Adenoma Of Salivary Gland Research Articles

Pleomorphic adenoma of the soft palate: A case report with literature review

Pleomorphic adenoma is a benign mixed salivary gland tumor and consists of a combination of epithelial and mesenchymal elements. The parotid and other major salivary glands are the common locations for it. Pleomorphic adenoma less frequently originates from minor salivary glands with a malignant potential in most of the cases. The present case is a pleomorphic adenoma of the minor salivary gland of soft palate in a 72-year-old male, and the tumor is large, well circumscribed, firm but still benign in nature and needs reporting.

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

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.

Pleomorphic Adenoma of Salivary Glands:

Pleomorphic Adenoma of Salivary Glands:

SYNCHRONOUS POLYMORPHOUS LOW-GRADE ADENOCARCINOMA AND CANALICULAR ADENOMA ON THE UPPER LIP: AN UNUSUAL PRESENTATION

Multiple salivary gland tumors (MSGTs) can be classified by topographic distribution (unilateral or bilateral) and chronologic appearance (synchronous or metachronous). Oral presentation of these tumors is rare, and have been reported as either benign or malignant. To our knowledge, synchronous occurrence of adenoma and adenocarcinoma of minor salivary glands has not been reported in the literature. Herein we present a case of synchronous polymorphous low-grade adenocarcinoma (PLGA) and multifocal canalicular adenoma (CA) affecting a 61-year-old female patient who exhibited, in the oral examination, 9 discrete firm to fluctuant submucosal nodules (ranging from 0.2 to 0.8 cm in diameter) on the upper lip, with a 12-month evolution. The histopathologic analysis showed focal area containing PLGA and multiple CAs. After 1 year of follow-up, no recurrence was observed. After review of the English-language literature and different from our case, only 11 intraoral MSGTs (either benign or malignant) have been identified to date.

Pleomorphic adenoma in the cheek a rare finding

Pleomorphic adenoma, also known as the benign mixed tumor is the most common tumor of salivary gland origin, accounting for about 60% of all salivary tumors. Up to 80% of tumors which occur in the parotid gland only, 10% in the submandibular glands, and the rest in the minor salivary glands. The pleomorphic adenoma comprises of the majority of both major and minor salivary gland tumors accounting for 3%–10% of neoplasms of head and neck region. The most common sites of pleomorphic adenoma of the minor salivary glands are the palate, followed by lips and then cheeks. These minor salivary gland pleomorphic adenomas require diagnosis based on clinical features and incisional biopsy should be avoided. These are managed by wide surgical excision. The recurrence of this tumor is a well-known factor, and inadequate initial surgical procedure is the most common cause of recurrence. Carcinoma arising from pleomorphic adenoma accounts for about 3% of salivary tumors. We are reporting a case of pleomorphic adenoma of minor salivary glands around the upper right buccal vestibule in a 36-year-old female.

Newly described salivary gland tumors

This review concentrates on three salivary gland tumors that have been accepted in the recent literature as new neoplastic entities: mammary analog secretory carcinoma (MASC), sclerosing polycystic adenoma (SPA) and cribriform adenocarcinoma of tongue and other minor salivary glands (CAMSGs). MASC is a distinctive low-grade malignant salivary cancer that harbors a characteristic chromosomal translocation, t(12;15) (p13;q25) resulting in an ETV6–NTRK3 fusion. SPA is a rare lesion often mistaken histologically for low-grade salivary carcinoma. Previously thought to be a reactive fibroinflammatory process, but recent evidence of clonality, recurrences in up 30%, and dysplastic foci suggest it may be truly neoplastic. CAMSG is a distinct tumor entity that differs from polymorphous low-grade adenocarcinoma (PLGA) by location (ie, most often arising on the tongue), by prominent nuclear clearing, alterations of the PRKD gene family and clinical behavior with frequent metastases at the time of presentation of the primary tumor. Early metastatic disease seen in most cases of CAMSG associated with indolent behavior makes it a unique neoplasm among all low-grade salivary gland tumors. Salivary glands may give rise to a wide spectrum of different tumors. They are often diagnostically challenging as morphological features often overlap between different entities. Although conventional morphology in combination with immunohistochemical findings still provide the most important clues for diagnosis, recent advances in molecular pathology offer new diagnostic tools in investigating the differential diagnosis, as well as providing potentially valuable prognostic indicators. In the last two decades, several new salivary gland tumor entities have been described, namely MASC, SPA and CAMSGs.

Carcinoma ex-pleomorphic adenoma of submandibular salivary gland: A case report and review of literature

Pleomorphic adenoma (PA) is the most common benign neoplasm affecting the major salivary glands. It is more common in parotid gland and sometimes occurs in submandibular and other minor salivary glands. Carcinoma ex-pleomorphic adenoma (CXPA) is the malignant transformation of a primary or recurrent PA. Here, we report a case of CXPA of submandibular salivary gland with metastasis in the cervical lymph nodes. He was treated with excision of the mass with radical neck dissection, followed by adjuvant radiotherapy.

