Carcinoma ex pleomorphic adenoma. Case report

Carcinoma ex pleomorphic adenoma (CXPA) is a rare and aggressive malignancy that usually develops in primary or recurrent pleomorphic adenoma. It occurs in 6% of all pleomorphic adenomas, of which only 7% of cases occur in minor salivary gland tumors. The rate of occurrence and malignant change increases with time if a case is left untreated. Intraorally, it is mostly seen in the palate, followed by the upper lip and buccal mucosa. CXPA of the hard palate typically presents as a painless, slow-growing swelling that frequently involves the periosteum and underlying palatal bone. Imaging of CXPA is usually noncontributory, leading to frequent misdiagnosis. Longstanding cases may extend up to the parapharyngeal space and cavernous sinus. We describe a rare case of CXPA of the palate with non-significant clinical and radiological findings. Early diagnosis for better prognosis is stressed.