Salivary Duct Carcinoma in the Palate: A Case Report of a Rare Entity

Salivary Duct Carcinoma (SDC) is a rare and highly aggressive salivary gland malignancy that closely resembles ductal carcinoma of the breast on histopathological examination. It predominantly involves the major salivary glands, whereas involvement of the minor salivary glands is uncommon, with the palate being a rare site. A 47-year-old male presented with a painful ulcerative lesion in the upper back tooth region. On examination, the lesion appeared erythematous with irregular margins and extended from the maxillary tuberosity to the retromolar trigone, involving the pterygomandibular raphe. Enlarged regional lymph nodes were also noted. Imaging with Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) revealed an ill-defined soft tissue lesion in the left retromolar trigone, showing hyperintensity on T2/Fluid-Attenuated Inversion Recovery (FLAIR) sequences. An incisional biopsy was performed, and histopathological evaluation confirmed the diagnosis of SDC. The patient subsequently underwent aggressive surgical management, including wide local excision, marginal mandibulectomy, posteroinferior maxillectomy, and neck dissection (levels I-IV) with lymph node removal. The patient remains disease-free after two years of follow-up. The present case highlights the aggressive behaviour and diagnostic difficulty of SDC when it arises in minor salivary glands. Early recognition and prompt, comprehensive treatment are crucial for improving outcomes. Careful and long-term follow-up is essential due to the high likelihood of recurrence and metastasis.