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Since the mass did not remit after MTX withdrawal, she underwent five courses of chemotherapy. Currently, the patient is in complete remission. In patients on MTX who develop a swelling on the palate, MTX-LPD should be included among the differential diagnostic possibilities. Diagnosis and treatment of MTX-LPD call for consultation with a haematologist. If the mass fails to regress following withdrawal of MTX, appropriate chemotherapy is indicated.<\/jats:p>","DOI":"10.1136\/bcr-2022-250616","type":"journal-article","created":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T11:35:47Z","timestamp":1664451347000},"page":"e250616","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Unusual manifestation of methotrexate-associated lymphoproliferative disorder as a palatal mass"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4051-1505","authenticated-orcid":false,"given":"Takuma","family":"Watanabe","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukina","family":"Teratani","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,9,29]]},"reference":[{"key":"2025082709114327000_15.9.e250616.1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.13103"},{"key":"2025082709114327000_15.9.e250616.2","doi-asserted-by":"crossref","first-page":"vi12","DOI":"10.1093\/rheumatology\/keab609","article-title":"Recent progress in treatments of rheumatoid arthritis: an overview of developments in biologics and small molecules, and remaining unmet needs","volume":"60","author":"Tanaka","year":"2021","journal-title":"Rheumatology"},{"key":"2025082709114327000_15.9.e250616.3","first-page":"1","article-title":"Sarilumab monotherapy versus sarilumab and methotrexate combination therapy in patients with rheumatoid arthritis","volume":"61","author":"Burmester","year":"2021","journal-title":"Rheumatol"},{"key":"2025082709114327000_15.9.e250616.4","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.ajoms.2015.12.002","article-title":"Methotrexate-Related lymphoproliferative disorder of the oral region in patients with rheumatoid arthritis","volume":"28","author":"Kondo","year":"2016","journal-title":"J Oral Maxillofac Surg Med Pathol"},{"key":"2025082709114327000_15.9.e250616.5","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1111\/cas.13249","article-title":"Clinicopathological analysis of methotrexate-associated lymphoproliferative disorders: comparison of diffuse large B-cell lymphoma and classical Hodgkin lymphoma types","volume":"108","author":"Gion","year":"2017","journal-title":"Cancer Sci"},{"key":"2025082709114327000_15.9.e250616.6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2020\/4814519","article-title":"Methotrexate-associated lymphoproliferative disorder developed ectopically in the maxillary gingiva and bilateral lungs","volume":"2020","author":"Obata","year":"2020","journal-title":"Case Rep Med"},{"key":"2025082709114327000_15.9.e250616.7","unstructured":"Gaulard P , Swerdlow SH , Harris NL . 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