Benign Mixed Tumor Research Articles

Mixed tumors of the canine mammary glands: Evaluation of prognostic factors, treatment, and overall survival

Mixed tumors are the most frequent mammary gland neoplasms in bitches; however, studies that thoroughly describe their clinicopathological data, treatment approaches, and the survival of bitches with mixed tumors are scarce. This study evaluated the epidemiological and clinicopathological data, prognostic factors, and therapeutic approaches for bitches with mixed tumors. In all, 162 benign mixed tumors, 682 carcinomas in mixed tumors, and 60 carcinosarcomas were included. Regarding tumor size, T3 lesions were predominantly associated with carcinosarcomas, while T1 and T2 lesions occurred more frequently in benign mixed tumors and in carcinomas in mixed tumors. Based on clinical staging, most bitches with benign mixed tumors presented with stage I tumors; 92% of bitches with carcinomas in mixed tumors presented with stage I–III tumors, while 8% presented with stage IV–V tumors; and 70% of bitches with carcinosarcomas presented with stage I–III tumors, while 30% presented with stage IV–V tumors. Surgery was curative for bitches with benign mixed tumors and for those with stage I–III carcinomas in mixed tumors. Combination therapy in bitches with carcinomas in mixed tumors (IV–V) and carcinosarcomas resulted in a higher overall survival compared with bitches who underwent surgery only. Carcinosarcomas presented higher relapse rates and distant metastases than carcinomas in mixed tumors did.

Carcinoma ex pleomorphic adenoma of the parotid gland with cardiac metastasis

Pleomorphic adenomas are the most common neoplasms of the major salivary glands. They are also known as benign mixed tumors because of the presence of both epithelial and mesenchymal elements. In parotid gland, approximately 65%-75% of tumors are pleomorphic adenomas. In parotid gland, usually it occur lateral to the plane of facial nerve. They present in middle aged patients as well defined, solitary, painless mass and are slow growing tumors. Few subset of tumors may undergo malignant transformation.Carcinoma ex pleomorphic adenoma is a rare and aggressive malignancy that arises from primary or recurrent pleomorphic adenoma. It occurs in 6% of all pleomorphic adenomas. Diagnosis of malignancy and treatment is largely based on pathologic and radiographic features. Distant metastases have been reported mainly in the lung. . We present an unusual case of 68 yrs female patient with carcinoma ex pleomorphic adenoma of the parotid gland with cardiac metastasis.

Relationship between the inflammatory tumor microenvironment and different histologic types of canine mammary tumors

Mammary neoplasms are the tumors with higher incidence in female dogs. Among the factors that contribute for the development of this and other neoplasms, the inflammatory tumor microenvironment plays a crucial role. Several studies reported important roles for lymphocytes, macrophages, plasma cells, neutrophils, eosinophils and mast cells in this context. In the present study, our aim was to evaluate the number of profile cells of inflammatory cells and area of tumor fibrosis and the relation of these features with canine mammary tumors of different histologic and clinical presentation (benign mixed tumor, carcinoma in mixed tumor, solid carcinoma and tubular carcinoma) Counting and staining of inflammatory cells and tumor fibrosis were performed through histochemistry, while counting and staining of CD4+, TCD8+ and FOXP3+ lymphocytes were performed through immunohistochemistry. Statistical analysis of the association between densities of inflammatory cells, tumor fibrosis and histologic types revealed significant difference for plasma cells (p = .035), neutrophils (p = .0113), macrophages (p = .0047), and tumor fibrosis (p = .05). The found data suggest associations between high number of neutrophils and aggressive mammary tumors, between high densities of plasma cells, macrophages and CD8+ cells and between low number of profile cells of CD4+ cells and less aggressive tumors. Larger areas of tumor fibrosis showed relation to more aggressive canine mammary tumors.

