Palatal polymorphous low grade adenocarcinoma: case report and review of diagnostic challenges

Polymorphous low-grade adenocarcinoma (PLGA) is an indolent malignancy developed almost exclusively in minor salivary glands. PLGA frequently manifests as an asymptomatic, slowgrowing mass within the oral cavity and its clinical behaviour resembles that of benign neoplasms often causing diagnostic delay. We report a 76-year-old lady who presented with a long standing mass in the palate which finally was diagnosed as PLGA. We review the epidemiology and characteristics of PLGA, highlight diagnostic challenges caused by the overlap of clinical and microscopic features between PLGA and other salivary gland neoplasms and discuss current management strategies. The potential implications of misdiagnosis and complications of late intervention are discussed and relevance of vigilance and long-term follow-up by oral health care providers are emphasized.