Treatment

Under IV general anesthesia a palatal flap was reflected where a large cystic lesion was identified. The lesion had perforated the palatal bone, the nasal floor and the labial cortical plate between teeth #ís 8 and 9. The area was curetted and irrigated. The patient healed with no complications.

Incisional Biopsy

Histologic examination reveals multiple pieces of soft tissue composed of a cystic structure lined by respiratory-type epithelium in most parts and focally by stratified squamous epithelium (Figure 2). The respiratory epithelium was focally ciliated with a few mucous-producing cells (Figure 3). The connective tissue wall comprised the bulk of the specimen and was cellular in some areas and fibrotic in others. It contained neurovascular bundles (Figure 4). Inflammatory cells were occasional to absent.

Figure 2 Low power (x100) H & E histology demonstrates multiple pieces of soft tissue composed of a cystic structure lined by epithelium and supported by fibrous connective tissue wall. The lining epithelium is mostly respiratory in type.

Figure 3 Higher power (x200) H & E histology demonstrates closer look at the lining epithelium which is ciliated psuedostratified squamous in type with occasional mucous producing cells.

Figure 4 Higher power (x200) H & E histology demonstrates closer look at the connective tissue wall with a peripheral nerve bundle and a cross section through a small artery.