title: Gingival mucinous adenocarcinoma of a minor salivary gland.
abstract: BACKGROUND
  A 47-year-old male non-smoker with a history of psoriasis sought a consultation because of a painless, hard-on-palpation, 1-cm exophytic lesion with a smooth and speckled surface located on the hard palate adjacent to tooth #12. The radiologic examination revealed no bone destruction. The lesion was clinically diagnosed as a fibrous hyperplasia or chronic pyogenic granuloma.
  
  
  METHODS
  The lesion was surgically removed, fixed in 10% neutral buffered formalin for 24 hours, and, following common practice, embedded in paraffin. Sections, 4 mum thick, were stained with hematoxylin and eosin, periodic acid-Schiff, and alcian blue, pH 2.5. An immunohistochemical study was also performed.
  
  
  RESULTS
  A definitive diagnosis of a mucinous adenocarcinoma (MAC), a very rare, high-grade malignancy tumor that more frequently appears in the elderly, was made. With the definitive diagnosis of an MAC of the palate, the upper-left premolars were extracted using a box osteotomy, and the surgical wound was reconstructed with a Bichat fat-pad flap. After a 6-month follow-up, no recurrence or cervical metastases were identified.
  
  
  CONCLUSIONS
  An MAC of a minor salivary gland may arise as a gingival exophytic lesion with a clinical appearance similar to a pyogenic granuloma. The existence of a light speckled pattern on the surface of the lesion indicates that an incisional biopsy is needed before surgical treatment to make possible a definitive diagnosis. To avoid delays in diagnosis and erroneous clinical approaches to exophytic gingival lesions, periodontists and practitioners should routinely perform a pathologic analysis to confirm the diagnosis when dealing with these kinds of lesions.
authors.affiliation: Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain. juanmanuel.seoane@usc.es
authors.forename: Juan
authors.initials: J
authors.lastname: Seoane
authors.forename: Pablo
authors.initials: P
authors.lastname: Varela-Centelles
authors.forename: Javier
authors.initials: J
authors.lastname: López-Niño
authors.forename: Inés
authors.initials: I
authors.lastname: Vázquez
authors.forename: Ihab
authors.initials: I
authors.lastname: Abdulkader
authors.forename: Tomás
authors.initials: T
authors.lastname: García-Caballero
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000473:pathology*; D003937:Diagnosis, Differential; D005887:Gingival Neoplasms / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D021362:Palate, Hard / Q000473:pathology*; D012468:Salivary Gland Neoplasms / Q000473:pathology*; D012470:Salivary Glands, Minor / Q000473:pathology*