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A Nodule of the Palate

Case Challenge Number: 43

Diagnostic Information

Past Medical History The patient’s past medical history was significant for a history of hiatal hernia and a partial gastrectomy secondary to gastric ulcers. Clinical Findings Extraoral examination revealed no lymphadenopathy and no facial asymmetry. Intraoral examination demonstrated a 1.0 cm slightly firm, sessile nodule on the right posterior hard palate. The lesion was red-purple in color and non-tender. Focal areas of ulceration were evident on the surface (Figure 1).

Case Challenge 43 - Content - Diagnostic Information - Figure 1

Figure 1.An ulcerated red nodule on the right posterior hard palate.

Excisional Biopsy and Histopathological Findings An excisional biopsy was performed. Microscopic examination revealed a well-circumscribed tumor composed of islands of mucous and epidermoid cells as well as cystic spaces (Figures 2-4).

Case Challenge 43 - Content - Diagnostic Information - Figure 2

Figure 2.A low power photomicrograph reveals stratified squamous epithelium overlying connective tissue containing an unencapsulated proliferation of islands of epithelial cells. (Hematoxylin and eosin stain)

Case Challenge 43 - Content - Diagnostic Information - Figure 3

Figure 3. Islands of epidermoid cells are noted containing small cystic and ductal structures. (Hematoxylin and eosin stain)

Case Challenge 43 - Content - Diagnostic Information - Figure 4

Figure 4. Mucous cells are demonstrated throughout the tumor. (Hematoxylin and eosin stain)