PMC4070476_01
Nodular lesion on right side of soft palate lined by normal mucosa (a). Axial (b) and coronal (c) computed tomography scans showing a hyperdense expansive lesion with well-defined limits measuring 3.7 x 3.3 cm, determining compression and displacement to the left part of the nasopharynx and oropharynx, and causing narrowing of the airways.
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The lesion had smooth surface, hard consistency, and irregular shape (Figure 1(a)). Cervical tomography was requested (Figures 1(b) and 1(c)).
Histopathological aspects of previous biopsies with conventional technique showing epithelial tissue, connective tissue, and minor adjacent salivary glands, with no sign of tumor (H&E x40) (a, b).
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However, the histopathological examination of the fragment revealed normal mucosa (Figure 2(a)). Once again, the histopathological analysis revealed normal mucosa (Figure 2(b)).
CNB procedure under local anesthesia.
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The localization of the lesion was identified during the intraoral exam with no need of imaging guidance (Figure 3).
Histopathological aspects of entire fragment obtained after CNB (H&E x40) (a) Strands and sheets of epithelial cells with ductal structures. Deposition of homogeneous, eosinophilic, hyaline material between tumor cells and dispersed in extracellular matrix (H&E x100) (b) Histopathological aspects of surgical specimen confirming diagnosis of pleomorphic adenoma (H&E x100) (c). Intraoral aspect at 12-month follow-up, with no signs of recurrence (d).
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The histopathological analysis of the sample revealed pleomorphic adenoma (Figures 4(a) and 4(b)). The specimen was sent to the pathology service and the histopathological analysis confirmed the diagnosis established with CNB (Figure 4(c)). No complications occurred in the postoperative period and no signs of recurrence were found at the 12-month follow-up (Figure 4(d)).