, then smeared her lips with honey but they became swollen and painful. The patient felt itchy on hertongue after consuming honey a few months ago. Clinical examination showed edema accompanied by erosive lesions, and ulcers, tend to bleed hemorrhagic crusts on the upper lip to the upper labial mucosa and lower lip. Laboratory examination showed IgE titer increased fourfold, IgG and IgM anti-HSV-1 were negative. The diagnosis was erythema multiforme. The therapy given is 0.9% NaCl compress on the lips using sterile gauze, applying topical corticosteroids to the lips, and educating the patient to not use and consume honey or other bee products. The patient recovered without scarring after two weeks of therapy. It was concluded that honey can be a risk factor for the emergence of EM, so it is very important to eliminate risk factors for the management and prevention of EM recurrence.

Use of Submental Intubation in the Full-Face Makeover (Orthognathic Surgery, Facial Prosthesis Combined With Rhinoplasty).

Submental intubation is an intubation technique used for the management of airways in patients who suffered from complex maxillofacial trauma. Few studies focused on the role of submental intubation during Full-Face Makeover, like orthognathic surgery, facial prothesis, and rhinoplasty. Authors describe a case series of 5 patients who underwent to Full-Face Makeover with submental intubation to manage the airways. The authors started with the Le Fort I subspinal osteotomy. The maxillary repositioning was guided through a 3D printed intermediate splint in all cases (previously simulated with Dolphin software).Subsequentially, the bilateral sagittal split osteotomy was performed. The mandibular repositioning was guided through a 3D printed final splint. The genioplasty was performed with a horizontal osteotomy after a labial mucosa incision. After the genioplasty, the authors used the incision previously used for the Le Fort I osteotomy to bluntly dissect the tissues in order to insert a custom-made polyether ether ketone zygomatic prosthesis. Lastly, an open rhinoplasty was performed. All the surgery lasted a mean less 6 hours. The submental intubation was removed in the operating room, at the end of the surgery. The patients were then discharged from the hospital 2 days after the surgery in all cases. Submental intubation is a valid method for the airway management in maxillofacial trauma and can be extended in case of Full-Face Makeover like orthognathic surgery combined with rhinoplasty. The absence of nasal traumatism during surgery leads to a more accurate rhinoplasty, with a greater satisfaction for the patient.

POLYMORPHOUS LOW-GRADE ADENOCARCINOMA: CASE REPORT

A 62-year-old White female patient presented to the stomatology clinic with a submucosal nodular lesion in a region of the lower right labial mucosa, asymptomatic, well delimited, circumscribed, movable, with a fibrous consistency, measuring 1 cm in diameter, with approximately 1 year of evolution. With the hypothesis of benign salivary gland neoplasm and benign mesenchymal neoplasm, an excisional biopsy was performed. Histologically, proliferation of cells organized in nests, ducts, and cords was observed, showing pale nuclei and evident nucleoli. The presence of mucous cells and cribriform areas and extracellular matrix, sometimes fibrous and other times hyaline, was noted. Immunohistochemically, cells were positive for cytokeratins 7 and 14, S-100, and p63 and focally positive for smooth muscle actin. The cell proliferation index measured by Ki-67 was less than 5%. In view of the clinical and microscopic characteristics, the diagnosis of low-grade polymorphous adenocarcinoma was closed. The patient was referred to the head and neck surgeon.