International Poster Journal of Dentistry and Oral Medicine



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Int Poster J Dent Oral Med 13 (2011), No. 2     15. June 2011

Int Poster J Dent Oral Med 2011, Vol 13 No 2, Poster 531

Entity with Diversity

Carcinoma ex pleomorphic adenoma of minor salivary gland involving upper lip

Language: English

Dr Bhakti Patil, Dr. Archana Patil, Dr. Ashok L, Prof. Dr. Sujatha G P, Prof. Dr. Shivaprasad,
Department of Oral Medicine and Radiology, Bapuji Dental College and Hospital, Davangere, India

9-7-2010 , 10-7-2010
Bangalore, Karnataka , India

Case history

Chief complaint:
Patient complains of swelling in upper lip since 3 months
History of presenting illness: Patient noticed swelling 3 months back which was of peanut size and gradually progressed to present dimensions. Swelling was localized to upper lip and was associated with pain. Pain insidious in onset, localized, intermittent, non progressive and mild in intensity. Aggravates on touching . No relieving factors present. Not associated with any symptoms.

Personal History:
Chews betel nut quid thrice daily since 30 years.

Fig. 1

Extra oral examination

Solitary diffuse swelling on the left upper labial mucosa, measuring about 1.5x1cms, oval in shape. Extending from inferior vermillion border of lip to labial vestibule. Medially from labial frenum to 2 cms lateral to it. Swelling is firm in consistency. Mucosa over swelling is stretched, yellowish hue, well defined margins, tender, nonfluctuant , mobile and lobulated , no visible pulsations and sinus evident.

Fig. 2
Fig. 3

Provisional diagnosis

• Benign tumour of mesenchymal origin on upper lip
• Chronic generalized gingivitis
• Partially edentulous arch- Kennedys class III mandible

Differential diagnosis

Lipid proteinosis
Pleomorphic adenoma
Canalicular adenoma
Palisaded encapsulated neurofibroma


Complete hemogram
Excisional biopsy

Fig. 4
Fig. 5


Malignant glandular epithelial cells arranged as nests separated by connective tissue septa.
Other areas- neoplastic epithelium arranged as sheets
Dark basophilic nucleus with nuclear and cellular pleomorphism, mitotic figures
Areas of necrosis
Chondroid metaplasia
Focal areas of keratinisation
Spindle shaped cells , stellate cells and plasmacytoid cells seen
Hyaline like material in profusion.

Fig. 6
Fig. 7


Surgical excision of tumour
Restoration in relation to 18
Oral prophylaxis

Final diagnosis

Carcinoma Ex pleomorphic adenoma [invasive] of minor salivary gland involving upper lip.
Chronic generalized gingivitis.
Partially edentulous arch- mandible Kennedys class III.

This Poster was submitted by Dr Bhakti Patil.

Correspondence address:
Dr Bhakti Patil
Bapuji Dental College and Hospital
Department of Oral Medicine and Radiology
Davangere, Karnataka 577004