Adenoid cystic carcinoma presenting as a midpalatal nodular mass with slow growth and long evolution: a case report with review of differential diagnosis.

Adenoid cystic carcinoma is an aggressive but slow-growing salivary gland tumor most commonly appearing in the palate. Though it is well recognized that this tumor has a slow-growing course, a clinical presentation of 10 years is uncommon. This article presents a case of a midpalatal nodular mass with a reported history of 10 years. The patient did not seek evaluation due to its small and asymptomatic clinical presentation, but an incisional biopsy later revealed the palatal nodular mass to be adenoid cystic carcinoma. The patient underwent surgical resection of the mass followed by adjuvant radiation therapy. This case report highlights the importance of prompt biopsy of a pathologic lesion despite an indolent history and benign clinical presentation. The various clinical differential diagnoses for a palatal nodular mass are also discussed.