Pleomorphic Adenoma Of Palate Research Articles

Comprehensive perioperative and minimally invasive post-operative defect approach of massive palatal pleomorphic adenoma: Case series

Introduction and importanceExtensive Palatal post-operative defect management following excision of neoplasm is one of the most difficult challenges for oral and maxillofacial surgeons regarding its limited surgical access and visibility on narrow area, airway management difficulty during intubation, richness of maxillary vascular network resulting in enormous bleeding risk. Decision making regarding its surgical approach and impact on speech and mastication is important. This case series aim to describe comprehensive step by step perioperative and palatal defect management approach based on tumor pathological characteristic and anatomical perspective to achieve good surgical outcome. Cases presentationTwo cases of massive palatal pleomorphic adenoma were presented. Both of cases occurs in female patients. Lesions was crossing the midline, impair speech and causing discomfort. Preoperative diagnostic from CT scan and FNAB result was pleomorphic adenoma. Clinical discussionSurgery for both cases done with wide periosteal sacrificing excision, ostectomy and surgical obturator placement from intraoral approach under general anesthesia with nasal intubation. Eventually the wounds healed without wound dehiscence and fistula, no speech impairment and no sign of reccurency. ConclusionUnderstanding pathological characteristic of pleomorphic adenoma and basic anatomy of surrounding structure are important to formulate minimal invasive surgical and post-operative defect management planning and improve patient's quality of life.

“The correlation between histopathological pattern and surgical treatment for palatal pleomorphic adenoma. Can we choose a more conservative approach?”

Pleomorphic adenoma (PA) is the most prevalent benign salivary gland tumor. Although rare, among the minor salivary glands, palatal PA exhibits the highest incidence. Unlike other benign tumors, PA infiltrates the surrounding tissues, posing challenges for complete removal through conservative measures. Surgeons often resort to aggressive surgical procedures involving resection of adjacent tissue to ensure clear margins and prevent recurrence.This study aims to analyze diverse histological characteristics of palatal PA, seeking statistical correlations for early prediction of tumor aggressiveness. The goal is to facilitate the preservation of the periosteum during surgical resection and attain conservative surgical margins. A retrospective histopathological investigation encompassed 18 patients diagnosed with palatal PA who underwent surgical treatment at Hadassah Medical Centre, Jerusalem, Israel. Evaluated parameters included tumor size, pseudocapsule thickness, tumor-periosteum distance, and the presence of pseudopodia and satellite nodules indicating tumor penetration. Statistical significance was set at P < 0.05.Tumors of varying sizes, whether large or small, lack consistent features. Neither tumor size, pseudocapsule thickness, nor tumor-periosteum distance displayed correlations with tumor penetration features. Palatal PA exhibits varied histological attributes impacting surgical technique. The absence of correlations among these attributes impedes early prediction of tumor aggressiveness, casting doubt on periosteum preservation. The periosteum is sufficiently robust to contain the tumor and should be excised. There is no data to support either ostectomy or a through-and-through surgical resection as part of the treatment.

Pleomorphic Adenoma of Palate: A Case Report

INTRODUCTION Pleomorphic adenoma is one of the most common benign salivary gland tumor affecting the major salivary glands mainly parotid gland of approx. 80% but infrequently the minor salivary glands of palate of approx. 7%. Salivary gland tumors are rare accounting only 2–3% of tumors occurring in head and neck region. The majority of minor salivary gland tumors are malignant in nature. The most common sites for minor salivary gland where pleomorphic adenoma arises are the palates followed by lips and cheek. This case report presents a case of pleomorphic adenoma of minor salivary gland of palate treated successfully by wide surgical excision with 1 cm healthy margin with uninvolved anatomical barrier under general anesthesia.

Surgical management of a large palatal pleomorphic adenoma by intra oral route: a difficult case

Despite being the most common benign tumor of salivary glands, pleomorphic adenoma in hard palate is a rare site. Such tumors are a challenge to remove surgically. These tumors usually require an extensive resection with wide margins and removal of surrounding mucoperiosteum. There is also usually requirement of removal of a number of teeth or portion of maxilla, especially if the size is huge. The resulting disfigurement can be a problem for young females. We present a case of successful treatment of pleomorphic adenoma of the hard palate in a 15-year old female patient, which was achieved through an enbloc removal technique with clear margins, without the need for partial maxillectomy or bone removal. This approach played a pivotal role in preventing any potential disfigurement and preserving the aesthetic appearance of the patient. The personalized approach towards patient care was instrumental in tailoring the surgical strategy to meet the specific needs of the individual.