Buccal Monomorphic Adenoma: a case report

Background: Minor salivary gland benign tumors constitute a very small fraction of salivary gland tumors. The majority of monomorphic adenomas arise from the main salivary glands but rarely these can arise from the minor salivary glands of the buccal mucosa. Case presentation: We present 60-years old female who reported for the slow growing swelling on her right cheek for over three years. She was diagnosed of having monomorphic adenoma of the minor salivary gland after ultrasound (US), contrast enhanced computerized tomography (CECT) and magnetic resonance imaging (MRI) studies with additional confirmation by fine needle aspiration cytology (FNAC). Conclusion: Dynamic contrast MRI played a key role in assessment of the mass for its benign nature before the surgical contemplation. This was also confirmed subsequently by the histopathology examination.

An unusual presentation of mixed tumor of salivary gland

Pleomorphic adenoma is one of the salivary gland tumors affecting both major and minor salivary glands. Parotid gland is the most commonly affected of the major group, and hard palate is the most common site of the minor salivary glands affected. Pleomorphic adenoma is a benign mixed tumor of the salivary glands that has elements of both epithelial and mesenchymal tissues. We report a case of pleomorphic adenoma of minor salivary glands in the soft palate. Incisional biopsy revealed features of pleomorphic adenoma.

Diffusion-weighted MRI for differentiation between sialadenitis and pleomorphic adenoma.

The aim of this study was to compare apparent diffusion coefficient (ADC) values from diffusion-weighted MRI (DWI) among normal salivary glands, cases with sialadenitis and cases with pleomorphic adenoma of major salivary glands. 22 patients (totalling 44 major salivary glands) diagnosed with either unilateral sialadenitis (on either parotid or submandibular gland) or parotid gland pleomorphic adenoma were selected. Contralateral non-affected glands (normal) were also analyzed. DW images were achieved using a spin-echo pulse sequence with a 1.5-T MRI device. Mean ADC values were compared among the three groups analyzed (contralateral normal glands, sialadenitis and pleomorphic adenoma). The mean ADC values were significantly higher in cases of parotid sialadenitis (p = 0.001), but not in cases of submandibular sialadenitis (p = 0.466), as compared with the contralateral non-affected glands. Cases of pleomorphic adenoma presented the highest ADC values of the study. In addition, one-way ANOVA test revealed a significant difference among the three groups of parotid glands analyzed. Within the limitations of this study, the present results suggest that DWI allows for differentiation between parotid sialadenitis and pleomorphic adenoma.

Pleomorphic adenoma and adenoid cystic carcinoma of salivary glands: E-cadherin immunoexpression and analysis of the CDH1 -160C/A polymorphism

ObjectiveDespite their similar cellular origin, pleomorphic adenomas (PA) and adenoid cystic carcinomas (ACC) present distinct behaviors. This study aimed to analyze the immunoexpression of E-cadherin in PA and ACC of salivary glands, and to investigate differences in its expression in relation to E-cadherin gene (CDH1) -160C/A polymorphism. DesignTwenty-four PA (15 cell-rich and 9 cell-poor tumors) and 24 ACC (10 tubular, 8 cribriform and 6 solid tumors) were selected for the analysis of pattern of distribution, and cellular localization of E-cadherin. In addition, E-cadherin expression was evaluated using the H-score scoring system. The CDH1 -160C/A polymorphism was investigated by PCR-RFLP. ResultsNo significant differences in pattern of distribution (p=0.181) and cellular localization (p=0.192) of E-cadherin were observed between PA and ACC. Comparison of PA and ACC cases revealed a higher median H-score in the latter (p=0.036). Cell-rich PA presented a higher H-score than cell-poor tumors (p=0.013), whereas no significant differences in E-cadherin expression were observed between ACC subtypes (p=0.254). The heterozygous genotype of the CDH1 -160C/A polymorphism was detected in only one PA and one ACC. H-scores for tumors carrying the polymorphism were below the lower quartile of their respective groups. ConclusionsThe results suggest that E-cadherin expression in PA and ACC is mainly related to cellular composition (epithelial cells versus myoepithelial cells) and degree of differentiation of myoepithelial cells in these tumors. The CDH1 -160C/A polymorphism does not seem to significantly influence the expression of E-cadherin in PA and ACC of salivary glands.

