Pleomorphic adenoma is the most common benign salivary gland neoplasm. Pdf pleomorphic adenoma is a benign salivary gland neoplasm with a diverse morphology. Dec 14, 2019 the etiology of metastasizing pleomorphic adenoma is not clearly understood, but a number of theories have been put forward. T rise within sg tissue, common parotid 78% composed of cellular elements oncocytes. Our goal was to investigate the prognosis of cxpa in the major salivary glands and factors influencing it. A unique case of benign pleomorphic adenoma metastasizing to the thyroid gland and liver mufaddal moonim1, katherine wiles1, alia nasir2, ricard simo1 1. A clinicopathologic study of a pleomorphic adenoma of the breast is presented and attention is drawn to a previously unreported association with a cyst. Conclusion a large pleomorphic adenoma of the nasal septum may show characteristic ct and mr. Surgery is the most common form of treatment for pleomorphic adenoma. This is the sixth case of lipomatous pleomorphic adenoma in the english literature. 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. Health, general adenoma case studies cancer research mouth cancer parotid glands physiological aspects. Lutfi kirdar kartal education and research hospital, ent department, istanbul, turkey. However, there is evidence to support the more conservative approach of.
A common histogenesis of the two entities is also suggested. Pleomorphic adenomas are benign and tend to increase in size slowly. Pleomorphic adenoma of the salivary glands radiology. Although pleomorphic adenomas most commonly occur in the parotid gland, it may also be encountered in the submandibular, lingual, and minor salivary glands. The majority of these tumors are found in the parotid glands, with less than 10% in the submandibular. Pleomorphic adenoma of the minor salivary glands most commonly occurs in the palate 16. Salivary gland basal cell and canalicular adenomas allen press.
K5k14positive cells contribute to salivary glandlike. It is the most common type of salivary gland tumor and the most common tumor of the parotid gland. Pleomorphic adenoma surgery recovery doctor answers. It derives its name from the architectural pleomorphism variable appearance seen by.
Features are characteristic of a pleomorphic adenoma which was subsequently excised and confirmed histologically. Ballance wa, ro jy, elnaggar ak, grignon dj, ayala ag, romsdahl mg. Pleomorphic adenoma is the most common salivary gland tumor and accounts for approximately 80% of parotid tumors. Differential diagnosis of pleomorphic adenoma by immunohistochemical means volume 105 issue 12 toshiro nishimura, mitsuru furukawa, ei kawahara, atsuo miwa. The tumor can occur at any age but it is most common in young and middle aged adults between the ages of 30 60. In such cases, it is critical to make a definite diagnosis as each of these tumors has an entirely different treatment protocol. They originate from an uncommitted reserve cell of the intercalated duct which has the potential to differentiate into epithelial and myoepithelial cells 25. It is found mostly in the parotid gland in middleaged women. Pleomorphic adenoma pa is the most common tumor of the salivary gland. Department of otorhinolaryngology head and neck surger y, guys hospital, great maze pond road, london se1 9rt, united kingdom. Pleomorphic adenoma, also known as benign mixed tumor is the most common tumor of the salivary gland accounting for 6080% of the benign variety. Extensive use of twocolour immunofluorescence staining for various cell markers in pleomorphic adenoma, revealed three consistent phenotypic features. The carcinoma component is on the lower right of the image. Pleomorphic adenoma of the cervical heterotopic salivary.
Doctors give unbiased, helpful information on indications, contraindications, benefits, and complications. Tumours of salivary tissue journal of clinical pathology. Mri through the left parotid gland demonstrates a sharply circumscribed solid mass in the superficial aspect of the gland. Pleomorphic adenoma definition of pleomorphic adenoma by. Salivary gland tumors are rare, comprising less than 3% of all neoplasia of the head and neck region. A case of lipomatous pleomorphic adenoma in the parotid gland. Pleomorphic adenoma, or benign mixed tumor, is the most common tumor of the parotid gland and represents 70% of all parotid neoplasms. Discussion pleomorphic adenoma appears as a painless slowly growing firm mass.
