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A firm, long-standing nodule of the upper lip should make a clinician think of canalicular adenoma since the upper lip is the most common location for that neoplasm. The age of the patient is consistent with that of most patients who present with canalicular adenoma, but not the gender. Nonetheless, canalicular adenoma should be on the differential diagnosis. The histology is not supportive of canalicular adenoma.
Canalicular adenoma is a benign neoplasm that is almost exclusively of minor salivary gland origin. The upper lip is the most common location, accounting for over 80% of all cases, followed by the buccal mucosa. Occurrences in the parotid gland and other major salivary glands are described, but rarely. They present as well-circumscribed, firm, movable, slow-growing, painless nodules. They occur in females over the age of 50 and are usually single nodules. However, canalicular adenomas are sometimes known to present in a multifocal manner, which a clinician may mistake for invasion or metastasis. They are treated by simple enucleation. Histologically, canalicular adenomas present as an encapsulated neoplasm with cords, duct-like structures of monotonous, cuboidal or low columnar basaloid cells, and sometimes with large cystic dilatation of the duct-like spaces.