Treatment

Under local anesthesia, an incision through the mucosa was performed (Figure 2) where an encapsulated tan-white nodule was released and excised (Figure 3).

Excisional Biopsy

Histologic examination reveals a multisected piece of soft tissue embedded in two separate blocks labeled A1 and A2. The specimens in both blocks are made up of a benign neoplasm surrounded by a capsule (Figures 4-5). This neoplasm is made up of duct-like structures as well as sheets and clusters of myoepithelial cells suspended on collagen fibers (Figures 4-6). The connective tissue background is loose and myxoid in some areas and fibrotic in others. Some of the duct-like structures are highly dilated while others are of variable shapes and sizes and contain mucoid coagulant.

Figure 2 This photograph is taken at surgery, note the encapsulated tan-white nodule emerging from the blunt mucosal incision.

Figure 3 This photograph is taken at surgery demonstrating the gross morphology of the encapsulated nodule.

Figure 4 Low power (x40) the H & E histology reveals an encapsulated neoplasm made up of duct-like structures and sheets of myoepithelial cells suspended on mixed collagenous and focally myxoid matrix.

Figure 5 Low power (x100) the H & E histology with a closer look at the encapsulated neoplasm with duct-like structures and myoepithelial cells.

Figure 6 High power (x200) the H & E histology with a closer look at the duct-like structures with eosinophilic coagulum and sheets of myoepithelial cells.