Mucinous cystadenoma: A rare entity
A 60-years-old female reported with an asymptomatic swelling in the right posterior palatal area in the region of missing 15,16 and 17 []. The swelling was present since several months and gradually increased to the presenting size. On examination, a well-defined, round mass, approximately 2 cm in diameter was revealed, which was soft to firm in consistency, non-movable, slightly compressible and painless. No carious tooth was found to be associated and there was no sign of tooth displacement. The mucosa over the swelling appeared normal.\nA provisional clinical diagnosis of benign minor salivary tumor was given For differential diagnosis, pleomorphic adenoma, a low- grade minor salivary gland malignancy acinar cell adenocarcinoma (AcAC), adenoidcystic carcinoma, mucoepidermoid carcinoma), residual cyst, retention phenomenon, lipoma, neurofibroma and palatal odontogenic keratocyst were considered.\nPatient was investigated with a panoramic and a maxillary occlusal radiograph, which showed no bony alteration in the area of the swelling. An intra-oral periapical radiograph was performed to rule out possible odontogenic origin. Fine needle aspiration cytology of the swelling yield a hemorrhagic aspirate of insignificant volume. H and E stained smear of the aspirate showed presence of mostly red blood cells and some chronic inflammatory cells. Routine hematological investigations were advised before the patient was referred to oral surgery for excision of the palatal mass.\nThe lesion was excised completely along with the nerves and vessels under local anesthesia by raising a mucosal flap [] and a single soft-tissue bit of about 2 cm × 1.6 cm [] was sent for histopathological examination. Primary closure of the overlying mucosa was performed [] and the wound healed by primary intention without any intra-or post-operative complications []. Periodontally compromised adjacent maxillary molar was later extracted.\nThe histopathological examination revealed numerous large and small cystic spaces interspersed in a fibrous connective tissue stroma []. The cystic lumens were lined by 1-3 cell layer thick epitheliums, which varied from flattened to cuboidal to tall columnar cells []. The stroma exhibited multiple hemorrhagic areas and focal aggregates of chronic inflammatory cells along with few mucous cells. Normal appearing mucous acini could also be appreciated in the deeper sections []. Cellular atypia and mitosis were absent. A diagnosis of mucinous cyst adenoma was made. Patient is under follow-up for identification of any recurrence.