Giant Myoepithelioma of the Soft Palate

Myoepitheliomas are benign salivary gland tumors and account for less than 1% of all salivary gland tumors. They are usually located in the parotid gland. The soft palate is very rare affected site. The differential diagnosis of myoepitheliomas should include reactive and neoplastic lesions. The treatment of myoepitheliomas is complete removal of the tumor. Herein, we report a case with giant myoepithelioma of the soft palate, reviewing the related literature. 1. Introduction Myoepitheliomas are rare benign salivary gland tumors composed entirely or predominantly of myoepithelial cells. They account for less than 1% of all salivary gland tumors and are mainly located in the parotid gland and less often in the minor salivary gland of the oral cavity. Although extraparotid myoepitheliomas are extremely rare, they have occurred in the palate, submandibular gland, nasopharynx, nasal cavity, oral cavity, and cheek [1–7]. Myoepitheliomas frequently affect patients between the fourth and fifth decades of life without gender predominance [3, 4]. In this report, we present a case of large myoepithelioma arising in the soft palate. 2. Case Report A 55-year-old male presented with a history of a painless swelling in his palate that gradually grew over the last five years. He complained snoring, obstructive sleep apnea, dysphagia, and hypernasal speech. There was a history of local trauma on his palate 11 years ago. Physical examination revealed, obstructing the nasopharyngeal port, a firm, immobile, well-circumscribed large submucosal mass in the soft palate (Figure 1). No lymph node was palpable in the neck. Computed tomography scan (CT) showed a well-defined, enhancing solid mass, measuring 50 × 35？mm, originating from the right posterior portion of the soft palate, but the lesion did not infiltrate adjacent fat plans and did not appear to involve the bone (Figure 2). Cytologic analysis of the aspirated material via a fine needle was composed of round to oval myoepithelial cells with eccentric nuclei and large eosinophilic cytoplasm. Figure 1: Preoperative view of large submucosal mass in the soft palate that nearly obstructs the nasopharyngeal port. Figure 2: (a) Axial and (b) sagittal contrast-enhanced CT scan demonstrated a well-circumscribed, enhancing solid mass (5 × 3.5？cm) originating from the right posterior portion of the soft palate and enlarging toward the oronasopharyngeal airway space, but the lesion did not infiltrate adjacent fat plans and did not appear to involve the bone. The patient was operated via transoral approach under general anesthesia.