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Clinical Challenge
Pathology
January 2, 2020

Diffuse Palatal Swelling in a Woman in Her 60s

Author Affiliations
  • 1Division of Oral and Maxillofacial Pathology, Department of Oral and Maxillofacial Surgery, Columbia University Irving Medical Center, New York, New York
  • 2Department of Oral and Maxillofacial Surgery, Columbia University Irving Medical Center, New York, New York
JAMA Otolaryngol Head Neck Surg. Published online January 2, 2020. doi:10.1001/jamaoto.2019.3993

A healthy woman in her 60s was referred by her dentist to an oral surgeon for evaluation of a palatal swelling of unknown duration. The patient first presented to her dentist with a complaint of “it feels like there is something on the roof of [her] mouth.” She was never aware of the palatal lesion before her initial presentation. She denied any pain or discomfort from the site, and stated that the increasing size of the mass was what first alerted her to its presence.

The extraoral examination results were within normal limits, with no evidence of swelling, expansion, trismus, or lymphadenopathy. Intraoral examination revealed a focally ulcerated, fluctuant 2.5 × 2 × 1-cm pink-red submucosal swelling in the right palatal mucosa (Figure, A). The lesion involved almost the entire right side of the hard palatal mucosa and soft palate and terminated at the palatal midline. Imaging studies were unremarkable.

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