Плеоморфна аденома піднижньощелепної слинної залози у мешканців Тернопільської області

<p>Frequency and gender features of pleomorfna adenoma of submandibular salivary gland among residents of Ternopil region for the period 2010 to 2014 were studied. Pleomorfna adenoma was found in <br /> 40 % of all detected tumors of submandibular salivary gland and occurs equally in both sexes.</p>

True Malignant Mixed Tumor of Submandibular Salivary Gland – A Case Report

Malignant mixed tumors of salivary gland are extremely rare tumors defined by the presence of malignant epithelial and mesenchymal components together. We report here a case of carcinosarcoma arising from a recurrent pleomorphic adenoma of submandibular salivary gland in a 36 year old woman. Histology showed a monomorphic picture dominated by malignant mesenchymal component with mixed nature proven by immuno histochemical analysis. We reviewed literature and discuss the theories on tumurogeneis, role of immunohistochemistry in diagnosis and clinicopathological features of this rare entity. Keywords: Carcinosarcoma, Immunohistochemistry (IHC), Malignant mixed tumors, Submandibular salivary gland

Primary Pleomorphic Adenoma of Minor Salivary Gland in the Parapharyngeal Space

ABSTRACTParapharyngeal space (PPS) lesions account for only 0.5% head and neck tumors and the majority of the minor salivary gland tumors are malignant. We report a case of pleomorphic adenoma of minor salivary gland in PPS as this is of a very rare occurrence. High index of suspicion and an adequate clearance of the tumor with a cuff of surrounding dispensable normal tissues are the key to successful treatment of such tumors.How to cite this articleRay CS, Joshi A. Primary Pleomorphic Adenoma of Minor Salivary Gland in the Parapharyngeal Space. Int J Otorhinolaryngol Clin 2016;8(3):125-127.

Giant pleomorphic adenoma of major salivary glands: A review of ten cases

Background: Pleomorphic adenoma (PA) of the major salivary glands has been documented to occur in various sizes ranging from 1 cm to 10 cm in their widest diameter; however, they can assume a grotesque proportion as a consequence of uninhibited growth in cases with delayed presentation. Patients and Methods: A retrospective study of all patients with PA of the major salivary glands with sizes >10 cm in its widest dimension and seen over a 10-year period was undertaken by retrieving sociodemographic and clinical data from patients’ case files from the Oral and Maxillofacial Unit of a Nigerian Teaching Hospital. Results: Case files of ten patients (4 males and 6 females) were reviewed over the study period. The ages ranged from 14 to 61 years, mean 33.8 ± 17.97 years. Equal distribution of five cases of PA was noted in the parotid and submandibular glands, respectively. The onset of symptoms ranged from 3 to 20 years and the largest tumor was 27 cm in its largest diameter. Only one case of malignant PA was recorded. Conclusion: Prevalence of giant PA from the study was found to be 13.5%, with a greater occurrence in the female (60%) patients compared to the male (40%) patients and with an equal distribution in both parotid and submandibular glands. PA of major salivary glands can assume a grotesque proportion when timely surgical intervention is not sought. Complete surgical excision in benign lesions can guarantee a cure and restore self-esteem.

Carcinoma Ex Pleomorphic Adenoma in a Minor Salivary Gland of the Hard Palate: Report of a Case

Carcinoma Ex Pleomorphic Adenoma in a Minor Salivary Gland of the Hard Palate: Report of a Case

Canalicular adenoma of the minor salivary gland in the upper lip

Canalicular adenoma is a rare benign tumor of the minor salivary glands that is the most prevalent in older adults (mean age, 60 years). The upper lip is the most commonly affected site, followed by the buccal mucosa and palate. It presents as a nodular lesion without a tendency for recurrence. Here, we describe a case of canalicular adenoma presenting as a nodular, painful mass in the upper lip of a 62-year-old man with a history of trauma. Fine needle aspiration biopsy yielded inconclusive results but excluded malignancy. The lesion was enucleated, and a definitive diagnosis of canalicular adenoma was established by histological and immunohistochemical analyses. No signs of recurrence were noted at the 8-month follow-up examination. The case emphasizes the importance of differential diagnosis of nodular lesions in the oral mucosa for appropriate treatment and histological analysis for definitive diagnosis.

Myoepithelial Carcinoma Arising In Pleomorphic Adenoma of Palatal MinorSalivary Gland: Report of a Rare Case

Salivary gland neoplasms composed exclusively or predominantly of myoepithelial cells are relatively uncommon and constitute 1 % of all salivary gland tumours. Most of them behave in a benign fashion and are designated as myoepithelioma. The malignant counterpart is known as myoepithellial carcinoma or malignant myoepithelioma, which is quite rare. This report presents about a rare case of a 45 year old female who had a painless swelling in the left posterior palatal region since childhood with a sudden increase in size since 2 months. Pre-operative biopsy failed to reveal any malignant changes. The mass was surgically excised and thorough evaluation revealed a myoepithelial carcinoma arising in pleomorphic adenoma of palatal minor salivary gland.

