Pediatric Pleomorphic Adenoma of the Palate: Diagnostic Challenges and the Role of Core Needle Biopsy.

Abstract

Pleomorphic adenoma (PA) is the most common benign salivary gland tumor and can also arise in minor salivary glands, particularly in the palate. Although generally benign, PA carries a risk of recurrence and malignant transformation, emphasizing the importance of accurate diagnosis. We report the case of a 16-year-old male with a 2-year history of an asymptomatic palatal mass. Initial open biopsy was performed, followed by magnetic resonance imaging, which revealed a subepithelial mass without invasion of surrounding structures. Complete surgical excision with local flap reconstruction was achieved, complicated by wound dehiscence that required revision. Final histopathology confirmed PA, and the patient remains disease-free after 2 years of follow-up. This case highlights the diagnostic and therapeutic challenges of minor salivary gland tumors in pediatric patients, particularly the limitations of open biopsy and fine-needle aspiration. Evidence from recent studies suggests that core needle biopsy provides higher diagnostic accuracy with fewer complications and may represent a safer, less invasive alternative. Further prospective studies are needed to validate core needle biopsy as the standard diagnostic tool for minor salivary gland tumors.