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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

• Mucocele – Sudden onset of the mucocele is often helpful in distinguishing this lesion from salivary gland malignancy.
• Palatal dental abscess (see abscess, cellulitis) – This lesion is usually quite painful, has a sudden onset, and is associated with an adjacent non-vital carious tooth.
• Necrotizing sialometaplasia – The sudden onset of necrotizing sialometaplasia plus the absence of a tumor mass are helpful features in distinguishing this process.
• Benign salivary gland tumor – Benign salivary gland tumors are usually more sharply demarcated or encapsulated than their malignant counterparts, and ulceration is seen less frequently.
• Squamous cell carcinoma – This malignancy generally arises from the surface epithelium, resulting in a more superficial presentation with adjacent areas of leukoplakia or erythroplakia in most cases.
• Non-Hodgkin's lymphoma – This process often has a more boggy texture compared to salivary gland malignancy.
• Benign mesenchymal tumors - These tumors are generally more sharply demarcated or encapsulated in comparison to salivary gland malignancy.

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