A case of heterotopic salivary tissue: Pleomorphic adenoma of the nose.

Introduction: In daily ophthalmological practice, lacrimal gland tumors are rare. They represent 5 to 7.5% of all intraorbital tumors. The most common epithelial tumor of this gland is the pleomorphic adenoma, with a percentage of 25 to 50% of its tumor lesions. Objective: In this communication we presented a case of lacrimal gland pleomorphic adenoma and study the expression of Ki67 and the location and expression of MUC-1 and its correlation with tumor prognosis. We also carried out a retrospective descriptive study of the literature on the subject published between 1951 and 2020, using the MEDLINE database. Material and methods: The surgical piece examined, was processed according to the paraffin embedding technique, was performed with a histopathological diagnosis of pleomorphic lacrimal gland adenoma. Histological sections were stained with Hematoxylin / Eosin. Immunostaining with Ki67 and MUC-1 was performed with the DAKO LSAB + kit. Results: The diagnosis of hypercellular pleomorphic adenoma with areas of the remaining lacrimal gland was made. Ki67 labeling was low (≤15%). MUC-1 expression was intense, situated to the apical cell membrane of approximately 10% epitheliocytes from pseudoductal and cystic structures.Conclusions: Through histopathological evaluation, the correlation of Ki67 expression and the location and expression of MUC1, we verified that it is a non-recurrent pleomorphic adenoma without malignant transformation.

Objectives:Pleomorphic adenomas are benign tumors that rarely involve nonsalivary glands. We report an uncommon case of ala nasi pleomorphic adenoma. We discuss the clinical and histopathologic characteristics, and review the literature on nasal pleomorphic adenoma.Method:A 20-year-old man presented with a painless slow growing lobulated mass located on the right ala nasi extending into the nasal vestibule.Results:Complete surgical excision was performed. Histologic examination found a mixed cellular component: epithelial and myoepithelial cells with chondromyxoid stroma. This was consistent with the diagnosis of a typical pleomorphic adenoma. There was no evidence of recurrence at 18 months after the surgery.Conclusions:Pleomorphic adenomas located in the external nose are extremely rare. In such case, pleomorphic adenoma could originate from ectopic minor salivary gland. Complete surgical excision with long-term follow-up is recommended due to the potential risk of recurrence and malignant transformation.

INTRODUCTION: Pleomorphic adenoma (PA) is rarely seen in the submandibular gland and even more rarely in the sublingual gland. It is characterized by its pleomorphic or mixed appearance with clearly recognizable epithelial tissue intermingled with tissue of mucoid, myxoid and chondroid appearance of glandular origin. We present a case of a pleomorphic adenoma of the sublingual salivary gland, which is quite rare. CASE REPORT: A 23 year old female presented with a painless swelling in the sublingual region for the last 1 year. Clinical examination revealed a 3cm x 4cm swelling in the submandibular region which was firm in consistency with a lobulated surface. FNAC was done from the swelling and it was diagnosed as a case of pleomorphic salivary adenoma. The patient was posted for surgery. After appropriate dissection, the swelling was identified and it was meticulously removed. Histopathological examination confirmed it as a case of pleomorphic salivary adenoma. CONCLUSION: Pleomorphic adenoma rarely affects the sublingual salivary gland. However, the differential diagnosis should always consider the possibility of such a tumour while evaluating a swelling in that region.

Valuation of Four-Quadrant Location Method in Diagnosis and Differential Diagnosis of the Orbital Tumor by Comparison Study Combining CT and MRI with Pathology

Objective:Our study aimed to characterize alteration in the immunohistochemical expression of estrogen, progesterone and androgen receptor in the tumour cells of primary pleomorphic adenomas and recurrent pleomorphic adenomas. Methods:A retrospective study of data including 30 cases of primary pleomorphic adenomas (PA) without recurrences and 15 cases of recurrent pleomorphic adenomas were examined (RPA). RPA included 8 males and 7 females. Immunohistochemical expression of estrogen, progesterone and androgen receptor was examined in the selected cases. The percentage of slides was semi-quantitatively assessed by two independent observers and scores were given. The statistical analysis included the use of descriptive statistics and proportional frequencies. Results:AR expression was identified in 12 (40. %) out of 30 cases of (PA) pleomorphic adenomas and 7 of 15 cases recurrent pleomorphic adenomas (RPA) (46 %). The results showed that ER and PR expression were negative in PA and RPA. Conclusion:Androgen receptors might have role in pathogenesis of PA and RPA. Estrogen and progesterone receptors have no role in development of recurrent pleomorphic salivary adenoma.

Bronchial pleomorphic adenoma successfully diagnosed and resected with left lower sleeve lobectomy; a case report and literature review.