Pleomorphic Adenoma of Palate - Two Similar Case Report with Surgical Management

Pleomorphic Adenoma of Palate - Two Similar Case Report with Surgical Management

Recurrent soft palatal tumour: from pleomorphic adenoma to mucoepidermoid carcinoma

Cases of mucoepidermoid carcinoma (MEC) is common among major salivary gland neoplasms, however infrequent cases are reported for this growth over the palatal region. We presented a case of a 50-year-old gentleman whom presented with tumour over soft palate with 3 different histopathological reports. This gentleman had history of excision of right soft palatal mass on his first presentation which was reported as palatal pleomorphic adenoma, he however had tumour recurrence over the same site after 3 years whereby biopsy was read as squamous cell carcinoma. A wide local excision of the tumour was performed and final report was disclosed as mucoepidermoid carcinoma.

Pleomorphic adenoma in an immunocompromised patient

Salivary gland tumors are known for its rarity and almost 30%–40% occur in the minor salivary glands, out of which, pleomorphic adenoma (PA) is rated to be the most common benign salivary gland neoplasm. This term was first termed by Willis and is called so, because of the ability of the cells of this tumor to differentiate into epithelial cells and mesenchymal cells, which gives it an unusual histologic pattern. Literature reports most PAs to be associated with parotid salivary glands and palatal salivary glands, the latter being the most common intraoral site of origin. Interestingly, no case reports have been published of a palatal PA in an immunocompromised individual. We report a unique case of a PA arising on the hard palate of a 54-year-old male human immunodeficiency virus-acquired immunodeficiency syndrome patient.

175. Paediatric Pleomorphic Adenoma of the Palate: A Case Report and Literature Review

Pleomorphic adenomas are common benign salivary gland tumours with a predilection for major salivary glands. They usually present in females aged 40-60. Salivary gland tumours of the minor salivary glands in children are rare. This report presents a case of a palatal pleomorphic adenoma in a child to raise awareness of this unusual presentation.

Pleomorphic Adenoma of Palatal Minor Salivary Glands with Bone Infiltration: Case Report with Long-term Follow-up

Intraoral pleomorphic adenoma is a rare entity, with the most common site of appearance being the palate. As a benign lesion, it rarely involves underlying structures. The aim is to present a case of a palatal pleomorphic adenoma (cellular) with bone involvement, with reference to clinical and histological features of the tumour, emphasis on diagnostic and therapeutic management and comparison with the findings of similar studies in the literature. Pleomorphic adenomas of the palatal minor salivary glands remain a rather rare clinical condition, and it is unusual to infiltrate the adjacent palatal bone. A thorough clinical imaging and histological/cytological examination should always be performed to define the benign or malignant nature of the lesion, preoperatively.

구개부 다형선종 수술시 구개건막의 보존 4례

Pleomorphic adenoma is one of the most common benign neoplasm of salivary glands and resection with enough normal tissue margin is important treatment for preventing the local recurrence. For palate tumor involving both soft palate and hard palate, palatal fistula is easier to occur as post-operative complication after resection of the tumor. The palatine aponeurosis is important anatomical barrier between soft palate and nasal cavity, and we found that by using palatine aponeurosis as surgical plane, we can do R0 resection of the tumor with preventing the palatal fistula complication. Also, we used inguinal full thickness skin graft to protect the exposed palatine aponeurosis in some cases. We analyzed 4 cases of palate pleomorphic adenoma resection using palatine aponeurosis as surgical plane and those operations were done by single surgeon. All of 4 patients had no palatal fistula and also had no recurrence of the tumor during the post-operative course. (J Clinical Otolaryngol 2021;32:158-162)

Soft Palatal Pleomorphic Adenoma with Dystrophic Calcifications and Upper Airway Obstruction

Pleomorphic salivary adenoma (PSA) is a benign tumor composed of epithelial and mesenchymal elements. Approximately 10% of pleomorphic adenomas occur in the minor salivary glands, with the palate being the most common site. Mesenchymal elements in PSA are capable of giving rise to various components that are usually seen in the tumor. Still, the presence of calcifications either from degenerations or the mesenchymal elements is rare. We are reporting a case of giant pleomorphic adenoma of the soft palate with dystrophic calcification and significant upper aerodigestive obstruction in a 49-year-old Nigerian. Surgical excision was done under general anesthesia via oral route.

“Intrabony” palatal pleomorphic adenoma

Pleomorphic adenoma (PA) is the most common neoplasm of the large salivary glands. It derives its name from the architectural pleomorphism seen by light microscopy. It is also known as the mixed tumor salivary type, which describes its pleomorphic appearance as opposed to its dual origin from epithelial and myoepithelial elements. We present a case of an adult who presented with a palatal swelling, which computed tomography (CT) scan showed to be “intrabony” but after considering other planes of the CT scan It was finally considered to be an intrabony extension of the palatal PA. The mass was successfully removed and the residual palatal defect left to granulate. Following 2 years of patient follow-up, there was no recurrence but the presence of a oronasal defect about 1 cm in diameter in the palate.

