Giant Myoepithelioma of the Soft Palate: Report of a case in a Teenage girl
Keywords:Myoepithelioma, Plasmacytoid, Salivary gland
Background: Giant myoepithelioma is a tumour arising from epithelial cells of mostly the major salivary glands. It is rare in the minor salivary glands .It constitutes less than 1% of salivary gland lesions. It is usually asymptomatic but with increase in size it can elicit pressure and obstructive symptoms as reported in our case.
Case Presentation: This 13-year-old girl presented with swelling on the soft palate for five years. Symptoms included dysphagia, hyper nasal speech, snoring and occasional sleep apnea for two years prior to presentation. Intraoral examination revealed an oval shaped swelling located at the posterior end of the hard palate extending downward and backward pressing on the dorsum of the tongue. CT showed a solid, well-circumscribed oval mass pedunculated at junction of the hard and soft palate. It extended downwards and backwards to the posterior wall of oropharynx. An excisional biopsy was carried out under general anesthesia through the transoral approach. The histology showed myoepithelioma with diffuse infiltrate of plasmacytoid cells. No mitotic figures were seen. The operative site healed without complications. No recurrence three years post op.
Discussion: Myoepithelioma should be distinguished from pleomorphic adenoma because it has been reportedto be more aggressive and occasionally transforms into malignant myoepithelioma, though our case was benign.
Conclusion: Myoepitheliomas are rare salivary gland lesions in comparison to pleomorphic adenomas. When large, they can elicit uncomfortable and sometimes dangerous symptoms. They should be considered more in the differential diagnosis of oral lesions in view of their more aggressive nature.
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