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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).

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).

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)

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

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