DOI: https://doi.org/10.36347/sasjs.2026.v12i05.008

Pages: 376-380

Introduction: Mucoepidermoid carcinoma [MEC] of the hard palate is the most common malignant minor salivary gland tumor but remains genuinely rare in adolescents. Its clinical presentation overlaps substantially with benign palatal lesions, which delays diagnosis and allows local invasion to progress before treatment begins. Case Presentation: A 16-year-old girl with no relevant medical history presented with a two-year history of a slowly enlarging right palatal mass. Clinical examination revealed a 4 cm soft, well-demarcated lesion with mucosal telangiectasia and bilateral jugulocarotid adenopathy. CT imaging showed a 40 × 27 × 24 mm lesion with cortical bone erosion and extension into the nasal cavity, staged cT4b N2c M0. The patient underwent right hemimaxillectomy with bilateral selective neck dissection [levels I–III]. Final pathology confirmed intermediate-grade MEC without lymphovascular or perineural invasion; surgical margins were positive and all dissected nodes were negative. Adjuvant intensity-modulated radiotherapy [IMRT] and prosthetic obturation were provided. At one year of follow-up, the patient showed no clinical evidence of recurrence. Conclusion: Advanced local disease is possible in adolescent palatal MEC even without constitutional symptoms. Early biopsy of any persistent palatal mass is essential. Multidisciplinary surgical and oncologic management, including adjuvant radiotherapy for positive margins, can yield favorable short-term outcomes even at presentation with an advanced stage.