Neoplasms of the Palate : A Review

Background: The palate is defined as the roof of the mouth. It is alienated into soft palate which is essential for nasal passage protection and formation of speech sound and the bony hard palate which acts as a barrier between the mouth and the nasal cavity. A natural opening in the palate for nerves and blood vessels can create a passage for neoplasms to spread into the nasal cavity such as epidermoid carcinoma, adenocarcinoma and benign mixed tumors and rarely Melanoma, lymphosarcoma and Myosarcoma. Neoplasms of the palates results in significant masticatory, speech and swallowing disturbance and surgery remains the recommended treatment modality. However, provided the profound functional and cosmetic importance of the oral cavity, management of Palates cancers requires a thorough understanding of disease progression, approaches to management and options for reconstruction. Aim of the study: wasto review the different types of neoplasms of the Palates along with the etiology, diagnosis and with emphasis on the surgical intervention. Methods: electronic search of available Literature review in the scientific database of retrospective studies and systematic reviews investigating incidence, prevalence, etiology, symptoms, risk factors, diagnosis and surgical intervention of different types of oral cavity particularly palatal neoplasm from 1960 to 2017– (Medline, Embase, the Cochrane Library , NHS center websites as well as an individual Dentistry journals such as International Journal of Prosthodontics, International Journal of Periodontics and Restorative Dentistry. Search included English Publications which were obtained from both reprint requests and by searching the database. Conclusion: Cancer of the oral cavity is mostly trigger by smoking, alcohol abuse. The most common neoplasms of the hard palate are MSGTs and SCCs for the soft palate. Primary surgical resection with or without postoperative adjuvant therapy remains the upmost recommended treatment approach. It is also critical to have a Multidisciplinary treatment to help improve the oncologic and functional results in oral cancer patients.

Ameloblastic fibro-odontoma or complex adontoma: A diagnostic dilemma?

Ameloblastic fibro-odontoma is a rare benign mixed odontogenic tumor exhibiting the histologic characteristics of ameloblastic fibroma and complex odontoma. Clinically, it represents a well-defined asymptomatic swelling with deformity of face, and radiographically a well-defined radiolucent area, which contains radiopaque foci of various sizes and shapes. These features overlap with other lesions such as calcifying odontogenic cyst, calcifying epithelial odontogenic tumor, and adenomatoid odontogenic tumor which makes a diagnostic dilemma for oral clinicians. Hereby we report such a rare case in a 7-year-old boy.

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.

Consensus regarding the diagnosis, prognosis and treatment of canine mammary tumors: benign mixed tumors, carcinomas in mixed tumors and carcinosarcomas

Consensus regarding the diagnosis, prognosis and treatment of canine mammary tumors: benign mixed tumors, carcinomas in mixed tumors and carcinosarcomas

Paraspinal Metastasizing Pleomorphic Adenoma

Pleomorphic adenomas (benign mixed tumors) are the most common benign tumors arising in the salivary glands. Rarely, they can undergo malignant transformation (carcinoma ex pleomorphic adenoma) or metastasize via hematogenous or lymphatic spread. We describe a case of a 51-year-old male with a benign metastasizing pleomorphic adenoma of the vertebrae and epidural space of the lumbar spine who presented with lower back pain. He developed spinal metastases within 8 months of excision of his primary tumor, which arose in the right submandibular gland. Most recently, he went on to develop pulmonary metastases about a year after surgical excision of the spinal metastases. We review the literature on benign metastasizing mixed tumors which involve the spine.

Prognostic Significance of Canine Mammary Tumor Histologic Subtypes: An Observational Cohort Study of 229 Cases.

Histopathology is considered the gold standard diagnostic method for canine mammary tumors. In 2011, a new histologic classification for canine mammary tumors was proposed. The present study was a 2-year prospective study that validated the 2011 classification as an independent prognostic indicator with multivariate analysis in a population of 229 female dogs, identifying subtype-specific median survival times (MST) and local recurrence/distant metastasis rates. Dogs with benign tumors and carcinoma arising in benign mixed tumors all had an excellent prognosis. Dogs with complex carcinoma and simple tubular carcinoma also experienced prolonged survival. Those with simple tubulopapillary carcinoma, intraductal papillary carcinoma, and carcinoma and malignant myoepithelioma had a more than 10-fold higher risk of tumor-related death. The prognosis was even worse for adenosquamous carcinoma (MST = 18 months), comedocarcinoma (MST = 14 months), and solid carcinoma (MST = 8 months). The most unfavorable outcome was for anaplastic carcinoma (MST = 3 months) and carcinosarcoma (MST = 3 months), which also had the highest metastatic rates (89% and 100%, respectively). Adenosquamous carcinoma exhibited the highest local recurrence rate (50%). In the same canine population, the tumor diameter was recognized as a strong predictor of local recurrence/distant metastasis and an independent prognosticator of survival in the multivariate analysis. Excision margins were predictive only of local recurrence, whereas lymphatic invasion and histologic grade were predictive of local recurrence/distant metastasis and survival, although only in univariate analyses. In conclusion, this study validated the 2011 classification scheme and provided information to be used in the clinical setting and as the basis for future prognostic studies.

