case_images: PMC10870806_01
case_images: Palatal mass. Visible in an intra-oral view, a nodular mass, approximately 2 cm in width, in the left hard palate of the 83-year-old patient, accompanied by a central ulcerative-like epithelial discontinuity.
case_images: cureus-0016-00000052436-i01.jpg
case_images: PMC10870806_01_cureus-0016-00000052436-i01.jpg
case_images: FIG1
case_images: The lesion also presented a central ulcerative-like epithelial discontinuity and drainage (Figure 1).
case_images: Panoramic X-ray showing multiple carious lesions and retained tooth roots
case_images: cureus-0016-00000052436-i02.jpg
case_images: PMC10870806_01_cureus-0016-00000052436-i02.jpg
case_images: FIG2
case_images: The patient was then informed about and consented to an orthopantomogram, ruling out an odontogenic origin (Figure 2).
case_images: Intra-operatory intra-oral view of the palatal mass (pre-excision) with delineated surgical margins
case_images: cureus-0016-00000052436-i03.jpg
case_images: PMC10870806_01_cureus-0016-00000052436-i03.jpg
case_images: FIG3
case_images: The surgical margins were established by digitally outlining the fibroelastic mass (Figure 3).
case_images: Post-excision view of the palatal mass
case_images: cureus-0016-00000052436-i04.jpg
case_images: PMC10870806_01_cureus-0016-00000052436-i04.jpg
case_images: FIG4
case_images: After the complete excision (Figure 4), closure was achieved by secondary intention with the application of a tie-over dressing with Vaseline-impregnated gauze (Figure 5).
case_images: Intra-oral view showing a tie-over dressing with Vaseline-impregnated gauze covering the surgical site following the excision of the palatal mass
case_images: cureus-0016-00000052436-i05.jpg
case_images: PMC10870806_01_cureus-0016-00000052436-i05.jpg
case_images: FIG5
case_images: After the complete excision (Figure 4), closure was achieved by secondary intention with the application of a tie-over dressing with Vaseline-impregnated gauze (Figure 5).
case_images: Gastric heterotopia of the hard palate (histological analysis with hematoxylin and eosin staining). A: At a 20x optical magnification, one can see a mucosal fragment from the hard palate, covered by a stratified, squamous, nonkeratinizing epithelium (arrow). Under the epithelium, a lesion is observed in the connective tissue (rectangle).. B: At 40x optical magnification, one can see in detail the delineated rectangle mucinous epithelium, without dysplasia.
case_images: cureus-0016-00000052436-i06.jpg
case_images: PMC10870806_01_cureus-0016-00000052436-i06.jpg
case_images: FIG6
case_images: Gastric heterotopia of the hard palate (Immunohistochemistry with CK7 and Ck20 staining). At a 20x optical magnification, one can see the presence of secretory epithelium strongly positive for CK7 (A) and negative for CK20 (B). The CK 7 positive/CK 20 negative immunoexpression profile is common either in the salivary glands or gastric epithelium.
case_images: cureus-0016-00000052436-i07.jpg
case_images: PMC10870806_01_cureus-0016-00000052436-i07.jpg
case_images: FIG7
case_images: Gastric heterotopia of the hard palate (Immunohistochemistry with MUC5AC, MUC2 and MUC6 staining). A: At a 40x optical magnification, one can see the presence of focal positivity for MUC5AC (arrows), specific for gastric-like epithelium surface.. B: At a 200x optical magnification, a more detailed view of the previous image is provided, characterized by the presence of columnar cells.. C: In contrast, at 40x optical magnification, MUC2 immunohistochemistry shows an uncolored sample, indicating a lack of staining.. D: Similarly, at 40x optical magnification, MUC6 immunohistochemistry also shows no impregnation.
case_images: cureus-0016-00000052436-i08.jpg
case_images: PMC10870806_01_cureus-0016-00000052436-i08.jpg
case_images: FIG8
case_images: Post-excision status of the palatal gastric heterotopia mass (one-month follow-up). Visible in an intra-oral view, the surgical site shows abundant granulation tissue formation, compatible with a secondary healing process. Also visible is a 2 mm oral-nasal communication in the posterior surface of the wound.
case_images: cureus-0016-00000052436-i09.jpg
case_images: PMC10870806_01_cureus-0016-00000052436-i09.jpg
case_images: FIG9
case_images: However, during the one-month follow-up intra-oral examination, a 2 mm oral-nasal communication was detected at the posterior aspect of the wound (Figure 9).
case_images: Post-excision status of the palatal gastric heterotopia mass (three-month follow-up). Intra-oral view shows a neo-mucosal tissue, occupying the totality of the surgical wound, accompanied by a successful and significant reduction of the oral-nasal communication.
case_images: cureus-0016-00000052436-i10.jpg
case_images: PMC10870806_01_cureus-0016-00000052436-i10.jpg
case_images: FIG10
case_images: Post-excision status of the palatal gastric heterotopia mass (six-month follow-up). Intra-oral view shows a significant macroscopic normalization of the surgical wound, indicating successful healing, accompanied by a successful closure of the oral-nasal communication.
case_images: cureus-0016-00000052436-i11.jpg
case_images: PMC10870806_01_cureus-0016-00000052436-i11.jpg
case_images: FIG11
case_images: Post-excision status of the palatal gastric heterotopia mass (two-year follow-up). Visible in an intra-oral view, a macroscopic normal palate, with no clinical signs of recurrence of the gastric heterotopia mass.
case_images: cureus-0016-00000052436-i12.jpg
case_images: PMC10870806_01_cureus-0016-00000052436-i12.jpg
case_images: FIG12