Institutional protocol and retrospective analysis of 23 cases of palatal pleomorphic adenoma at a Nigerian tertiary hospital

Abstract

Background: Pleomorphic adenoma (PA) of the minor salivary gland is the most common benign tumour of the minor salivary glands as majority of the tumours of the minor salivary gland are malignant. The most common site of occurrence of PA of the minor salivary gland is the palate. The major challenges in the surgical management of these cases include management of associated primary haemorrhage and prevention of recurrence. This study documents the experiences gained from management of 23 cases at a Nigerian tertiary hospital. Methods: A retrospective review of patients who had surgical excision of histologically diagnosed PA of the palate was conducted amongst patients attending maxillofacial outpatient clinic over a 5-year period (January 2012–December 2016). The information retrieved from the patients' case files included the sociodemographics as well as clinical characteristics. The data were analysed using the Statistical package for the Social Sciences (SPSS) software version 15.0 (SPSS Inc., Chicago, IL, USA). Results: A total of 23 cases of PA were operated in 23 patients. Fourteen of these were female, while 9 were male, giving a gender ratio of 1:1.5 (m:f). Ages of the patients ranged from 19 to 51 years, with a mean age (standard deviation) at 33 (7.1) years. Clinical symptoms varied from painless asymptomatic palatal swelling to complaints of mild discomfort. The sizes of the lesions ranged from 2 cm to 10 cm in the widest diameter (mean 4.6 ± 3.2 cm). The duration of hospital stay ranged from 7 days to 14 days (mean 5 ± 4.1 days) which was counted from the date of admission to the date of discharge. Surgical treatment in all cases was excision with a margin of grossly intact tissue as well as overlying mucosa. Conclusion: PA of minor salivary glands of the palate can be complicated by an eventful primary haemorrhage and tumour recurrence. Ligation of related vasculature and complete surgical excision will guarantee cure and uneventful surgery.