ADENOID CYSTIC CARCINOMA IN THE PALATE: NUMBNESS AS INITIAL OROFACIAL MANIFESTATION

Adenoid cystic carcinoma (ACC) is a malignant epithelial tumor of the salivary glands that commonly affects the minor salivary glands, and the palate is the most recurrent site. Treatment is challenging because this tumor tends to recur with distant metastases and poor prognosis. A 50-year-old woman complained of numbness in the upper left hemimaxilla, extended to the labial region, nose wing, and nasolabial sulcus, with clinical intra-oral alterations similar to an endodontic fistula tooth 25 palatal mucosa and discrete periapical rarefaction on radiologic evaluation. Endodontic treatment was provided with laser therapy administered for persistent numbness. After 3 months a palate volume increase and small ulcerated region were noted encompassing the region of teeth 24 to 27. The panoramic and tomographic examination was performed showing extensive bone destruction, and the patient underwent a biopsy followed by microscopic and immunohistochemistry evaluation and diagnosis as ACC. The patient was forwarded to a head and neck surgeon.