Papillary cystadenocarcinoma of the hard palate

Papillary cystadenocarcinoma (PCC) is an uncommon malignant tumour of the salivary gland, sometimes involving the minor salivary gland. Previously this entity was classified as an atypical type of adenocarcinoma, malignant papillary cystadenoma, low-grade papillary adenocarcinoma or mucus producing adenopapillary carcinoma. PCC is a glandular tumour with an indolent biological behaviour characterised by cysts and papillary endophytic projections. We report two cases of PCC involving the minor salivary gland of the hard palate. Both the patients presented with a swelling in the palate with difficulty in chewing. MRI revealed an extensively destructive lesion involving hard palate, alveolar ridge and maxillary antrum. Clinical and radiological features suggested the malignant nature of the lesion. Histopathology of incisional biopsy revealed tumour proliferation in a multicystic pattern, with extensive papillary proliferation. Diverse and cellular cytomorphology, and cellular and nuclear pleomorphism with few mitotic figures were the prominent features. Both the lesions were confirmed as PCC.