A small lesion is located in the midline at the junction of the hard and soft palate, slightly posterior. All of the following are reasonable differential diagnoses EXCEPT:

Correct answer: A. Nasopalatine (incisive canal) cyst

• A. Correct (this is the EXCEPTION). A nasopalatine/incisive canal cyst arises in the anterior midline behind the maxillary central incisors — far from the hard/soft palate junction, so it does not fit this location.
• B. A granular cell tumor can occur on the palate/tongue and is a plausible soft-tissue differential.
• C. A central giant cell lesion can present in the palatal region and remains on the differential.
• D. Pleomorphic adenoma is THE classic minor salivary gland tumor of the posterior hard palate — a strong fit for a lesion near the hard/soft palate junction.