The advantage of MRI in detection of Coincidental adenocarcinoma of palate and pleomorphic adenoma of parotid - a case report

Abstract

Salivary gland tumors account for fewer than 3% of the head and neck tumors. Typically salivary gland neoplasm presented as a single swelling localized to one salivary gland. A more unusual event is the development of multiple neoplasms located either in different glands or in one gland. This manuscript present a case of palatal swelling diagnosed by incisional biopsy as polymorphous adenocarcinoma (PAC). Magnetic resonance imaging (MRI) examination revealed another parotid lesion which was diagnosed as pleomorphic adenoma (PA). Palatal mass was resected with safety margin; superficial parotidectomy was also done for parotid lesion sparing facial nerve. Post-operative radiotherapy was recommended by pathologist due to evident perineural invasion of PAC. The patient is tumor free after one year follow-up. The present case has more than one risk factor which favors expectation of multiple tumors and mandate examination of all salivary tissues. In case of multiple salivary tumors each tumor should be diagnosed and treated separately according to its nature and extension.

Keywords: Salivary gland; tumors; parotid; palate; MRI