PMC4278096_01
45-year-old male patient with lesion on the right side of the palate diagnosed as mucoepidermoid carcinoma - intermediate stage. Intra-oral photograph shows the ulcerated lesion on the right upper palate (arrow).
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F1
On palpation, the growth was non-tender, firm in consistency, and fixed to the underlying bone [Figure 1].
45-year-old male patient with lesion on the right side of the palate diagnosed as mucoepidermoid carcinoma - intermediate stage. Orthopantomograph shows radiolucency superimposing the right maxillary sinus (arrow).
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F2
Panoramic radiograph showed a well-defined radiolucent shadow exactly over the right maxillary sinus [Figure 2].
45-year-old male patient with lesion over on the right side of the palate diagnosed as mucoepidermoid carcinoma - intermediate stage. Coronal CT image shows the lesion as a faint soft tissue mass (arrow) on the palate.
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F3
The findings showed a faintly enhancing lesion, 26 x 11 mm in size, in the soft tissue of the hard palate to the right of the midline, associated with slight thinning of the underlying hard palate and a few small calcific densities within the mass [Figure 3].
45-year-old male patient with lesion on the right side of the palate diagnosed as mucoepidermoid carcinoma - intermediate stage. PET image shows a prominent nodular enhancing lesion over the palate (outline arrow) and mildly enhancing lymph nodes (solid arrows). The SUVmax over the palate was 16.5 and on the right level II node was 4.8.
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F4
The PET impression was that of a focal erosion of the hard palate, associated with 1.9 x 1.2 x 1.6 cm nodular enhancing soft tissue, possibly of neoplastic etiology, and few mildly prominent right upper jugular and left posterior cervical lymph nodes raising suspicion of metastatic or reactive nature of the lesion [Figure 4].
45-year-old male patient with lesion on the right side of the palate diagnosed as mucoepidermoid carcinoma - intermediate stage. Incisional biopsy specimen suggested mucoepidermoid carcinoma - intermediate stage.
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F5
Considering the history, clinical and imaging findings, incisional biopsy of the lesion and fine needle aspiration cytology of the lymph nodes were performed [Figure 5].
45-year-old male patient with lesion on the right side of the palate diagnosed as mucoepidermoid carcinoma - intermediate stage. Photomicrograph of the hematoxylin and eosin stained biopsy tissue (10x) shows presence of mucus (black arrow) and epidermoid cells (white arrow) with connective tissue septum (red arrow) suggestive of mucoepidermoid carcinoma - intermediate stage.
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F6
Concentric lamellated calcifications were evident suggestive of mucoepidermoid carcinoma (MEC) - intermediate grade [Figure 6].
45-year-old male patient with lesion on the right side of the palate diagnosed as mucoepidermoid carcinoma - intermediate stage. Post treatment intra-oral photograph shows complete healing of the tumor site (arrow).
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F7
The patient reported for the first 6-month follow-up and was found to be tumor free [Figure 7].