The histogenesis of lipomatous or lipomalike pleomorphic adenoma is not still clear, but metaplastic transformation of myoepithelial cells to adipocytes and entrapment of fat tissue are known to. It is often called a mixed tumor because it consists of both epithelial and mesenchymal elements. We report a case of a giant pleomorphic adenoma of the parotid gland and its surgical technique in a 70year old female with a history of that tumour for more than 35 years. Pleomorphic adenoma surgery, symptoms, causes, treatment. Pleomorphic adenoma benign mixed tumor is the most common neoplasm of the salivary glands. The latter merge imperceptivity into the surrounding mesenchymal elements. Pleomorphic adenoma is the most common benign neoplasm of the salivary glands. On the 1 year followup there is no recurrence or complaint detected. Statistical data included by ear, nose and throat journal.
Benign neoplasms of the salivary glands clinical gate. Thus, when a multilobular tumor of the nasal septum exhibiting curvilinear enhancement and small. Pleomorphic adenoma, the most common salivary gland tumor, consists of epithelial and. Imaging characteristics of recurrent pleomorphic adenoma of. Pleomorphic adenoma 1280 patients constituted 84% of benign tumors and 45% of all. The pleomorphic adenoma in this case resembles a typical adenoma of the parotid gland more closely than one of the nasal septum.
Histogenesis of benign pleomorphic adenoma mixed tumor of the major salivary glands. Discussion pleomorphic adenoma pa is a benign salivary gland tumour. Metastasizing pleomorphic adenoma the term currently preferred by the world health organization who is also known as metastasizing benign pleomorphic adenoma. Herein, a rare case of lipomatous pleomorphic adenoma arising in the parotid gland of a 14yearold japanese woman is presented. 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. Eighty per cent of pleomorphic adenomas of this particular gland are benign, and 20 per cent are cancerous. It is the most common salivary gland tumor, with a slight. Histogenesis of benign pleomorphic adenoma mixed tumor of. Carcinoma ex pleomorphic adenoma cxpa is an uncommon malignant tumor with highly aggressive biological behavior. By combining mabs against cks and vimentin pkk2, pkk3 and vim 9. Pdf pleomorphic adenoma, also called benign mixed tumor, is the most. Other benign salivary gland tumours do not do this. Metastatic pleomorphic adenoma e195 authors such as czader 9 have described the metastatic mixed tumor as a link between a pleomorphic adenoma and a cepa and suggested that metastases of pleomorphic adenomas may be the first stage in the transformation of a tumor into a carcinoma, though this does not occur in.
Carcinoma ex pleomorphic adenoma ca ex pa is a type of cancer typically found in the parotid gland. The patient presented excellent cosmetic and functional results, without signs of facial nerve palsy, damage or recurrence. If yes, where can i get it done and what is the expected cost of the surgery. Twocolour immunofluorescence marker study of pleomorphic. Metastasizing pleomorphic adenoma is the third type of malignant mixed tumor of salivary glands and is the rarest.
During the surgery the part of the organ that is affected by the pleomorphic. The glandular tissue is merging into the mucoid matrix. Histogenesis of salivary gland pleomorphic adenoma mixed. Histologically, it is characterized by the presence of cellular pleomorphism and is composed of an epithelial and connective tissue component within a stroma of. Recurrent pleomorphic adenoma of submandibular region aydin s1, demir mg2, akbulut s1, alt. 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.
Pdf pleomorphic adenoma benign mixed tumor of the breast. Health, general adenoma case studies cancer research. Malignant transformation, though rare, has been reported. The epidemiology of pleomorphic adenoma can cover all ages and both genders but is more prevalent among women from thirty to sixty years of age. Pleomorphic adenoma is, by far, the most common benign salivary gland tumor, accounting for as many as 80% of all such tumors. Immunohistochemical pattern of pleomorphic adenoma. Comparative histogenesis and morphogenesis of mucoepidermoid carcinoma and pleomorphic adenoma. It is isointense to muscle on t1 and strikingly hyperintense on t2. Pleomorphic adenoma, abbreviated pa, is a very common benign salivary gland tumour. Here we are presenting a case of giant pleomorphic adenoma of the parotid, being the largest in size to be excised in pakistan in. Benign tumour polymorphous low grade adenocarcinoma plga rare lesion 23% of benign s. Management and prognostic factors of recurrent pleomorphic.
