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+A 67-year-old woman consulted our department for swelling in the posterior region of the right hemipalate. A biopsy was performed under local anaesthesia with the diagnosis of PLGA. The cervical examination revealed a right submandibular lymphadenopathy. The most relevant antecedent was a radiotherapy treatment in childhood for an unclassified pathology in the head and neck region.
+The orthopantomography was normal. A cervicofacial computerised tomography was requested, which showed a stage IV lesion at the level of the right nostril (T4N2CMx). A cytological puncture of the submandibular adenopathy was performed and reported as probable PLGA. MRI showed a well-defined lesion at the level of the nasal fossa with extension towards the pterygoid region.
+
+Surgical intervention under general anaesthesia was decided. The tumour was approached by means of a Lefort I type maxillotomy. A unilateral suprahomohyoid cervical ganglionic cervical emptying was also performed. Tumour resection and bone repositioning of the maxilla was performed using 1.5 mm preformed mini-plates.
+
+The definitive result of the pathological anatomy confirmed the diagnosis of PLGA, with invasion of surgical margins at the level of the right pterygomaxillary area. Metastatic adenopathies (2/16) were detected on the right side (5).
+
+The patient was presented at the Maxillofacial Surgery-Oncology session, and it was decided to perform adjuvant radiotherapy in the right pterygomaxillary region and to follow imaging controls by means of resonance imaging. Given the persistence of tumour remains, it was decided to extend the surgical margins in the right pterygomaxillary region and reconstruct the defect using a buccal adipose Bichat ball.
+Two years later, the patient is still undergoing periodic check-ups and is free of disease.
+