LAUSR

Background Salivary gland cystadenomas are rare, benign, epithelial tumors. They are typically characterized by multicystic growth and often contain intraluminal papillary projections. Most cases present in the parotid gland or minor salivary glands of the lips or buccal mucosa. Case A 78-year-old female patient presented with a 3-month history of an asymptomatic palatal swelling. Clinical examination revealed a 6-mm raised, nodular, soft, sessile lesion on the left hard palate. Differential diagnoses included mucocele or salivary gland tumor. An excisional biopsy was performed, which demonstrated a benign cystic structure with a complex multilocular architecture and morphology of the epithelial lining. Intermittently, a double-layered arrangement of the epithelium was seen with occasional papillary projections, apocrine and mucous cells. A patchy chronic inflammatory infiltrate was also noted. The histopathology was most in keeping with a cystadenoma with lesional cystic spaces extending focally to the deep margin of the specimen. Following discussion at a clinicopathologic conference, the clinical consensus was for surveillance rather than re-excision owing to low recurrence rate of these tumors. Conclusions Cystadenomas in palatal minor salivary glands are rare. They do not possess any distinct clinical features and can mimic simple mucous retention cysts, such as in our case; therefore, histopathologic confirmation is paramount. Oncocytic change is commonly seen, therefore histologic differential diagnosis can include Warthin's tumor. Malignant salivary tumors (e.g., low-grade mucoepidermoid carcinoma, adenocarcinoma, NOS, intraductal carcinoma, and mucinous cystadenocarcinoma) should also be ruled out. Treatment with conservative local excision is usually curative.