Prevalence and Histopathologic Analyses of Mammary Tumors in Female Dogs in the Northeast of Algeria

Cancers development and complications are a major cause of death in dogs all over the world. The current study attempts to describe the prevalence and anatomo-pathologic traits of mammary gland tumors (MGTs) in bitches in northeast Algeria. From November 2013 to April 2016, a total of 215 bitches originating from four provinces (Constantine, Oum El Bouaghi, Annaba and Skikda) were enrolled. The overall prevalence of MGTs was 19.53%. It was higher in littoral provinces (27.22%) than in inland ones (15.33%). A high rate was documented in Caniche (43.75%) as compared to Cross-breed (16.17%) and German shepherd (14.78%) bitches. The mean age of positively diagnosed animals was 9±0.3 years and the mean size of tumors was 5.4±04 cm. Histopathological classification revealed that 40.47% tumors were benign (mainly benign mixed tumors and benign complex tumors), 30.95% were malignant (especially epidermoid carcinoma, mammary sarcoma and malignant complex tumors) and 28.57% were identified as dysplasia (Mostly Osteo-mammary, benign hyperplasia and fibrocystic mastopathy). Finally, more epidemiological investigations are needed to determine the risk factors that may be implicated in the initiation and evolution of these health problems.

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.

Pleomorphic adenoma of palpebral part of lacrimal gland: A rare case report

The aim of this study is to report a case of pleomorphic adenoma of palpebral part of lacrimal gland. A 38-year-old female was admitted with the complaints of swelling in the left upper eyelid which was gradual in onset and progressive in nature for 4 years. A firm nodular mass was seen protruding from left superior temporal region of orbit causing mild ptosis. Blood examination showed raised erythrocyte sedimentation rate. Ultrasound was typically hypoechoic well-capsulated mass. Under general anesthesia, the tumor was totally excised with anterolateral orbitotomy. Histopathological examination revealed a pleomorphic adenoma of the lacrimal gland with no evidence of malignancy. Postoperatively, mild ptosis was present and the patient was advised to use lubricating eye drops. Follow-up showed no recurrence. Pleomorphic adenoma (benign mixed tumor) of the lacrimal gland accounts for approximately 12–25% of all lacrimal tumors. Among these, 90% are orbital and only 10% are palpebral part of lacrimal gland tumor. It should be excised completely with a margin of normal tissue as incomplete resection may lead to recurrence. Incisional biopsy is believed to increase the risk of recurrence due to disruption of the pseudocapsule and tumor spillage.

Comparative diagnosis of canine mammary tumours by cytology and histopathology

The aim of the present study was to correlate cytological diagnosis after pre-operative fine needle aspiration biopsies from canine mammary tumours with that of histopathological findings. In prospective study, 40 fine-needle aspirate samples were obtained from 40 different cases, out of that, 15 cases were diagnosed mammary gland tumours. Histopathology results included four cystic papillary adenoma, three benign mixed mammary tumours, two each of papillary adenocarcinoma, solid adenocarcinoma, and mammary gland adenoma, and one each of benign mammary myoepithelioma and malignant myoepithelioma. The neoplastic cells in smears were round to caudate, exhibiting anisocytosis, spherical to oval nuclei, anisokaryosis, abnormal nuclear/nucleolar shapes, anisonucleoli, abnormal chromatin pattern, multinucleation and mitotic figures. In case of benign category cells were uniform and in large clusters, having clear cytoplasmic boundaries. On comparing results of cytological diagnosis with the histopathology revealed that 86.66% (13/15) cases of benign and malignant tumours had positive correlation.

