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History of Present Illness
The patient had noticed a swelling in his palate for approximately two weeks. He had not experienced any previous swellings in his palate and did not recall any trauma prior to the onset of the swelling. He had not received any recent dental treatment. The swelling was completely asymptomatic and the patient had no other complaints.
Past Medical History
The patient reported a history of epilepsy, but he apparently was not receiving any anti-seizure medication at the time of examination. The remainder of his medical history was unremarkable and review of systems did not reveal any other abnormalities.
Clinical and Radiographic Findings
Clinical examination revealed a 2.5 x 3.0 cm raised firm nonindurated mass on the left hard palate. The epicenter of the mass was adjacent to the maxillary left first molar and the lesion extended to the midline (Figure 1). The lesion was compressible to palpation and demonstrated a slight bluish hue. The remainder of the oral cavity was within normal limits. The patient’s dentition was in good repair and several cast gold restorations were present. Radiographs of the left maxilla were negative for any pathology and all teeth in the area tested vital.
Incisional Biopsy and Photomicrographs
An incisional biopsy was performed by obtaining a full-thickness wedge of mucosa taken from within the confines of the mass down to the periosteum. Microscopic examination revealed a wedge of mucosa surfaced by keratinized stratified squamous epithelium overlying minor salivary gland tissue. An area of necrosis was also identified (Figure 2).
