Pleomorphic Adenoma Of Submandibular Gland Research Articles

Giant Pleomorphic Adenoma of Submandibular Gland.

Pleomorphic adenoma is a benign tumor of salivary glands which is relatively rare among head & neck neoplasms. Parotid gland is the most common site of occurrence whereas submandibular gland is rarely affected. We present a case of a giant pleomorphic adenoma of submandibular gland.

Pleomorphic Adenoma of Submandibular Gland in a Pediatric Case.

Neoplasms of the salivary glands are relatively uncommon, with varied histologic subtypes. Only 5% of these occur in the pediatric age group. The submandibular gland tumors account for just 11.5% of pediatric salivary gland tumors. Few studies have reported the occurrence of pleomorphic adenoma arising in submandibular gland in a child. We describe a case of pleomorphic adenoma affecting submandibular gland in a girl aged eleven years and provide a brief review of current literature. Thorough diagnostic evaluation is required, considering the diverse differential diagnoses of pediatric submandibular masses. Although benign, recurrence and malignant transformation are pertinent concerns in pleomorphic adenoma, especially in a child, considering long life expectancy.

Carcinoma ex pleomorphic adenoma of the submandibular gland: A retrospective analysis of 86 patients.

To evaluate the prognostic and locoregional metastatic features of carcinoma ex pleomorphic adenoma of submandibular gland (SMG-CXPA) and improve the understanding of this uncommon condition. We retrospectively reviewed patients who were diagnosed with SMG-CXPA. The survival data of SMG-CXPA patients were statistically analyzed using Cox regression and Kaplan-Meier method. The associations between cervical metastasis and clinicopathological parameters were evaluated using chi-squared test. Additionally, two different histological categories (histological grade and invasiveness) and their combination were evaluated with the Kaplan-Meier method and receiver operating characteristic curves. In total, 86 patients were diagnosed: 38clinically node-negative, 31 pathologically node-negative, and 17 node-positive patients. Clinical tumor stage and histological grade were two independent prognostic factors for SMG-CXPA. There were significant correlations between sex, tumor size, clinical tumor stage, clinical lymph node stage, histological grade, invasiveness, malignant components, perineural invasion, and no specific criteria exist for the clinical outcome. SMG-CXPA is a high-grade malignancy with an unfavorable prognosis. Elective neck dissection should be performed in SMG-CXPA patients with a risk of locoregional metastasis. Histological grade seems to be a more valuable predictor of lymph node involvement than invasiveness.

Functional gland-preserving surgery for submandibular gland pleomorphic adenoma.

Conventional surgery for submandibular gland tumour is total excision of the gland affected by the tumour. Gland-preserving surgery is commonly used for benign tumours arising in the parotid gland but not in the submandibular gland. This study evaluated long-term oncological and functional outcomes after gland-preserving surgery in patients with pleomorphic adenoma of the submandibular gland via the submental approach. This longitudinal study included 105 consecutive patients with submandibular gland pleomorphic adenoma who underwent the gland-preserving surgery combined with the en-bloc resection of tumours via the submental approach. Salivary scintigraphy was performed 6months after surgery, and ultrasonography was regularly followed. Intraoperative findings, postoperative complications, cosmetic and salivary functions, and tumour recurrence were assessed in these patients. Median tumour size and submental incision length were 2.0 and 3.3cm, respectively. Median operation time and amount of blood loss were 25min and 18.5mL, respectively. None had marginal or lingual nerve paralysis and most patients were satisfied with incision scar and facial contour. The salivary function of the affected gland was equal to that of the unaffected gland. One patient (0.9%) had single nodular recurrence 54months after surgery and others had no recurrence for follow-up of median 96months. Pleomorphic adenoma of the submandibular gland can be safely removed by the gland-preserving surgery via the submental approach which has operation time, cosmetic and functional benefits with compromising oncological outcomes.

An Unusual Giant Pleomorphic Adenoma of Submandibular Salivary Gland: A Rare Case Report

ABSTRACT Pleomorphic adenoma is the most common benign tumor of salivary glands. Eighty percent of pleomorphic adenomas occur in the parotid gland, 10% in the submandibular gland, and 10% in minor salivary glands and sublingual glands. In this case report, we aim to present the unusually giant presentation of submandibular gland pleomorphic adenoma and its management of a 52-year-old female patient who presented to us with a swelling in the right submandibular region for the last 5 years. Fine needle aspiration cytology (FNAC) suggested salivary gland origin. Ultrasonography of the neck revealed a well-defined large lobulated heterogeneous echotexture lesion with few cystic areas within and showing internal vascularity in the right submandibular region. Computed tomography (CT) scan revealed a large lobulated heterogeneously enhancing mass of 15 cm × 13 cm in the right submandibular region. The patient underwent right submandibular gland mass excision under general anesthesia. The patient presented good aesthetic and functional results with no clinical and radiographic evidence of recurrence. Being painless and slowly growing, some patients neglect it to such large sizes especially if surgery was a psychological setback for them which can then lead to facial disfigurement and severe pressure symptoms which may be fatal. Giant pleomorphic adenoma of the submandibular gland is a rare finding and should be diagnosed cautiously. Proper treatment is complete surgical excision with removal of the fibrous capsule so as to prevent recurrence. How to cite this article: Prajapati BJ, Gupta S, Gupta DP, et al. An Unusual Giant Pleomorphic Adenoma of Submandibular Salivary Gland: A Rare Case Report. Int J Otorhinolaryngol Clin 2020;12(1):14–16.

