Rachel Musselwhite

Tara King
Hollie Schroeder
Case Study Report #8
Our case study included a 65-year-old male with a large palatal
swelling. He stated that he has had notice this large palatal swelling on
the right side of his hard palate 12-18 months earlier. He stated that it
has a mild pain that has lasted for several months. He has had no
previous trauma, sinus infections, or tooth related pain in the area. He
has a history of smoking two packs per day and moderate to heavy
alcohol consumption. Also has a history of non-insulin dependent
diabetes and glaucoma. His medications included 200 milligrams of
chlorpropamide, orally and one drop of timodol maleate, opthalmically.
His dental history included sporadic dental exams, routine extractions
and restorative treatment. He vitals were within normal limits. When
examining the large palatal swelling, palpation of the area reveled a
firm, non-movable, solid tumor mass that had pain upon compression.
The correct diagnosis based on the clinical evidence presented in
this case study is Adenoid Cystic Carcinoma. This is because an
adenoid cystic carcinoma is a malignant tumor of salivary glands that
can originate from either major or minor salivary glands. It is a slow
growing enlarged tumor that is more common in the palate of the oral
cavity, and pain is often present. It is an adult tumor and treatment is a

complete surgical excision. We made this diagnosis because of the

patient pain that is associated with the lesion and the location of the
lesion. We associated this with the two packs of cigerrates he smokes a
day along with the moderate to heavy alcohol consumption that he
consumes. This could have been caught earlier on since its slow
growing has been present for 12-18 months but his dental history
reveled that he has sporadic dental exams.
The other clinical diagnosis included Maxillary torus. We voted
this out because this is an exophytic growth of normal compact bone
that develops gradually. It is also in the midline of the hard palate and
varies in size and shape. It is normal painless unless involved in trauma
which our patient stated that he has had no previous trauma to the
area. Median palatal cyst is a well-defined unilocular radiolucency that
is also located in the midline of the hard plate. We did not choose this
diagnosis because this is seen in the evaluation of a radiograph were
as we diagnosed the patient from a clinical examination. Pleomorphic
adenoma is a benign salivary gland tumor that has a common intraoral
site of the palate. It is also a slow growing enlarged, nonulcaated,
painless, dome shaped mass. We did not choose this diagnosis
because of it being without pain and our patient has had pain present
for several months. This surface can be ulcerated if traumatized but
when questioning the patient he stated that he has had no previous
trauma in the area. The last diagnosis is Sinus tract, which is a narrow

opening or passageway underneath the skin that can extend in any

direction though soft tissue and results in dead space with potential for
abscess formation. Most common cause is infection of the underlying
tissues and treatment is treating the cause. We did not choose this
because there is no sign of a passage way or opening during the
examination and this does not include a large mass that is painful.
Also no related sign of infection is present as well.