History of Present Illness
A 36-year-old female physician presents to your office for a new patient examination. The patient is asymptomatic but noticed a “bump on the roof of my mouth” several months ago. She denies local trauma and all teeth in the area are asymptomatic and demonstrate normal vitality testing. A periapical radiograph of the affected area is within normal limits.
Extraoral examination is within normal limits. Intraoral examination reveals a well-defined, 1.5 x.1.5 cm smooth surfaced mass on the right side of the posterior hard palate, just anterior to the vibrating line (Figure 1). The overlying surface mucosa is intact. An incisional biopsy is performed and the tissue submitted for histopathologic examination.
The incisional biopsy shows a circumscribed partially encapsulated glandular neoplasm composed of ductal epithelial cells, myoepithelial cells, and mesenchymal stromal elements. The myoepithelial cells display a plasmacytoid morphology with pink cytoplasm. The stroma consists of fibrohyaline to loose myxoid fibrous connective tissue with areas of cartilaginous matrix. No marked cytologic pleomorphism, mitotic activity, necrosis, or infiltrative growth are identified.