Uncommon sites of pleomorphic adenoma in salivary glands: Series of 2 cases with review of literature

Salivary gland tumors compromises <3% of the head and neck tumors. Mixed tumor (pleomorphic adenoma) of the salivary gland is a benign tumor arising mainly in the major salivary glands (65%), especially in the parotid and, less frequently, in accessory salivary glands (35%). A small minority (8%) occurs in the oral cavity, neck and nasal cavity. Most common site for minor salivary gland pleomorphic adenoma is palate, though it can also occur in the upper lip, cheek, floor of the mouth, larynx and trachea. Here we report series of 2 cases of pleomorphic adenoma of submandibular gland and floor of mouth respectively. Both are less frequent sites for this pathology.

Paediatric pleomorphic adenoma of sub mandibular gland – a uncommon occurrence

Salivary glands tumours are rare, representing a wide variety of benign and malignant histologic subtypes, consisting of a group of heterogeneous lesions with complex clinico-pathological characteristics and distinct biological behaviours. Among salivary gland tumours incidence of pleomorphic adenoma in submandibular gland is 5-10% of the cases. We report a case of 13 year oldmale patient who presented with a swelling in left submandibular region since 3 months. On clinical examination he was found to have a 3x3cm solitary non tender firm swelling palpable in left submandibular triangle. Remaining ENT examination clinically unremarkable. Ultrasonography of neck showed Hetero echoic lesion of about 3.0x3.5cm size in left submandibular gland with mild increased vascularity. Similar findings were noted in computed tomography of neck. Fine needle aspiration cytology of swelling showed features suggestive of Pleomorphic adenoma of submandibular gland. Patient underwent excision along with submandibular gland under general anaesthesia and post operative period procedure was uneventful. Histopathology of excised specimen was consistent with pleomorphic adenoma. Patient is on regular follow up with no post operative complications.

Submandibular gland pleomorphic adenoma: Histopathological capsular characteristics and correlation with the surgical outcome.

Pleomorphic adenoma (PA) of the submandibular gland is known to have a very low recurrence rate. The aim of this study was to investigate the histopathological and capsular characteristics of submandibular gland PA, looking for any differences between submandibular PA and the reported data for PA of the parotid gland as possible explanation for its low recurrence rate. We reviewed 72 submandibular gland PAs resected at our center between 2000 and 2016. Patient age ranged from 14 to 77 years (mean, 47.2). At least follow (range, 12 to 170 months; mean, 82), none of the 72 patients developed a local recurrence. Histologically, all of the tumors were encased by a complete and intact anatomical capsule (100%). Pseudopodia were detected in 11 (15.3%) and satellite nodules in 3 (4.2%) cases. The histological subtype (according to Seifert et al.) was classic (mixed) in 39 (54.2%), stroma-rich/myxoid in 18/72 (25%) and cellular in 15 (20.8%) cases. A complete rim of healthy pericapsular tissue encasing the tumor and its capsule was observed in only 23/72 (31.9%) cases. In conclusion, submandibular PAs are characterized by consistent presence of an intact anatomical capsule, infrequent occurrence of pseudopodia, a remarkably infrequent occurrence lower frequency of secondary satellite tumor nodules and a comparatively lower proportion of the fragile risky myxoid subtype. Despite the fact that surgery of the submandibular gland can frequently lead to focal capsular exposure, the aforementioned capsular characteristics of submandibular gland PA are probably responsible for the excellent oncologic results.

The recurrent pleomorphic adenoma conundrum.

