Masked in the Maxilla: An Unusual Presentation of Adenoid Cystic Carcinoma

Swellings affecting the oral mucosa are common and can have many potential aetiologies, ranging from normal anatomy, such as the parotid papillae, to developmental swellings, such as maxillary and mandibular tori, inflammatory lesions, such as a pyogenic granuloma, to traumatic lesions, such as an epulis. In some cases, the swelling may be the initial presentation of an underlying systemic condition, such as lip swelling in Crohn’s disease or a manifestation of a systemic condition, such as tongue swelling in Amyloidosis.

Occasionally, the swelling is associated with more significant pathology, such as connective tissue disease or malignancy. In these situations, there are often additional concerning symptoms such as pain, asymmetry or altered sensation. We present a case of an intra-oral swelling with long-standing paraesthesia that was referred to the Oral Medicine Clinic for further investigation, resulting in a devastating diagnosis of adenoid cystic carcinoma of the right maxillary sinus. We present an overview of the case presentation, special investigations undertaken to confirm the diagnosis and management. Additionally, a review of the literature on the presentation and management of adenoid cystic carcinomas will also be presented.