Abstract
ABSTRACT Clinical case description of a papillary mucinous cystadenocarcinoma, extremely rare malignant tumor in the salivary gland and difficult to diagnose, in geriatric patient. Patient with 86 years old was referred for treatment with nodular lesion on the inner side of left lower lip extending to the bucal mucosa, without any clinical appearances of malignancy. The lesion was asymptomatic, had flabby consistency and slow growth. Despite the favorable clinical features, after surgical removal, was diagnosed as papillary mucinous papillary mucinous cystadenocarcinoma. Nonetheless, the cellular atypia found was considered to be mild and immunohistochemical evaluation the reaction to Ki-67 was low, indicating a low rate of proliferation of the tumor. Medical evaluation confirmed the absence of systemic disorders or distant metastases. Although it is a malignant lesion, due to low degree of proliferation of lesion and the careful follow-up carried out, there was a favorable evolution after conservative treatment in a follow-up period of 11 years and six months.
Highlights
In turn, comprises an extremely rare lesion, accounting for 0.5% of all epithelial lesions affecting the salivary glands[2] and according to the second largest survey on cystadenocarcinomas described in the literature, the highest prevalence is observed in the major salivary glands[3]
Minor salivary gland tumors are distributed in the upper aerodigestive tract, palate, paranasal sinuses, nasal cavity, tongue, gums, pharynx, larynx and trachea[6] and comprise several subtypes[5]
The lesion site in this case report complies with the findings of Foss et al.[3], who observed that most cystadenocarcinomas afflicting minor salivary glands (35%), affected the lips, followed by buccal mucosa, palate and tongue
Summary
Malignant tumors of the salivary glands are rare, comprising from 1 to 6% of all head and neck tumors and the parotid is most commonly affected, accounting for 70% of the lesions[1]. The presence of painful symptoms is more common in cases of lesions with malignant characteristic, but asymptomatic malignant tumors of minor salivary glands are not uncommon either[7]. Cystadenocarcinoma stands out due to its rarity in the salivary gland with only a large series of 57 cases described in the literature[3].
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