Adenoid cystic tumor of palate

Case contributed by Melbourne Uni Radiology Masters

Presentation

Loose teeth. Painful bite.

Patient Data

Age: 50 years

OPG

x_ray

There is no bone abnormality seen within the mandible. There is an area of extensive bone destruction involving the maxilla on its left lateral side. These appearances are suspicious for bone destruction secondary to a probable squamous cell carcinoma.

CT Neck

ct

Soft tissue mass destroying the maxillary alveolus and hard palate.

There is involement of the left maxillary antrum and extentsion posteriorly into the pterygopalatine fossa. No enlarged cervical nodes are seen

MRI supra-hyoid neck protocol

mri

27 x 34 x 38 mm mass destroying the left hard palate, maxillary tuberosity and posterior aspect of maxillary alveolus bulges into the inferior nasal cavity and maxillary sinus. Abnormal enhancing soft tissue extends superiorly from the mass along the greater palatine canal into the pterygopalatine fossa. There is equivocal thickening of the left vidian nerve. No convincing asymmetric enhancement along V2 or V3. The left maxillary sinus is lined by T2 hyperintense mucosa. Inferiorly this mucosa is elevated by the intrasinus component of the mass. There is also an apparently separate 8 x 5 mm nodule of relatively T2 hypointense tissue at the superolateral wall of the sinus, lateral to the infraorbital canal. No evidence of infiltration of fat in the extraconal space of the orbit. 9 x 3.5 mm left lateral retropharyngeal node is at the upper limits of normal size. No cervical lymphadenopathy by size criteria.

Case Discussion

Adenoid cystic tumor of the palate on histology.

Malignant  tumors of the palate are usually squamous cell carcinoma; other malignant lesions include metastasis, lymphoma and primary sarcoma

Minor salivary gland tumors both benign and malignant also are encountered in the hard palate.

 

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