Malignant myoepithelioma is a very rare salivary gland tumor that can arise de novo or within a pre-existing pleomorphic adenoma. We report a case of malignant myoepithelioma most probably arising in a pre-existing pleomorphic adenoma of the left parotid gland. The patient was a 60-year-old man who presented with a multinodular mass lesion over left side of the face and neck. He had undergone removal of a pleomorphic adenoma of the left parotid gland twice (8 and 22 years ago). Histological examination showed locally concentrated highly invasive myoepithelial cells with bland-looking morphology and no evidence of mitosis or necrosis. Immunohistochemistry confirmed the myoepithelial differentiation (S-100+, SMA+) and a low Ki-67 labeling index (<5%).

Background: Salivary gland neoplasms are originated from the various salivary gland compartments and are histologically related to these structures. Several protein and molecular markers are employed in research and diagnosis in order to classify and understand histogenesis and other aspects of salivary gland neoplastic lesions. Pleomorphic adenoma is a benign salivary gland neoplasm composed by epithelial and myoepithelial cells and a complex stroma. Its varied structural and architectural aspects suggest the participation of stem cells in its composition. Additionally, pleomorphic adenoma originates from intercalated duct of salivary glands, a region reputed to host the regenerative/ stem-cell compartment of these glands. The present work investigated stem-cell markers (CD24, CD44) in pleomorphic adenoma and in specimens of developing human salivary glands using immunohistochemistry and real-time RT-PCR. Material and Methods: 101 cases of pleomorphic adenomas were used - 55 cases were FFPE and 60 specimens were fresh frozen tissue. From the total, 14 were pared (FFPE and frozen tissue). Salivary gland specimens dissected from 20 human foetuses were also included. Results: All cases of pleomorphic adenomas were positive for the stem-cell markers studied. Neoplastic luminal structures were positive for CD24. Modified myoepithelial cells were positive for CD44. In foetal salivary glands, these markers were restricted to the intercalated duct region. Increased expression of CD44 stem-cell marker was observed in pleomorphic adenoma specimens using real-time RT-PCR technique when compared to normal salivary gland controls. An specific expression pattern was not observed for CD24 when compared to the normal salivary gland tissue - in some cases of pleomorphic adenoma there was an increased expression of the protein, whilst in other cases the expression was decreased or normal-like. Conclusion: Pleomorphic adenoma cells share similar markers with stem-cells; it is not possible to confirm that neoplastic cells bear the same characteristics of multipotency. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 5352. doi:1538-7445.AM2012-5352

Pleomorphic adenoma is a benign tumor that frequently occurs in the salivary glands; however, it occurs in the breast rarely. There have been few reports of breast cancer complicated by pleomorphic adenoma of the mammary gland. A 70-year-old woman was found to have a mass lesion in her left breast during a medical examination. A needle biopsy was performed, and a diagnosis of pleomorphic adenoma was made. We performed a partial mastectomy with a margin of several millimeters from the tumor. Pathological examination revealed a diagnosis of pleomorphic adenoma with ductal carcinoma in situ. The resection margin was sufficient, and the patient was followed up. Pleomorphic adenoma arising in the mammary gland is difficult to differentiate from adenomyoepithelioma, mucocele-like tumor, and metaplastic carcinoma. Since the tumor can become malignant, resection with a narrow margin is recommended, along with special efforts not to damage the capsule at diagnosis.

Background: Pleomorphic adenoma (PA) is a benign tumor, with a high recurrence rate. This study aimed to compare the Mucin-2 (MUC2) expression in primary and recurrent cases of PA in tertiary care hospitals of Peshawar. Methods: In this study, there were 60 PA cases, 51 being primary lesions and 9 recurrent lesions. Formalin-fixed and paraffin-embedded (FFPE) blocks of the two groups were examined for the immunohistochemical expression of MUC2. The clinicopathological parameters were also examined. This study was conducted at the Pathology Department, Pakistan Institute of Medical Sciences (PIMS), Peshawar, between January 2019 to January 2021. A nonprobability sampling technique was used while collecting the samples. SPSS version 21 was used and p-value&lt;0.05 was considered significant. Results: The mean age was 32.3±8 years for both primary and recurrent PA cases. Out of the total, there were 30 (50%) females with 21 (35%) males, while all the recurrent cases were females 9 (15%). Most common microscopic features evaluated by H&amp;E-staining showed Myxoid and chondroid stroma along with sheets of epithelioid and basaloid cells. Among 51 cases of primary PA, 17 (33%) showed positive MUC2 expressions and 34 (66.6%) showed negative expressions while all cases of recurrent PA showed positive MUC2 expression with a p-value of 0.05. In primary PA, only a single (1.66%) case showed a strong stain, while there were 5(55.3%) cases in the recurrent PA. Conclusion: The expression of MUC2 is a useful marker to predict recurrence and there was a significant difference in the expression of MUC2 in primary and recurrent cases of PA.

