Dermoid cysts in the floor of the mouth are relatively uncommon developmental lesions. They are thought to arise in the midline and along the lines of embryonic fusion of the facial processes containing ectodermal tissue.

A 17-year-old female presented with a 3-month history of a growing, progressive swelling in the mouth floor. Clinical examination revealed a rather large symmetrical, soft swelling in the mouth floor, displacing the tongue superiorly. The fast growing nature and size of the lesion raised suspicion of potential compromise to the airway. Surgical excision was therefore performed.

Differential diagnosis of cystic lesions in the floor of the mouth is of paramount importance, as the recommended surgical techniques vary depending on the anatomical position of the lesions. The intraoral approach is preferred for those lesions that do not extend beyond the mylohyoid muscle boundaries; this leads to a satisfactory cosmetic and functional outcome.

We present the first reported case of sebaceous adenoma of the palate, to our knowledge.

Case report and review of the English language literature, with a focus on the pathological spectrum of sebaceous glands.

A woman presented with a growth on the hard palate, which was excised and examined. Histopathological analysis showed features of sebaceous adenoma. Further evaluation with Sudan Black B special stains and Ki 67 immunohistochemistry was performed.

Sebaceous adenomas in the oral cavity are very rare, with only 10 cases previously reported in the English language literature. Sebaceous adenoma of the palate has not previously been reported, to our knowledge. We discuss the role of special stains and immunohistochemistry in the diagnosis of this tumour.