Uterine adenofibroma: An unsual cause of nonpuerperal uterine inversion in postmenopausal female

Uterine adenofibroma is an extremely rare benign mixed mullerian tumor, most often presenting as vaginal mass with pain and abnormal uterine bleeding in postmenopausal females. Nonpuerperal uterine inversion is also an uncommon entity. We present a rare case of nonpuerperal uterine inversion due to a uterine adenofibroma. A 56-year-old postmenopausal female presented to us with bleeding and discharge per vaginum. Examination showed a polyp. Due to associated comorbidities, polypectomy was chosen as management modality failing which laparotomy was done, and the uterus was found to be inverted through the cervix, hysterectomy was done. Histopathological evaluation showed uterine adenofibroma. This is the first case of inversion reported due to uterine adenofibroma.

Pleomorphic Adenoma of Breast, Unusual in its Location

Aim: Pleomorphic adenoma (PA) is a common benign mixed tumor of salivary gland. It rarely involves the breast and due to limited yield of tissue samples on fine needle aspiration and core biopsies, it poses a diagnostic difficulty to the pathologist. Case Report: Here we report a rare case, with clinical suspicion of malignancy of breast in 60 year old lady, which was diagnosed as pleomorphic adenoma on histopathology. Discussion: PA is grossly well circumscribed and on microscopy shows both epithelial and myoepithelial cells embedded in chondromyxoid stroma. With adequate sampling, it is not difficult to diagnose this rare entity of breast on histopathology. Conclusion: As PA mimicks malignancy, it is important to identify this benign entity in breast and prevent radical mastectomy surgery in these patients.

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.

The clinicopathological characteristics of non-specific variant of dysembryoplastic neuroepithelial tumor

Background Dysembryoplastic neuroepithelial tumor (DNT) is a benign neuronal and mixed neuronal-glial tumor (WHOⅠ) and may present 3 histological subtypes: simple, complex and non-specfic. Non-specific DNT is very difficult to be diagnosed because of the lack of specific glioneuronal element. Herein we describe one case of non-specific DNT in frontal lobe. The radiological and clinicopathological features of this lesion, as well as its diagnosis and differential diagnosis are discussed. Methods The clinical data of one patient with non-specific DNT was presented retrospectively. Gross totally resected mass was routinely paraffin embedded and stained with hematoxylin and eosin. Immunohistochemical staining was used to detect antigen expression. 1p/19q co-deletion was also detected by fluorescence in situ hybridization (FISH) utilizing Vysis dual-color probe. Results A 16-year-old boy presented with recurrent headache and dizziness. He had a history of at least two complex seizures over the previous 3 years. MRI revealed a small, well-demarcated cystic lesion within the cortex of right frontal lobe with hypointense on T 1 WI and hyperintense on T 2 WI. There was no obvious peritumoral edema or enhancement. The tumor was removed totally. The histological sections revealed cystic area with neuroglial nodule attached on the cyst wall. The nodule was mainly composed of oligodendrocytic-like components and scattered neuronal cells. Typical specific glioneuronal element was not seen. Microcolumnar arrangement was found in the adjacent cortex of lesion, which conformed with the histological features of focal cortical dysplasia (FCD) typeⅠ a. Immunohistochemically, the oligodendrocytic-like component was diffusely positive for synaptophysin (Syn) in cytoplasm and oligodendrocytes transcription factor-2 (Olig-2) in nuclei, focally positive for CD34, S-100 protein (S-100) and BRAF V600E in cytoplasm. However, there was no positive signal found for detection of glial fibrillary acidic protein (GFAP) and isocitrate dehydrogenase 1 (IDH1) R132H. Ki-67 labeling index was 2%. FISH showed that there was no 1p/19q co-deletion. Based on clinical presentation and histological findings, a final diagnosis of non-specific variant of DNT, WHO Ⅰ, accompanied by FCD Ⅲ b, was made. Accessory treatment was not given postsurgically. The patient was regularly followed-up for one year. Head MRI was reexamined 3 and 6 months after operation. No recurrence or seizure occurred. Conclusions In clinical practice, non-specific variant of DNT is diagnostic challenging and may be confused with other low-grade gliomas even if there are typical clinical manifestations and radiological appearance of DNT exhibited in lesion. The accurate diagnosis of this tumor is obtained from carefully histological inspection and a panel of immunohistochemical and molecular study for CD34, IDH1 R132H, BRAF V600E and 1p/19q co-deletion. DOI: 10.3969/j.issn.1672-6731.2016.12.008