Recurrent pleomorphic adenoma of the parotid gland: Long-term outcome of patients treated with radiation therapy

Objective : Pleomorphic adenoma (PA) is the most common benign neoplasm of the minor salivary glands. Clinical behavior,diagnosis, treatment modalities and evolution of nine cases of pleomorphic adenoma were discussed.Materials and methods : This is a descriptive and retrospective study about 9 cases of pleomorphic adenoma conductedover a period of 20 years (1990 à 2009) at the ENT department of Sousse (Tunisia).Results : There were 5 men and 4 women having a mean age of 40 years. The main site of this adenoma was the hard palate. The others 3 tumors were seen in the nasal cavity, in the parapharyngeal space and in cervical soft tissues. Clinical examination showed a swelling at the level of the interested region. Computed tomography (CT) was made in 5 cases,associated to the magnetic resonance imaging (MRI) in 2 cases. The treatment was based in surgical excision of the tumors. Histologically, the tumor showed features of a benign PA in 8 cases and of malignant PA in 1 case. Two patients had a documented local recurrence. The evolution was good for the first patient after secondary excision of the tumor.The patient presenting a carcinoma ex pleomorphic adenoma developed quickly pulmonary and cerebral metastases.Conclusion : Pleomorphic adenoma of minor salivary gland is generally known to be a slow-growing tumour. They must be evoked before all painless swelling in the upper aerodigestive tract developed under a healthy mucosa. The surgical management is basically total resection of the tumor with a safety margin of 5 mm. Longer follow-up was needed due to the possibility of recurrences and malignancy transformation.Keywords : Pleomorphic adenoma, Minor salivary gland, Imaging.

PLEOMORPHIC ADENOMA OF PAROTID GLAND: A CASE REPORT

To examine the expression of MMPs and TIMPs in pleomorphic adenoma of salivary gland and to investigate the relationship between the expression and the biological behaviour of the tumor. Twenty-three cases of pleomorphic adenoma were divided into active type and common type according to their biological behavior. Immunohistochemistry for MMP-2, MMP-9, TIMP-1, TIMP-2 and gelatin zymography analysis were performed in these 23 cases and in 6 malignant and 6 benign salivary gland tumors. The immunoreactivity of MMP-2 protein and MMP-2/TIMP-1, 2 ratio were significantly higher in active pleomorphic adenoma than in common pleomorphic adenoma (P = 0.028, P = 0.009, P = 0.045). The expression of active MMP-2, proMMP-9 and active MMP-9 were significantly higher in active pleomorphic adenoma than in common pleomorphic adenoma (P = 0.034, P = 0.021, P = 0.001). There was no significant difference in expression of MMP-2, MMP-9, TIMP-1 and TIMP-2 between the salivary malignant tumor and active pleomorphic adenoma, also between the salivary benign tumor and common pleomorphic adenoma. The expression of MMPs and TIMPs in active pleomorphic adenoma is similar to that in salivary carcinomas, and the expression in common pleomorphic adenoma also resembled to that in salivary adenoma. The expression of MMP-2, 9 and TIMP-1, 2 is related to the biological behavior of pleomorphic adenoma of salivary gland.

Introduction: Pleomorphic adenoma is the most common benign tumor of the minor salivary glands. Despite its benign nature, its potential for recurrence and malignant transformation makes it clinically significant. This study aims to describe the epidemiological, diagnostic, and therapeutic characteristics of pleomorphic adenomas of the minor salivary glands and to compare the findings with those reported in the literature. Materials and Methods: A retrospective descriptive study was conducted over a two-year period (March 2023 to March 2024), involving three patients diagnosed with pleomorphic adenoma of the minor salivary glands. Clinical features, diagnostic imaging, treatment approaches, and follow-up data were collected and analyzed. Results: The study included three patients (1 male, 2 females) with a mean age of 22.7 years. Tumor locations included the hard palate, lower lip, and inner cheek. The average time to diagnosis ranged from 1 to 6 months. In all cases, the clinical presentation was a painless swelling. Diagnostic imaging included soft tissue ultrasound and CT scan. Surgical excision was performed under local anesthesia using a monobloc technique. Histopathological analysis confirmed the diagnosis of benign pleomorphic adenoma in all cases. One recurrence was observed after 18 months of follow-up. Conclusion: Pleomorphic adenoma is the most frequent histological subtype of benign minor salivary glands tumors and typically exhibits slow progression. It should be considered in the differential diagnosis of any painless, submucosal lesion in the oral cavity. Complete surgical excision with a 5 mm margin of healthy tissue remains the treatment of choice. Due to the risks of recurrence and malignant transformation, long-term follow-up is essential.