Pedunculated Pleomorphic Adenoma With Adipocytic Metaplasia of the Hard Palate: A Case Report.

Background: Salivary gland tumors represent less than 4% of all head and neck tumors, with pleomorphic adenoma (PA) being the most common among them. The palate represents the most frequent site of occurrence. Although typically presenting as a firm and sessile mass, PA may occasionally exhibit unusual clinical or histological features that complicate diagnosis. Case presentation: We describe an unusual case of a 46-year-old woman presenting with a pedunculated PA of the hard palate, exhibiting superficial ulceration and mild pressure induced bone erosion detected radiographically. The lesion was completely excised under local anesthesia. Histopathological examination confirmed the diagnosis of PA with adipocytic metaplasia, an uncommon finding that may mimic malignant transformation. Healing occurred uneventfully and no recurrence was observed after a 12 month follow up. Conclusion: This case highlights the importance of recognizing atypical clinical and histological variants of pleomorphic adenoma and establishing an appropriate differential diagnosis. Accurate diagnosis and optimal management require careful correlation of clinical, radiological, and histopathological findings. Long term follow up remains essential to ensure early detection of potential recurrence or malignant transformation.