1 International Journal of Medical and Dental Case Reports (2019), Article ID 060936, 4 Pages Abstract Leiomyoma is a circumscribed benign smooth muscle tumor with rare incidence in the head-and-neck region of about 0.065% and occurring most commonly in uterine myometrium, gastrointestinal tract, skin, and lower extremities. The lesion usually presents as an asymptomatic lesion, with slight female predilection with the World Health Organization classifed into three subtypes: Solid, angioleiomyoma, and epithelioid types, with angioleiomyoma (74%) outnumbering in terms of occurrence in oral cavity. We have described a rare occurrence of solid variant of leiomyoma in hard palate along with clinical presentation, investigation, and reconstruction of defect using buccal pad of fat with a brief review of literature. Leiomyoma accounts for less than 0.5% of all benign smooth muscle tumors occurring in oral cavity. It presents as a relatively asymptomatic lesion, with confrmed diagnosis being only through histopathological and immunohistochemistry. Surgical excision of the lesion with sound safety margins remains as the treatment of choice with almost nil recurrence rate. Leiomyoma is a benign rare occurrence in oral cavity with minimal documentation of solid variant in hard palate of less than 9% and thereby diagnosis and management including reconstruction of secondary defect is of utmost importance. Keywords: Palate, smooth muscle, solid leiomyoma Correspondence: Venkatesh Anehosur, Department of Oral and Maxillofacial Surgery, SDM Craniofacial Research Centre, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, India Received 16 August 2019; Accepted 18 September 2019 doi: 10.15713/ins.ijmdcr.124 How to cite the article: Anehosur V, Acharya P, Shetty D, Dinesh US. Solid variant of leiomyoma in the hard palate: A rare case report and review of literature. Int J Med Dent Case Rep 2019;6:1‑4. Introduction Leiomyoma is a benign smooth muscle tumor occurring at any location, with female genital tract (95%) followed by skin (3%) and gastrointestinal and food intake tract (1.5%) being the most common site of occurrence in descending order (World Health Organization [WHO], 2013). [1] The incidence of the occurrence of leiomyoma is rare in the oral cavity, caused by the lack of smooth muscle in this region and accounts to only about 0.42% of all soft tissue lesions. [2,3] In oral cavity, it frequently involves the lips, tongue, buccal mucosa, palate, and gingiva in the descending order with peak incidence of occurrence between 40 and 49 years of age and with 2:1 female predilection; however, considerable controversy exists regarding gender predilection. [4-7] Leiomyoma presents asymptomatic in nature with defnitive diagnosis solely based on histopathology and immunochemistry with surgical excision of lesion being modality of choice in management. [8-10] We are reporting a case of solid leiomyoma which presented at rarest site in the oral cavity, i.e., hard palate with brief review of literature. Case Report A 26-year-old Indian female, who was a lactating mother reported to us with the chief complaints of pain and ulceration in the hard palate for 7 months. Pain was intermittent, sharp aching, and intermittent in nature which was reduced in intensity on taking analgesics. On examination, a solitary, well-defned oval ulcerative lesion was noted in the hard palate measuring approximately about 1 cm× 1.5 cm with rolled out margins. Surrounding mucosa was erythematous. Lesion was non-scrapable and tender on palpation [Figure 1]. Incisional biopsy of the lesion was performed under local anesthesia which was suggestive of leiomyoma. Radiographic evaluation (orthopantomograph) was suggestive of no palatal bone erosion [Figure 2]. Routine blood investigations and physician ftness were sought and wide excision of lesion was performed under general anesthesia [Figure 3]. Reconstruction of defect was done using local fap (buccal pad of fat) and secured using 4–0 vicryl. The specimen was sent for histopathological examination which revealed a discontinuous predominantly hyperparakeratinized to hyperorthokeratinized squamous CASE REPORT Solid variant of leiomyoma in the hard palate: A rare case report and review of literature Venkatesh Anehosur 1 , Priyanka Acharya 1 , Deepthi Shetty 1 , U. S. Dinesh 2 1 Department of Oral and Maxillofacial Surgery, SDM Craniofacial Research Centre, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, India, 2 Department of Pathology, SDM College of Medical Sciences and Hospital, Dharwad, Karnataka, India