Carcinoma of hard palate

Lesions affecting the hard palate - possible cancer of the hard palate

Most lesions are benign. The most common are minor salivary gland tumours which may be treated by excision.

Adenoid cystic carcinomas may need to be widely excised as these lesions can spread into the cranium along the perineural spaces of the greater palatine nerves.

Squamous carcinoma is uncommon and may represent an extension of a maxillary carcinoma. Palectomy and subsequent radiotherapy is often indicated. Any defect in the palate may be filled with a dental obturator.

Consider oral exotosis (oral tori) in the differential diagnosis of possible cancer of the hard palate.

Tori are benign bony outgrowths from the mandible and hard palate:

• oral tori (oral exostosis) are relatively common (1)
  • with a prevalence of about 20-30% in the general USA population (2)

For an image of Torus palatinus then click here

• Torus palatinus
  • generally occurs along the midline (1)
• Torus mandibularis
  • appears on the lingual surface and is often bilateral (1)
• Tori are more common in females and in specific ethnic and racial groups, especially Asians (1)
• underlying pathogenesis is thought to be largely genetically driven
  • however local stressors and micro trauma may be contributory
• have a benign natural history and are slow growing and noninvasive
• removal is required only if they are symptomatically burdensome or interfere with denture placement in edentate individuals

Reference:

• Vaduganatham M et al. Torus palatinus.Proc (Bayl Univ Med Cent). 2014 Jul; 27(3): 259.
• Hanafi A, Alweis R. Images in medicine: torus palatinus.J Community Hosp Intern Med Perspect. 2019; 9(4): 367-368.