Twentytwo benign pleomorphic adenomas of the major salivary glands were studied by transmission electron microscopy and immunohistochemical techniques three cases in order to characterize the cell types comprising the epithelial and socalled. In addition to carcinoma ex pleomorphic adenoma, true malignant mixed tumors of the salivary glands usually arise from preexisting pleomorphic adenomas 1,3. It progresses slowly and, left untreated, can produce signi. A pleomorphic adenoma is a tumour of a gland that produces saliva in the mouth.
Pdf we report a case of pleomorphic adenoma benign mixed tumor of the breast, which is an extremely rare location for this tumor. A case of lipomatous pleomorphic adenoma in the parotid. Pdf wt1 expression in salivary gland pleomorphic adenomas. Histogenesis of benign pleomorphic adenoma mixed tumor. A unique case of benign pleomorphic adenoma metastasizing. Histogenesis of salivary gland pleomorphic adenoma mixed tumor with an evaluation of the role of the myoepithelial cell. Epithelial and stromal patterns of pleomorphic adenoma of minor. Prognostic factors affecting the clinical outcome of. Pleomorphic adenoma is the most common amongst these, comprising 60 70% of all parotid tumours. 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. Comparative histogenesis and morphogenesis of mucoepidermoid. It arises from the benign tumour pleomorphic adenoma.
Immunohistochemistry stresses the similarity between pleomorphic adenoma of salivary gland and breast. Histogenesis and classification based on 186 cases. Pleomorphic adenoma is a benign salivary gland tumor that exhibits wide cytomorphologic and architectural diversity. Multiple primary pleomorphic adenomas in a single parotid gland.
This chapter discusses some of the advances made in understanding the etiology and histogenesis of salivary tumors and describes a contemporary approach to the diagnosis and management of patients with benign neoplasms of the salivary glands. Pleomorphic adenoma an overview sciencedirect topics. Similar tumor arising in a benign mixed tumor has only been reported once. Malignancy was strongly suspected in the light of radiologic features. There are three main patterns of malignant change that occur in pleomorphic adenoma. Imaging characteristics of recurrent pleomorphic adenoma. The role of myoepithelial cells in stromal histogenesis was confirmed. It is a mixed tumor of salivary gland origin and has elements from both epithelial and mesenchymal. Pleomorphic adenoma symptoms, causes, treatment, surgery. Pathogenesis and histogenesis of salivary gland tumours by.
The treatment of pleomorphic adenoma is surgical excision. Extensive lipomatous involvement of the tumor is, however, a very rare finding. Four pleomorphic adenomas of the breast, one of which was in a papillary lesion, and four salivary pleomorphic adenomas were analyzed. Recurrent pleomorphic adenoma of submandibular region. Printable pleomorphic adenoma of the breast surgical. 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 adenoma, the most common salivary gland tumor, is also. Ultrastructural study of the histogenesis of salivary gland mucoepidermoid car cinoma. Lam rmy 1984 an electron microscopic histochemical study of the histogenesis of major salivary gland pleomorphic adenoma.
Transsphenoidal approach has become the surgery of choice for pituitary adenomas. An epithelial cell component a myoepithelial cell component a stromal mesenchymal component identification of these 3 components, which may vary quantitatively from one tumor to anot. Pleomorphic adenoma, also referred to as benign mixed tumors bmts, is a benign or a noncancerous growth in the salivary gland, the most commonly occurring parotid tumor. This is outer myoepithelial cell layer or layers which merges into the. Pleomorphic adenoma is a benign salivary gland tumor that exhibits. Salivary gland mixed tumor i i istogenesisdarimk rt al. Pleomorphic adenoma is a most common benign tumor which affects the major salivary glands and infrequently arises from minor salivary glands. Multiple primary pleomorphic adenomas in a single parotid. The acini took up a blend of magenta and blue color, indicating the presence of both acidic and neutral mucins.
17 1515 1241 758 985 709 1313 547 969 1175 676 1486 150 116 990 1406 29 838 1129 517 392 132 740 403 838 615 837 328 1040 722 1098 511 617 1247 1291 182 820 1217