Rare presentation of pleomorphic adenoma originating from the buccal minor salivary gland

Pleomorphic adenoma (PA) of the buccal minor salivary gland is a rare clinical entity that may mimic other benign cheek swellings, often leading to diagnostic uncertainty. We report the case of a woman in her forties who presented with a 14-year history of a painless, slow-growing swelling in the left cheek. Clinical and radiological findings suggested a benign soft tissue lesion, and a provisional diagnosis of fibrolipoma was made. Intraoral excision was performed with special attention to avoid injury to the parotid duct and facial nerve branches. A well-encapsulated mass measuring 3 × 2.3 × 1.5 cm was completely excised. Histopathological analysis confirmed the diagnosis of pleomorphic adenoma. No recurrence was observed at the 18-month follow-up. This case highlights the importance of considering PA in the differential diagnosis of intraoral swellings, the need for meticulous surgical technique, and the value of long-term follow-up in preventing recurrence or development of carcinoma ex pleomorphic adenoma.