Teaching Case

Tumefaction of the soft palate

25 year old patient without previous medical history presented with a tumefaction of the soft palate. Physical examination evidenced a submucosal mass. MR was requested. The patient was operated, and histologic diagnosis was obtained.

The soft palate belongs the oropharynx. Imaging of this region is difficult because it is approximately concave in all directions, and therefore there is no ideal imaging plane, either on CT or MR. Pseudo-thickening may be due to malpositionning of the patient in the axial and coronal plane or to a partial volume effect in the sagittal plane. Moreover, the soft palate enhancement with contrast (iodine and Gadolinium) is often similar to that observed in tumors. However well delineated tumor, such as in this case can be well displayed. The characteristics of this lesion are those of a non aggressive salivary gland lesion (high signal intensity on T2 weighted view, clear margination) and the diagnosis of pleomorphic adenoma could be anticipated. In fact, histology is mandatory since aggressive salivary gland tumor (such as adenoic cystic carcinoma) may present the same feature. This underlies the fact that histology is always mandatory.