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J Surg Case Rep. 2015 Sep 14;2015(9). pii: rjv113. doi: 10.1093/jscr/rjv113.

A challenging case of squamous metaplasia in a pleomorphic adenoma: diagnostic and clinical pitfalls.

Author information

1
Otolaryngology and Head and Neck Surgery Division, Department of Surgery, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada simon.brisebois@usherbrooke.ca.
2
Department of Pathology, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada.
3
Otolaryngology and Head and Neck Surgery Division, Department of Surgery, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada.

Abstract

Squamous metaplasia in a pleomorphic adenoma (PA) has been reported, but rarely has it been documented as being extensive enough to cause significant misdiagnosis. We present a case of a 37-year-old man presenting with a 1.7-cm minor salivary gland PA of the palate. It exhibited extensive squamous metaplasia mimicking a squamous cell carcinoma (SCC) on multiple preoperative biopsies. The final diagnosis was only made after a complete oncological excision with margins and free flap reconstruction. Florid squamous metaplasia in a PA, although rare, should be recognized and distinguished from SCC. Failure to differentiate these entities can lead to patient overtreatment.

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