Photo Rounds

Mass on hard palate

During a routine physical exam, a family physician (FP) noted a mass at the midline of his elderly patient’s hard palate. The patient indicated that the mass had been there her whole adult life and didn’t bother her. She did, however, want to know what it was.

What's your diagnosis?


 

The FP explained that the mass was a torus palatinus and that nothing needed to be done about it.

Torus palatinus is a benign bony exostosis occurring in the midline of the hard palate. It is the most common bony maxillofacial exostosis, and it is usually diagnosed in adults older than 30 years of age. It is more common in women than men.

The differential diagnosis for a mass in this location includes an adenoid cystic carcinoma, a rare tumor that can start in a minor salivary gland over the hard palate. Note, however, that this tumor will not occur at the midline. If a suspected torus is not midline, a biopsy will be needed to rule out this potentially fatal carcinoma. Excision of a torus is only indicated if the lesion interferes with function, such as the fit of dentures or phonation.

Photos and text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. This case was adapted from: French L, Smith M. Torus palatinus. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. Color Atlas of Family Medicine. 2nd ed. New York, NY: McGraw-Hill; 2013:206-207.

To learn more about the Color Atlas of Family Medicine, see: http://www.amazon.com/Color-Family-Medicine-Richard-Usatine/dp/0071769641/ref=dp_ob_title_bk

You can now get the second edition of the Color Atlas of Family Medicine as an app for mobile devices by clicking on this link: http://usatinemedia.com/

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