Longitudinal Claudin Gene Expression Analyses in Canine Mammary Tissues and Thereof Derived Primary Cultures and Cell Lines.

Human and canine mammary tumours show partial claudin expression deregulations. Further, claudins have been used for directed therapeutic approaches. However, the development of claudin targeting approaches requires stable claudin expressing cell lines. This study reports the establishment and characterisation of canine mammary tissue derived cell lines, analysing longitudinally the claudin-1, -3, -4 and -7 expressions in original tissue samples, primary cultures and developed cell lines. Primary cultures were derived from 17 canine mammary tissues: healthy, lobular hyperplasia, simple adenoma, complex adenoma, simple tubular carcinoma, complex carcinoma, carcinoma arising in a benign mixed tumour and benign mixed tissue. Cultivation was performed, if possible, until passage 30. Claudin mRNA and protein expressions were analysed by PCR, QuantiGene Plex Assay, immunocytochemistry and immunofluorescence. Further, cytokeratin expression was analysed immunocytochemically. Cultivation resulted in 11 established cell lines, eight showing epithelial character. In five of the early passages the claudin expressions decreased compared to the original tissues. In general, claudin expressions were diminished during cultivation. Three cell lines kept longitudinally claudin, as well as epithelial marker expressions, representing valuable tools for the development of claudin targeted anti-tumour therapies.

About a Long Lasting Primary Pleomorphic Adenoma of the Lung with a Misleading Pattern

Background: Pleomorphic adenoma is a benign mixed tumor of salivary gland type. It has been rarely reported in the lung. Our aim is to report a rare case of primary pleomorphic adenoma of the lung with a misleading pattern and to perform a mini-review of the literature. Materials and Methods: We report a case of pleomorphic adenoma in a 12-yearold child with a mini-review of the literature in the site pubmed using the keywords: pleomorphic adenoma AND lung. Results: Our patient presented chest pain and fever. His past medical history was characterized by recurrent pneumonia. This case is interesting because it highlights a potential consequence of PA of the lung, which is bronchial dilatation. Besides, it puts emphasis on the diversity of the architectural patterns like acinar feature which was reported in our observation and which can be confusing. Keywords: Pleomorphic adenoma, lung, pathology, surgery.

Naso-Glabello-Frontal Advancement Reconstruction for Chondroid Syringoma of the Nasal Tip

OBJECTIVE: To present a naso-glabello-frontal advancement modification of the dorsal advancement (Rintala) flap for reconstruction of an unusual case of chondroid syringoma occurring at the nasal tip.
 METHODS:
 Design: Case report
 Setting: Tertiary Government Training hospital
 Patient: One
 RESULTS: A 23-year-old man who presented with a nasal tip mass initially diagnosed as a benign adnexal tumor underwent excision and reconstruction with a naso-glabello-frontal advancement flap modification of the dorsal advancement flap with median brow lift. The procedure resulted in nasal tip reconstruction with minimal scars, including a horizontal upper medial brow margin scar that eventually became less apparent. Final histopathology revealed a rare benign mixed tumor, chondroid syringoma.
 
 CONCLUSION: The naso-glabello-frontal advancement flap is a one-stage procedure that can be used to reconstruct such a cutaneous nasal defect after tumor excision. The modification observes nasal aesthetic subunits and may have a better aesthetic outcome than traditional rotational flaps or advancement flaps.
 
 Keywords: rhinoplasty, surgical flaps, sweat gland neoplasm