Recurrent pleomorphic adenoma (RPA) is uncommon. Treatment selection is based on the likely possibility of minimizing the risk of tumour recurrence, avoiding local functional and cosmetic sequelae, and eradicates the possibility of metastatic or malignant transformation. Much has changed since the topic was reviewed in 2001, and this manuscript comments on clinical progress and discusses patient treatment options. Surgery is the preferred treatment for head and neck pleomorphic adenoma. Over the recent decade the surgical radicality is favoured for parotid and submandibular gland pleomorphic adenoma, from total gland and tumour removal to endoscopic or minimal open extracapsular tumour excision. Currently molecular pathology and biomarker research has not identified any evidence that separates pleomorphic adenoma from RPA, thus supporting that tumour recurrence is likely associated with surgery. Revision surgery has been reported to be frequently noncurative depending on the extent of the primary surgery, with the added risk of local cosmetic and functional sequelae. Radiotherapy as a nonsurgical modality has advanced and has been shown to be effective in controlling, if not curing, high-risk patients who have identifiable prognostic factors of developing a recurrence and patients with RPA. Current surgical management of pleomorphic adenoma is associated with improved quality of life and minimal disturbance to cosmetic and functional. The reported incidence of RPA has been reduced by 'expert surgeons' but with limited short-term follow-up following more recent surgical modifications. Patients with RPA should be offered treatment that includes surgery and/or radiotherapy and should be encouraged to partake of this decision making process.

Pleomorphic adenoma of submandibular gland: not so common occurrence

Background: The salivary glands tumour are relatively rare, yet they represent a wide variety of both benign and malignant histologic subtypes. Several studies have been conducted on the tumors of the parotid and minor salivary glands, but very few reports in the literature have focused on submandibular gland tumors as they are rare and are usually grouped with other salivary glands. Approximately 70% of the salivary gland tumors affect parotid gland with the submandibular gland being affected in 5-10% of the cases, sublingual gland in 1% and minor glands in 5-15% of the cases. So, we describe a series of 50 patients of pleomorphic adenoma affecting submandibular gland.Methods: The prospective study was conducted at Department of General Surgery, Indira Gandhi Government Medical College, Nagpur between January 2008 to December 2017.Results: Out of the 50 patients, 10 were male and 40 were female. Thus, male to female ratio is 1:4. Most of the 42 (84%) patients presented with painless swelling in submandibular region. Clinically the tumour has the texture of cartilage and has an irregular and bosselated surface observed in all the patients. The size of tumour was 3 to 6 cm in 32 (64%) patients observed in the present study. Fine needle aspiration cytology was performed in all the patients. All patients were managed by surgical excision. Recurrence occurred in a single patient who was managed with radical excision including a neck dissection with postoperative radiotherapy.Conclusions: Submandibular gland pleomorphic adenoma being common benign tumor, occurring commonly between the 3rd and 5th decade of life and presenting as slow growing asymptomatic swelling with female preponderance. The precise surgical excision along with whole submandibular salivary gland and postoperative radical radiotherapy required for recurrence as the accepted mode of management. However, further long-term studies involving submandibular gland have to be carried out to know the pattern of tumor recurrence.

Eternal dilemma of the interplay between coexisting tuberculosis and malignancy: Clinical scenario of coexisting submandibular carcinoma with disseminated tuberculosis: A case report

Tuberculosis (TB) and malignancy are two lethal diseases that cause significant morbidity and mortality in developing countries like India. Extrapulmonary tuberculosis (TB) constitutes about 15 to 20 per cent of all cases of tuberculosis with lymph nodes being the most common site of involvement.1 Malignant transformation in pleomorphic adenoma lead to carcinoma ex pleomorphic adenoma (CXPA). CXPA of the salivary glands, however, is relatively uncommon, accounting for 3.6 % of all salivary gland neoplasms and 11.7 % of all malignant salivary gland neoplasms.2 Here we report a case of carcinoma ex pleomorphic adenoma of submandibular gland which presented as a swelling in submandibular region along with generalized lymphadenopathy which mimicked widespread metastases but later on histologically showed tuberculosis. Asian Journal of Medical Sciences Vol. 7(3) 2016 115-117

A Case of Adenosquamous Carcinoma Ex Pleomorphic Adenoma of Submandibular Gland

다형선종유래암종(carcinoma ex pleomorphic adenoma) 은 타액선 종양 중 드문 종양으로 기존의 양성 종물인 다형선 종에서 유래한 악성 혼합종이다. 75%는 이하선에서 발생하 며, 그 외에는 악하선 및 소타액선에서 발생한다. 진단은 조 직학적으로 기존의 다형선종에서 악성종양세포로 일부분 또 는 대부분 치환된 양상을 통해 규명할 수 있다. 다형선종유래 암종 내의 악성종양은 선암종(adenocarcinoma), 미분화암종 (undifferentiated carcinoma), 편평세포암종(squamous cell carcinoma) 등의 빈도로 나타난다. 악하선에서 발생하는 다 형선종유래암종은 국내외에서 몇 예가 보고되어 있으나, 악하 선에서 발생하는 다형선종 내의 암종이 선조직과 편평세포조 직으로 구성된 다형선종유래 선편평세포암종은 국내외에서 아직 보고된 바 없어, 저자들은 최근 악하선에서 발생한 다형 선종유래 선편평세포암종 1예를 경험하였기에 문헌고찰과 함 께 보고하는 바이다.

