Carcinoma ex pleomorphic adenoma affects glandular structures, occurring mostly in major salivary glands and less commonly in the lacrimal gland. It is a benign tumor composed of epithelial and myoepithelial cells arranged in various morphological patterns. Differential diagnosis of pleomorphic adenoma by immunohistochemical means. Pleomorphic adenoma is the commonest benign neoplasm of the parotid gland and minor salivary. Oct 25, 2007 even though many hypotheses for recurrences of parotid gland pleomorphic adenoma have been advanced, including cell biological and genetic factors 2, 3, obvious or underestimated tumor spillage, incomplete excision, and violation of the pseudocapsule of the tumor are considered the only proven reasons contributing to recurrent disease. The objective of this study was to clarify the clinical presentation and treatment of pa of the eac. The patient presented with a slowly progressing asymptomatic swelling on the left side of the face. Pleomorphic adenoma pleomorphic adenoma is a common benign salivary gland neoplasm characterised by neoplastic proliferation of parenchymatous glandular cells along with myoepithelial components, having a malignant potentiality. Herein, a rare case of lipomatous pleomorphic adenoma arising in the parotid gland of a 14yearold japanese woman is presented. The parapharyngeal space is very rare site for this tumour. Atypical pleomorphic adenoma with chronic sialoadenitis of.
Recurrent pleomorphic adenoma of submandibular region aydin s1, demir mg2, akbulut s1, alt. Pleomorphic adenoma of lacrimal gland journal of surgical. Pleomorphic adenoma of the cervical heterotopic salivary. Although basic pattern of the tumour is variable, individual cells are not pleomorphic. Excision and histopathologic evaluation revealed a pleomorphic adenoma pa originating from heterotopic salivary gland tissue. Discussion the pleomorphic adenoma is the most frequent benign tumor of the salivary glands, however, it is rarely present. Pdf pleomorphic adenoma is the most common benign tumour of salivary glands which is known for its wide pleomorphic architecture. These files will have pdf in brackets along with the filesize of the download. Primary pleomorphic adenoma of the external auditory canal. A case presentation of pleomorphic adenoma authorstream presentation. Pleomorphic adenoma of nasal septum is a rare, benign, minor salivary gland tumour arising from the nasal septum. After three years of followup, there are no signs or symptoms suggestive of relapse. The deep and diffuse distribution of salivary glands in the soft tissue of the head and neck region is one common limitation to the early diagnosis of pleomorphic adenoma pa from those glands.
Management and prognostic factors of recurrent pleomorphic adenoma of the parotid gland. Management and prognostic factors of recurrent pleomorphic. In 3 of the 4 cases, diffusionweighted and apparent diffusion coefficient adc mapping images clearly revealed carcinoma as a hypercellular area with low adc values and pleomorphic adenoma as a hypocellular area with high adc values. Article information, pdf download for pleomorphic adenoma with. Recurrent pleomorphic adenomas of the parotid gland warrant consideration because of the potential for facial nerve injury occurring with surgical treatment and the risk of malignant conversion. Some investigators have reported pleo morphic adenomas originating in the deep lobe of the. Pleomorphic adenoma of the lateral nasal wall an international. Surgical management of pleomorphic adenoma of parotid gland in elderly patients. View the article pdf and any associated supplements and figures for a period of 48 hours. On these bases, a diagnosis of atypical pleomorphic adenoma was performed. Surgical treatment of recurrent pleomorphic adenoma of the. Prognostic factors affecting the clinical outcome of.
Fortyeight cases of recurrent pleomorphic adenoma treated at the university of michigan, ann arbor. Pleomorphic adenoma in the parotid gland mayo clinic proceedings. A limited number of cases with lacrimal pleomorphic adenoma were reported. Pleomorphic adenoma is a common benign salivary gland neoplasm characterised by neoplastic proliferation of parenchymatous glandular cells along with myoepithelial components, having a malignant potentiality. They are benign except for a rare carcinoma ex pleomorphic adenoma but are not always completely encapsulated and show a definite tendency to recur after excision, in which case recurrence represents local growth because of incomplete excision and not malignancy. Downloaded from the university of groningenumcg research database pure. Pleomorphic adenoma is the most common epithelial tumour of the lacrimal gland, accounting for half of all epithelial lesions in the lacrimal fossa.
