Rare upper lip pleomorphic adenoma presents as cutaneous skin lesion: Case report

Pleomorphic adenoma of the minor salivary gland is not uncommon. Although malignant lesion is the most common in the minor salivary glands, benign lesion has been also reported. Many ectopic sites for minor salivary gland including the lip have been reported mainly intra-orally. But external cutaneous lesion is not that common, which will confuse the diagnosis.

This is a case report of a small 1.5 × 1 cm lesion in the left side of the upper lip in a healthy male. The lesion is fixed to the skin and was confused as dermal sebaceous cyst, which was excised with 2 mm safe margin under local anesthesia in an academic setting and closed primarily. Wound healed completely with no local complication and no evidence of recurrence in 1 year.

Minor salivary glands are numerous in numbers specially in the oral cavity mainly in the hard and soft palate. Ectopic site in the head and neck area is well documented including the upper lip. But cutaneous presentation in the skin of the upper lip is not very common and can be easily missed especially if the specimen is not sent to permanent pathology. Pleomorphic adenoma has a unified histopathological feature that can be diagnosed by expert histopathologist.

Even for benign looking skin lesions excision with safe margin and histopathology should be the standard of care. By executing this we ensure a serious malignancy will not be missed, were additional surgical or non-surgical management might be considered necessary.