Abstract
Carcinoma ex-Pleomorphic adenoma is defined as a carcinoma that arises in the epithelial and/or myoepithelial component of a pleomorphic adenoma. Prognosis and management is highly dependent on the type of carcinoma and extent of invasion. The malignant component is classified as non-invasive (intracapsular), minimally invasive, and widely invasive. Non-invasive and minimally invasive tumours have an excellent prognosis and very low metastatic potential. This case study is of a 59-year-old man with a tumour in the Thoracic 9 vertebra that was compressing the spinal cord. Multiple tissue fragments were sent to our department for frozen tissue assessment which microscopically showed a tumour with features resembling carcinoma ex-pleomorphic carcinoma with a malignant component suggestive of myoepithelial carcinoma. This was confirmed with immunohistochemistry done on further samples of the tumour. The patient was discovered in our databases to have had a previous left parotidectomy in 2008 for a carcinoma ex pleomorphic adenoma with features similar to the frozen section tissue. The clinicians involved with this case had no knowledge of this. This case, whilst rare, highlights the importance of the pathologist's role in diagnosis and patient management.
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