Pleomorphic adenoma is, by far, the most common benign salivary gland tumor, accounting for as many as 80% of all such tumors. Pleomorphic adenoma of breast, unusual in its location. Between 70% and 85% of cases occur in the parotid gland. Pleomorphic adenoma of the minor salivary glands most commonly occurs in the palate 16. Full text views reflects the number of pdf downloads. Dec 14, 2019 the etiology of metastasizing pleomorphic adenoma is not clearly understood, but a number of theories have been put forward. Pdf pleomorphic adenoma of the palate researchgate. Pleomorphic adenoma is the most common benign salivary gland neoplasm.
Here we are presenting a case of giant pleomorphic adenoma of the parotid, being the largest in size to be excised in pakistan in. Find, read and cite all the research you need on researchgate. Undifferentiated pleomorphic sarcoma genetic and rare. A case of lipomatous pleomorphic adenoma in the parotid gland. Complete wide surgical excision is the treatment of choice. Carcinoma ex pleomorphic adenoma of the parotid gland. During the surgery the part of the organ that is affected by the pleomorphic. Metastasizing pleomorphic salivary adenoma oncology jama. Pleomorphic adenoma in the parapharyngeal space joms. It constitute approximately 7080% of benign parotid gland tumors. In addition to carcinoma ex pleomorphic adenoma, true malignant mixed tumors of the salivary glands usually arise from preexisting pleomorphic adenomas 1,3. It is found mostly in the parotid gland in middleaged women. The most likely clinical diagnosis was pleomorphic adenoma. Pleomorphic adenoma of lacrimal gland pdf paperity.
Alternatively, you can download the file locally and open with any standalone pdf reader. A case of lipomatous pleomorphic adenoma in the parotid. Malignancy must be considered for cases with pain and progredien symptoms. The salivary glands give rise to a diversity of tumors that belies their small size. Most common presentation is recurrent epistaxis and nasal obstruction. Pleomorphic adenoma symptoms, causes, treatment, surgery. Atypical multiple metastasis of recurrent pleomorphic adenoma. Pleomorphic adenoma surgery, symptoms, causes, treatment. Pleomorphic adenoma is the most common neoplasm of the salivary glands and is most commonly located in the parotis followed by the. Pleomorphic adenoma of the lacrimal gland in a teenager. A massive pleomorphic adenoma of the submandibular salivary gland.
Hence, the final diagnosis was of giant pleomorphic adenoma with negative surgical margins. Pleomorphic adenoma of the salivary glands oral surgery, oral. The most frequent benign tumor is the pleomorphic adenoma. Intraoperative tumor spill or inadequate resection may be associated with an increase in the recurrence rate of pleomorphic adenoma. Discussion pleomorphic adenoma pa is a benign salivary gland tumour. The proliferative index of tumor cells, detected by ki67 immunostaining, reached levels around 10% in some tumor areas characterized by the highest frequency of atypical tumor cells. Return to article details pleomorphic adenoma of the parotid gland download download pdf.
If the pleomorphic adenoma is in your parotid gland it can be a delicate surgery due to the closeness to your facial nerves and the potential for the surgery to cause damage to these facial nerves. If you have problems viewing pdf files, download the latest version of adobe reader. Primary pulmonary pleomorphic adenoma is a very rare benign tumor that tends to arise in the large airways tumors tend to show small, branching, double layered ductules rather than ducts and less cartilaginous stroma as compared to pleomorphic adenomas arising in the salivary gland. Pleomorphic adenomas almost always arise in the deep lobe of the parotid gland.
Salivary gland tumors are rare and account for 23% of tumors occurring in the head and neck. Etiology and management of recurrent parotid pleomorphic. Pleomorphic adenoma is the most common benign salivary gland tumor, accounting for almost threefourths of all such tumors. We report an interesting case of pleomorphic adenoma pa with extensive adenoid cystic carcinoma acc. Metastasizing pleomorphic adenoma occurred on average 16 years following the initial treatment of a benign pleomorphic adenoma. Pleomorphic adenomas are the most frequent type of epithelial salivary gland neoplasms, and their malig nant counterpart, the. Histopathology images of pleomorphic adenoma by pathpedia. The term pleomorphic adenoma describes a being tumor with varied histologic appearances and consists of epithelial and mesenchymal tissues of possible myoepithelial lineage. It has a relatively high rate of recurrence after surgery. Carcinoma ex pleomorphic adenoma cxpa is an uncommon malignant tumor with highly aggressive biological behavior. Volume 12, supplement 2, october 2014, pages s12s16.
