A 10-year-old boy presented to the hospital with a swelling on his hard palate. According to his parents, the swelling appeared ten days before admission. In addition, there was mild bleeding and he also complained of pain while chewing. There was no history of trauma and his family history was insignificant too.
The doctors performed a physical examination. His vital signs (heart rate, breathing rate and blood pressure) were normal. Moreover, he was conscious and cooperative, ruling out any neurological deficits. Oral examination revealed a well-circumscribed mass on his hard palate. The mass was soft, tender and pseudomembranous.
Rareness of the Tumor and Young Age Lead to a Difficult Diagnosis
Myoepithelioma is a rare benign tumour of the salivary gland, prevalent only in adults between thirty to fifty years of age. Hence, the diagnosis was very difficult to make. After multiple differentials on the table including hemangioma, pyogenic granuloma and angina bullosa hemmorrhagica, they were able to diagnose the child with myoepithelioma. Moreover, the differential diagnosis also included a palatal minor salivary gland tumour after the MRI showed an encapsulated mass.
Doctors opted for the complete removal of the mass and histopathological assay. The histopathology results showed ulceration, inflammation and the presence of spindle-shaped cells. Moreover, there was an absence of local invasion and necrosis, which confirmed the diagnosis of benign palatal myoepithelioma.
What is Myoepithelioma?
Myoepithelioma accounts for 1-1.5% of the tumours of the salivary gland. Furthermore, it usually affects the parotid gland. Myoepithelioma of minor salivary glands especially in the palate is highly rare. Only a few cases have been described to date and one of them is of the 10-year-old boy.
Source: Kumar, M., Acharya, S., Pai, K. et al. Unusual neoplasm on the hard palate of a child: a case report. J Med Case Reports 11, 149 (2017). https://doi.org/10.1186/s13256-017-1321-4