A case of pleomorphic adenoma of submandibular gland

Pleomorphic adenoma is the most common salivary gland tumor. It possesses epithelial and myoepithelial elements with mucoid, myxoid, or chondroid tissue in a mucopolysaccharide stroma. Pleomorphic adenoma of submandibular gland is generally seen in middle aged women. It presents as a solitary, well defined, painless slowly growing benign tumor but can turn malignant. USG, FNAC and CT scan help in establishing diagnosis, extent and tumor’s relation with surrounding structures. Surgical excision is treatment of choice because of chances of malignant transformation.Our case was a young male who presented with right sided upper neck swelling for four months. It was painless, progressive and without any pressure symptoms. On examination, a 3 x 2 cm, globular swelling was seen in the right submandibular region. It was firm, non tender, mobile and ballotable on bidigital palpation. USG neck revealed a 2.1 x 2.7 x 3.1 cm well defined hypoechoic lesion in right submandibular gland. FNAC reported a pleomorphic adenoma.Gland was excised under general anaesthesia. Skin incision was given 2 cm below right mandible. Subplatysmal flaps were raised. Gland was excised in totality with precise dissection, preserving marginal mandibular nerve. Histopathological examination reported a final diagnosis of Pleomorphic Adenoma of right submandibular gland.

Carcinosarcoma of submandibular salivary gland: our experience of a rare tumour with review of literature

Carcinosarcoma arising from the submandibular gland is a very rare pathologic entity. Rarity of tumour makes the treatment recommendations difficult. We share our experience of a 76 year old gentleman who presented with a swelling in right submandibular region which was present since last fifteen years and increased over last one month. Fine needle aspiration cytology was done preoperatively which was suggestive of salivary gland carcinoma. After investigating properly a diagnosis of malignant tumour arising from submandibular gland was made and he underwent submandibular gland fossa clearance with ipsilateral modified radical neck dissection. Post-operative histopathology with immunohistochemistry correlation was suggestive of carcinosarcoma arising from pre-existing pleomorphic adenoma of submandibular gland. He received radiotherapy as adjuvant treatment.

English

Pleomorphic adenoma of submandibular gland is a very rare condition compared to that of parotid. We are here discussing a case of the same in a 40yrs old male with clinical, operative, and histological findings .

Pleomorphic adenoma of submandibular gland: An uncommon occurrence

Pleomorphic adenoma (PA) is the most common tumor of the benign salivary gland neoplasms, and the most common gland to be involved is the parotid gland. Its occurrence in the submandibular or the sublingual gland is uncommon. We present a case of a histologically proven PA involving the submandiblular gland.

Pleomorphic adenoma of the submandibular gland: an evolving change in practice following review of a personal case series

We reviewed patients with submandibular gland pleomorphic adenoma treated at a tertiary referral centre in the United Kingdom (1988-2004). Thirty-seven patients were identified, 32 newly diagnosed cases and 5 cases of recurrent disease previously treated elsewhere. The exact pre-operative diagnosis was "unknown" in 76% of the new cases. All cases were surgically excised (41% with extracapsular gland excision and 59% by selective level Ib, IIa and III neck dissection). Temporary marginal mandibular nerve neuropraxia was documented in 25% of cases. All 32 new cases remain clinically tumour free at the time of writing. In patients with recurrent disease, complete microscopic tumour clearance was achieved in three of the five cases, however all remain clinically tumour free. Pleomorphic adenomas of the submandibular gland are uncommon, with good prognosis following complete tumour excision. Recurrent tumours, however, are frequently multi-focal and difficult to excise completely. The adequacy of primary surgery is crucial and supports an approach for a more radical excision primarily by a selective level lb, IIa and III neck dissection; ensuring complete disease clearance for pleomorphic adenoma, avoiding the risks of tumour spillage associated with a limited excision and tumour handling; and removing the primary echelon of lymph nodes at risk of metastasis if the pathology turns out to be malignant.

Submandibular duct lithiasis associated with a mixed salivary gland tumor. A case report.

Abstract A case of submandibular gland pleomorphic adenoma in association with duct lithiasis is presented. These are probably incidental findings, but it is possible that they may be causally related.

Pleomorphic adenoma of submandibular gland

Pleomorphic adenoma of submandibular gland

顎下腺に発生した多形性腺腫の 1 例

Plemorphic adenoma is the most common tumor on salivary glands. Of the major salivary glands, the parotid gland is the most common site of the pleomorphic adenoma, but pleomorphic adenoma of the submandlbular gland is relatively rare. This case report presents the pleomorphic adenoma of submandibular gland which occurred in a 53-year-old woman. Light and electron microscopic observation was done and discussed. Postoperatively, a follow-up for two years has been performed and no recurrence occurred.