Imaging features of recurrent parotid pleomorphic adenoma have been infrequently reported in the radiology literature. It derives its name from the architectural pleomorphism variable. Pleomorphic adenoma with foci of squamous and mucinous differentiation. Imaging characteristics of recurrent pleomorphic adenoma of. Pleomorphic adenoma is the most commonly occurring tumor of the parotid gland 8090%. Pleomorphic adenoma the name of this tumour attempts to describe the unusual histopatholgy but terms are not correct. Role of ffdg petct in management of highgrade salivary. Pleomorphic adenoma of breast, unusual in its location addeddate 20190107 05. Most recurrent pleomorphic adenoma are multinodular with different recurrent sites and time duration. A presentation on pleomorphic adenoma prepared from standard textbooks. We highlight the importance of keeping this rare tumor in mind and the early detection of symptoms because such a malignant transformation could occur in pleomorphic adenomas. Parotid pleomorphic adenoma is the most common slowgrowing benign neoplasm of the salivary glands. Pleomorphic adenoma is a benign neoplasm which is commonly encountered in the parotid gland and other major salivary glands.
Transsphenoidal approach has become the surgery of choice for pituitary adenomas. About 80% of tumors occur within the parotid glands and most of the others in the submandibular glands. This is a temporary file and hence do not link it from a website, instead link the url of this page if you wish to link the pdf file. Pleomorphic adenoma is the most common salivary gland tumor and accounts for approximately 80% of parotid tumors. The presence of tumors within the parapharyngeal space is rare. Pleomorphic adenoma is the most common neoplasm of salivary gland origin and represents 45% to 74% of all salivary. At times they can also develop in minor salivary glands of the palate. The primary tumor arose most commonly from the parotid gland, followed by the minor salivary and submandibular glands. However, there is evidence to support the more conservative approach of. Nov 12, 2009 world literature suggests parapharyngeal space lesions account for only 0. The presence of these different elements accounts for the name pleomorphic tumor or mixed one characteristic of a pleomorphic adenoma is the presence of microscopic projections of tumor outside of the. Minor salivary gland tumors are relatively rare, but have a higher chance of malignancy than major salivary gland tumors. We present 4 cases of carcinoma ex pleomorphic adenoma of the parotid gland. Pdf pleomorphic adenoma pa is the most common salivary gland tumor, accounting for about 4070% of all major and minor.
If you do not see its contents the file may be temporarily unavailable at the journal website or you do not have a pdf plugin installed and enabled in your browser. It is the most common type of salivary gland tumor and the most common tumor of the parotid gland. Pleomorphic adenoma must be considered for the patients whose clinical course lasts for 12 months. Pleomorphic adenoma usually develops as a nontender nodular lesion with a slow growth rate persisting for years. The majority of minor salivary gland tumors are malignant. Pleomorphic adenoma an overview sciencedirect topics. A case presentation of pleomorphic adenoma authorstream. Histologically, it is characterized by the presence of cellular pleomorphism and is composed of an epithelial and connective tissue. Pleomorphic adenoma is the most common parotid neoplasm. Our goal was to investigate the prognosis of cxpa in the major salivary glands and factors influencing it. Pleomorphic adenoma of the lacrimal gland in a teenager, a. This distribution corresponds with that of psas in general.
Although pleomorphic adenomas most commonly occur in the parotid gland, it may also be encountered in the submandibular, lingual, and minor salivary glands. The palate appears to be the most commonly involved site. Mixed tumor of the lacrimal gland pleomorphic adenoma definition. Salivary gland pleomorphic adenoma in the netherlands rug. For language access assistance, contact the ncats public information officer. Pleomorphic adenoma, or benign mixed tumor, is the most common tumor of the parotid gland and represents 70% of all parotid neoplasms. Pleomorphic adenomas are the commonest tumors of the salivary glands.
The tumor was a circumscribed, submucosal nodule, about 2. Pleomorphic adenoma benign mixed tumor is the most common neoplasm of the salivary glands. Statistical data included by ear, nose and throat journal. Abstractwe present a case of a 62yearold male patient with pleomorphic adenoma and. Pleomorphic adenoma presents as a painless and slowly growing mass and also as exophthalmoses. Pleomorphic adenoma is the most common amongst these, comprising 60 70% of all parotid tumours. It arises from the benign tumour pleomorphic adenoma. This case report aims to throw light on an interesting case of pleomorphic adenoma of the parotid gland in a 50 years old female patient. The dominant tumor arising in the parotids is the benign pleomorphic adenoma, which is sometimes called a. Pleomorphic adenoma is the most common benign neoplasm of the salivary glands. Pleomorphic adenoma of the upper lip turkish journal of pathology. Recurrent pleomorphic adenoma of submandibular region. Pleomorphic adenomas benign mixed tumor are the most common salivary gland tumors, and the major ity of them. Multiple primary pleomorphic adenomas in a single parotid gland.