Ki-67 Index in Salivary Gland Neoplasms

Abstract Assessment of proliferation is a means of predicting local recurrence and metastatic potential of malignancies. A mitotic count is not an ideal marker for proliferation in certain situations, such as salivary gland neoplasms. Ki-67 expression as a proliferation marker has been investigated in many human tumors. In the present study, Mitotic index (MI) and Ki-67 index were studied in pleomorphic adenoma, basal cell adenoma, mucoepidermoid carcinoma, adenoid cystic carcinoma epithelial myoepithelial carcinoma, carcinoma ex Pleomorphic adenoma and adenocarcinoma of salivary glands. The results were compared. The MI was similar in benign neoplasms, mucoepidermoid carcinoma and epithelial myoepithelial carcinoma, whereas it was high in carcinoma ex pleomorphic adenoma, adenocarcinoma and adenoid cystic carcinoma. The Ki-67 index was different in basal cell adenoma and pleomorphic adenoma. It was helpful in differentiating high grade and low grade mucoepidermoid carcinoma. It highlighted the malignant behavior of epithelial myoepithelial carcinoma. It was concluded that Ki-67 in benign neoplasms is 5% or less and in malignant ones more than 23% with a few exceptions. In mucoepidermoid carcinoma and epithelial myoepithelial carcinoma, Ki-67 index was found to be a better indicator for aggressiveness. These findings will be presented in this paper, with review of literature. How to cite this article Kaza S, Rao TJM, Mikkilineni A, Ratnam GV, Rao DR. Ki-67 Index in Salivary Gland Neoplasms. Int J Phonosurg Laryngol 2016;6(1):1-7.

Salivary Gland Fine-Needle Aspiration Cytology: A Single Institution Experience

Introduction 208 FNA cytology diagnoses between 2008-2014 Materials and Methods • Computer search was used to identify salivary gland FNA performed in the 2008-2014 period. • Cytologic diagnostic categories for the analysis were malignant neoplasm, suspicious for malignancy, benign neoplasm, neoplasm NOS, non-neoplastic, atypical cells and nondiagnostic. • Cyto-histologic correlation was performed on patients who underwent surgical excision post FNA. Conclusion • Salivary gland FNAC is a valuable tool for distinguishing between benign and malignant neoplasms, and between neoplastic and nonneoplastic lesions. Introduction: Fine needle aspiration cytology (FNAC) is considered an important tool in the diagnosis of salivary gland lesions. However, the great variety and overlapping features of salivary gland tumors can make a precise diagnosis difficult. At our institution, FNAs are performed from salivary gland lesions to discriminate between neoplastic and non-neoplastic lesions and to guide clinical management. This study reviews FNAC of salivary gland lesions performed at our institution during the past 7 years. Materials and Methods: Computer search was used to identify salivary gland FNA performed in the 2008-2014 period. Palpable lesion FNAs were performed by cytopathologists and deep-seated lesions by radiologists with cytopathologistperformed onsite evaluation in most cases. Cytologic diagnostic categories for the analysis were malignant, suspicious for malignancy, benign neoplasm, neoplasm NOS, non-neoplastic, atypical cells and nondiagnostic lesions. Cyto-histologic correlation was performed on patients who underwent surgical excision post FNA. Results: 208 salivary gland FNAs were reviewed. FNAC diagnoses included 79 benign neoplasms, 21 malignant, 9 suspicious for malignancy, 16 neoplasms NOS, 74 non-neoplastic, 4 atypical and 5 nondiagnostic lesions. Eighty-five (41%) of 208 FNAs had histological correlation; 43/44 (97.7%) benign neoplasms, 8/9 (89%) malignant and 6/8 (75%) non-neoplastic lesions were correctly categorized. Concordant histologic subtype was found in 39/43 (90.7%) benign and in 5/8 (62.5%) malignant neoplasms. There was one false positive: 1 atypical pleomorphic adenoma (PA) diagnosed as metastatic carcinoma favor prostate primary; and one false negative, a myoepithelial carcinoma ex-PA diagnosed as salivary gland adenoma. Conclusions: Salivary gland FNAC is a valuable tool for distinguishing between benign and malignant neoplasms, and between non-neoplastic and neoplastic lesions. FNAC is highly accurate for specific histologic subtype of benign neoplasms, and less for malignant. Molecular markers may help overcome diagnostic pitfalls of cytomorphology. • Fine needle aspiration cytology (FNAC) is considered an important tool in the diagnosis of salivary gland lesions. • However, the great variety and overlapping features of salivary gland tumors can make a precise diagnosis difficult. • At our institution, FNAs are performed from salivary gland lesions to discriminate between neoplastic and nonneoplastic lesions and to guide clinical management. • This study reviews FNAC of salivary gland lesions performed at our institution during the past 7 years. Diagnoses No. (%)