Abstract
IntroductionWe present a case of long-term evolution of a submandibular pleomorphic adenoma. There is little information about topographic malignant transformation patterns of pleomorphic adenomas.Case presentationWe extensively analyze a giant submandibular mixed tumor of 25-year evolution in a 57-year-old Caucasian woman. Deoxyribonucleic acid ploidy was evaluated in different superficial and deep areas using flow cytometry analysis and correlated with pathological and immunohistochemical characteristics. Superficial areas exhibited a typical histological pleomorphic adenoma pattern and were deoxyribonucleic acid diploid. Deep samples showed deoxyribonucleic acid aneuploidy, atypical histological benign features and expression of markers involved at an early-stage of malignant transformation, such as tumor protein 53 and antigen Ki67.ConclusionThese findings revealed that deep tumor compartments may be involved in the initial stages of malignant transformation. Deoxyribonucleic acid ploidy analysis may provide an additional diagnosis tool and indicate 'uncertain' areas that require careful study to avoid diagnostic errors. Larger studies are needed to confirm our results and to evaluate the usefulness of the technique.
Highlights
We present a case of long-term evolution of a submandibular pleomorphic adenoma
These findings revealed that deep tumor compartments may be involved in the initial stages of malignant transformation
Pleomorphic adenomas (PAs) are the most common benign tumors arising in salivary glands and their malignant transformation to carcinoma ex pleomorphic adenomas (CXPAs) accounts for between 4.5% and 15% of all cancers of these glands [1]
Summary
There is little information in the literature regarding topographic malignant transformation patterns of PA. This study revealed that deep tumor compartments may be involved in the initial stages of malignant transformation. The authors of the present study suggest that deep areas in long-term evolution PAs should be carefully assessed by serial sectioning to document evidence of malignancy. Consent Written informed consent was obtained from the patient for publication of this case report and any accompanying images. Author details 1Department of Oral and Maxillofacial Surgery. Doi:10.1186/1752-1947-5-541 Cite this article as: Gallego et al.: DNA aneuploidy as a topographic malignant transformation pattern in a pleomorphic adenoma of longterm evolution: a case report.
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