Concluded Case

ACINIC CELL CARCINOMA (ACC) OF PALATE, A RARE PRESENTATION.

Good Afternoon Everyone...!! Sharing another RARE Case with you all today..!! Patient reported with chief complaint of mildly painful non healing small swelling in right upper back region of palate since 1 to 2 months. H/O presenting illness revealed gradual increase in size of swelling along with H/O sensitivity to hot & cold in 16 17 teeth. O/E the swelling is solitary, lobulated, erythematous with intact overlying mucosa measuring 2×3 cm in size, present in upper right posterior teeth region distal to 17. On palpation it is soft, slightly tender, non-fluctuant. Also 16 17 are tender on both vertical & horizontal percussion. Electrical pulp testing showed delayed response w.r.t 16 17. On above basis P/D of PERIAPICAL ABSCESS w.r.t 16 17 was made. D/D-1). Benign salivary gland tumor, 2).fibroma , 3).vascular lesion and 4).ACC were considered. IOPA-15 16 17: showed proximal deep caries w.r.t 16 & 1 along with horizontal bone loss w.r.t 15 16 17 respectively. MAXILLARY Occlusal View (Cross-sectional) showed no bony expansion. FNAC was suggestive of ACC palate and also the biopsy confirmed ACC ( papillary cystic type). "ACC is a malignant epithelial tumour of salivary glands & forms only 0.5% of all tumors of minor salivary gland. It's usual course follows an asymptomatic painless mass which grows slowly, very rarely entirely cystic in nature". THANK YOU.

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@Dr. Saloni Arora Gud case and truly said we should not conclude our case so fast as investigations r damn imp.. I do agree Histopath/ Cytology @Dr. Ashish Tiwari is equally important as our Radiographic... Though above mentioned Dds come under palatal Swelling.. Most commonly present involving minor salivary gland is Pleomorphic Adenoma and Schwannoma as well... ACC has one characteristic H/ P feature as 'SWISS CHEESE PATTERN' found which make it differ Frm others.
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Case presentation is Gud Thnks 4 sharing
Thank you @Dr. Sabista Naaz mam.
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@Dr. Saloni Arora Gud case and truly said we should not conclude our case so fast as investigations r damn imp.. I do agree Histopath/ Cytology @Dr. Ashish Tiwari is equally important as our Radiographic... Though above mentioned Dds come under palatal Swelling.. Most commonly present involving minor salivary gland is Pleomorphic Adenoma and Schwannoma as well... ACC has one characteristic H/ P feature as 'SWISS CHEESE PATTERN' found which make it differ Frm others.
Absolutely @Dr. Haritma Nigam mam,, very well explained,, thanks for putting your valuable opinion on this case. Much appreciated. Many Regards.
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Nice case presentation @Dr. Saloni Arora . This case emphasis on never go by the innocuous looking lesion. ACC is characterized by an indolent clinical course with the potential for both local recurrence and distant metastases thereby early diagnosis is pivotal in successful management.
Agree with you @Dr. Kausar Yadwad ,, even a simple looking lesion sometimes turn out to be of complex variety. Thanks for putting your valuable opinion mam.
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Looks like just another oral manifestation but turned out to be ACC. That's why we should never shy away from cytology examination. Great case @Dr. Saloni Arora . Thank you for sharing.
Thanks for putting your opinion @Dr. Ashish Tiwari , you are right just seeing it clinically we should never jump to the diagnosis and this might lead to wrong Rx planning too sometimes, proper Investigations need to be done before coming up with diagnosis.
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A very important feature of ACC is that it's capable of perineural invasion. NEET MCQ
Point to be noted,,thanks for sharing sir...☺️☺️
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Dr. @Saloni Arora Nice case and ur presentation mam..
Thank you doctor
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Awesome... excellent presentation, rarity is your speciality.
Hehe...thank you sir.... actually sir rarity chose me always...
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Gud presentation Dr.
Thank you doctor
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