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Case Reports in Surgery
Volume 2015, Article ID 638025, 8 pages
http://dx.doi.org/10.1155/2015/638025
Case Report

Massive Neurilemoma of the Hard Plate in Which Preoperative Diagnosis Was Difficult

1Division of Oral and Maxillofacial Surgery, Ebina General Hospital, 1320 Kawaraguchi, Ebina City, Kanagawa 243-0433, Japan
2Oral and Maxillofacial Surgery, Department of Oral Restitution, Division of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University, Japan
3Division of Diagnostic Pathology, Ebina General Hospital, Japan
4Division of Oral and Maxillofacial Surgery, General Tokyo Hospital, Japan

Received 18 March 2015; Accepted 12 July 2015

Academic Editor: Frédéric Marchal

Copyright © 2015 Masanori Kudoh et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The patient was an 84-year-old man who was referred to our hospital in mid-December 2012 for a close examination of a mass arising from the left side of the hard palate that was found by a local dentist. The initial examination revealed the presence of a 3.0-cm elastic soft, dome-shaped mass in the left hard palate. CE-CT showed a lesion of size 1.8 × 1.4 cm in the right hard palate, which extended upward and invaded the nasal cavity. The mass was a solid tumor associated with resorption of surrounding bone and expansion of the greater palatine canal. CE-MRI indicated that the mass extended upward and invaded the nasal cavity, and the mass showed hypointensity on T1-weighted images, hyperintensity on T2-weighted images, and an irregular margin with internal enhancement. Abnormal uptake of FDG on PET-CT (SUVmax = 5.2) was observed in the left hard palate. The biopsy site lesion rapidly increased in size and biopsy was performed again in January 2013 due to suspicion of a malignant tumor. The histopathological diagnosis was a suspected malignant neurogenic tumor. Therefore, the patient underwent partial maxillectomy and a split-thickness skin graft in late February 2013. No recurrence was noted 29 months after the operation.