Pleomorphic Adenoma of Palate – A Case Report and Review of Literature

10% of pleomorphic adenomas occur in the minor salivary glands with the palate being the most common site. Pleomorphic adenomas account for the majority of palatal tumours; however, minor salivary gland tumours have a higher risk of malignancy compared to tumours of the major salivary glands, so definite diagnostic evaluation should be executed. A case of 26-year-old man with a longstanding history of a soft palate pleomorphic adenoma which required excision under general anaesthetia We discuss the appropriate preoperative investigations, operative technique for surgical excision, histopathologic interpretation for this patient and brief review of literature for pleomorphic adenoma.

Análise volumétrica de adenoma pleomórfico palatino como aprimoramento diagnóstico e de plano de tratamento: relato de caso

O adenoma pleomórfico (AP) é o tumor benigno mais comum dentre as neoplasias das glândulas salivares. Softwares de reconstrução tridimensional oferecem ferramentas de caracterização da lesão, permitindo avaliar a morfologia da doença, analisar estruturas anatômicas isoladas, e elevar a acurácia do tratamento. O objetivo deste artigo é demonstrar como o uso da reconstrução tridimensional tem o potencial de contribuir para a elucidação da morfologia da doença, levando os profissionais da saúde à execução de um tratamento preciso e eficaz por meio de diagnóstico e planejamentos pré- operatórios virtuais. Apresenta-se um caso de um homem de 37 anos, portador de adenoma pleomófico palatino sem queixa álgica. Não apenas a morfologia da doença foi estudada, mas o volume da lesão foi calculado, medindo 2.304 mm3. O volume da doença atuou como um marcador que possibilitou avaliar a extensão da lesão e o comprometimento das regiões adjacentes.

Pleomorphic adenoma of palate: Two case reports and literature – A review

Pleomorphic adenoma of palate: Two case reports and literature – A review

MR Imaging Characteristics of Myoepithelial Carcinoma Ex Pleomorphic Adenoma of the Palate: Rare Case Report

: Carcinoma ex pleomorphic adenoma is an uncommon tumor of salivary gland; moreover, myoepithelial carcinoma of palate is exceedingly rare. This report documents a case of carcinoma ex pleomorphic adenoma arising in the hard palate. A 51-year-old woman presented with foreign body sensation without pain. Preoperative biopsy was performed and resulted in pleomorphic adenoma of the hard palate. MR imaging findings were well circumscribed, dome-shaped, lobulated mass with hyposignal intensity at peripheral fibrous capsule on T2WI. The mass showed internal cyst, hemorrhage, necrosis and heterogeneous enhancement. Because it showed both benign and malignant findings, the radiologic diagnosis was likely to be a malignant tumor of palate. Postoperative pathological analysis revealed invasive myoepithelial carcinoma ex pleomorphic adenoma.

Surgical Management of the Palatal Pleomorphic Adenoma.

Surgical excision is the basic treatment option of the palatal pleomorphic adenoma (PA), it is generally accepted to prevent for recurrence. The purpose of this study was to determine the decision criteria for the management of the palatal PA through evaluating the postoperative results of palatal PA correlation with the clinical appearance. All of patients were evaluated the mucosal ulceration, palatal erosion, and size with CT images in all 18 palatal PAs. The clinical features, surgical methods, and surgical results of these 18 PAs were reviewed. The most common age was 51 to 70 years. One patient was in pediatric age (14 years). Females were involved more commonly than males (F:M ratio was 5:1) Mucosa was normal in 16 patients. Ulcerations of the overlying mucosa were seen in 2 cases. On the coronal CT images, hard palate was erosion in 14 patients who had involved hard palate. The size of tumors was from 7 mm to 33 mm in CT scans. Two patients were ruptured the tumor during the operation, and 1 out of 2 patients was recurred. For the definitive diagnosis is necessary to perform the preoperative core biopsy for the histopathological examination, and CT is necessary for evaluating the erosion of the hard palate and severity of the erosion. Hard palatal PA can be managed by surgical enucleation and removal of the periosteum or involved bone. Soft palatal PA can be managed by surgical enucleation without mucosal resection. Rupture of the tumor is related to the recurrence.

Bogota Bag Inspired Technique for the Treatment of Palatal Pleomorphic Adenoma

Bogota Bag Inspired Technique for the Treatment of Palatal Pleomorphic Adenoma

Removal of a Massive Pleomorphic Adenoma on the Palate Using Subtotal Maxillectomy: A Report of a Rare Case and Literature Review

Pleomorphic adenoma is the most prevalent salivary tumor, 65% of which occur in major glands. This tumor varies in terms of size depending on the gland where it is located. The most common sites of the minor salivary glands are the palate, lips, cheeks, and throat. Palatal pleomorphic adenoma is laterally located, rarely crossing the midline. This tumor is painless with slow growth rate, which often appears in the fourth or fifth decade of life with female predominance. The tumor may enlarge with delayed treatment. This study aimed to present the case of a 51-year-old woman with an oversized mass on the palate (diameters: 8.5x5.5x2.5 cm), which extended from the anterior portion of the hard palate to the soft palate with a slow growth rate within 10 years. The case definition was accompanied by the determined surgical treatment.

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.