Pleomorphic adenoma pa is a benign tumour that mainly arises from salivary glands, and pa of the external auditory canal eac is very rare. Carcinoma ex pleomorphic adenoma of the lacrimal gland. We report a case of a pleomorphic adenoma, which occurred in the hard and soft palate of a 34. The pdf file you selected should load here if your web browser has a pdf reader. Pleomorphic adenoma table of contents previous next.
Pleomorphic adenomas are benign and tend to increase in size slowly. Surgical management of pleomorphic adenoma of parotid. On the 1 year followup there is no recurrence or complaint detected. Pleomorphic adenomas are the most common benign salivary gland neoplasms. Pdf most of the documents on the racgp website are in portable document format pdf. Health, general adenoma case studies cancer research mouth cancer parotid glands physiological aspects. Pleomorphic adenoma or mixed tumor of salivary gland tissue consists of epithelial elements in a matrix of mucoid, myxoid, or chondroid tissue. Immunohistochemical pattern of pleomorphic adenoma. Extensive lipomatous involvement of the tumor is, however, a very rare finding. Unlimited viewing of the articlechapter pdf and any associated supplements and figures. Presentations ppt, key, pdf logging in or signing up.
The stroma may be chondroid, myxoid, osteoid, or fibroid. Pleomorphic adenoma of the soft palate radiology jama. Pleomorphic adenoma of the upper lip in a child journal of oral. This is the sixth case of lipomatous pleomorphic adenoma in the english literature. The epithelial cells make up a trabecular pattern that is contained within a stroma. Pleomorphic adenoma is the most common neoplasm of the parotid gland. Metastasizing pleomorphic adenoma is the third type of malignant mixed tumor of salivary glands and is the rarest. This article is from journal of surgical case reports, volume 20. Pleomorphic adenoma presenting a 2x2cm well circumscribed lesion on the palate of a 67year old female iarc screening group.
Integrated 18ffdg petct is also poor at distinguishing between benign and malignant tumors of the salivary gland 15. In such cases, it is critical to make a definite diagnosis as each of these tumors has an entirely different treatment protocol. Etiology and management of recurrent parotid pleomorphic adenoma. Imaging characteristics of recurrent pleomorphic adenoma. A 38yearold woman is described who presented with a slowly growing mass on the posterior aspect of the left ear. This is the sixth case of lipomatous pleomorphic adenoma in.
Pleomorphic adenoma surgery recovery doctor answers. To open a pdf file you will need compatible software such as adobe reader. Lutfi kirdar kartal education and research hospital, ent department, istanbul, turkey. They originate from an uncommitted reserve cell of the intercalated duct which has the potential to differentiate into epithelial and myoepithelial cells 25.
Occasionally, some scattered foci of capsular pseudoinfiltration were detected. Carcinoma ex pleomorphic adenoma ca ex pa is a type of cancer typically found in the parotid gland. Many authors have presented cases of pas originating from ceruminous glands in the external auditory canal or of socalled. Multiple primary pleomorphic adenomas in a single parotid. It progresses slowly and, left untreated, can produce signi. Pleomorphic adenoma may show various architectural and cytologic features that resemble other salivary tumors identifying areas typical of pleomorphic adenoma with triphasic ductal, myoepithelial and stromal components is helpful to establish the diagnosis squamous cell carcinoma. Media in category histopathology of pleomorphic adenoma the following 18 files are in this category, out of 18 total. According to these studies, the role of 18ffdg pet for the diagnosis of salivary gland cancer is disappointing. In 2 major series evaluating a total of 590 pediatric orbital tumors, no case of pleomorphic adenoma of the lacrimal gland was encountered. The patient presented excellent cosmetic and functional results, without signs of facial nerve palsy, damage or recurrence.
841 71 94 1299 188 479 718 130 864 402 184 670 272 1102 395 1432 1520 1169 561 942 1476 540 844 898 1041 1153 765 252 1394 430 957