Presentation Of Pleomorphic Adenoma Research Articles

Pleomorphic Adenoma: Case Series and Literature Review

Pleomorphic adenoma, usually referred to as a ‘benign mixed tumor,’ is the ‘most prevalent’ salivary gland neoplasm. It typically arises in the parotid gland, one of the main salivary glands, and has a limited development potential. Pleomorphic adenoma can also occur in minor salivary glands located in the pharynx, oral cavity, and other areas. The purpose of this paper is to provide an overview of the histology, therapy, and clinical features of pleomorphic adenoma in a number of patients. This case series provides an overview of key characteristics, clinical presentation, diagnosis, and management of pleomorphic adenoma. A review of the update of histogenesis is also explored. Pleomorphic adenoma is typically characterized by its histological diversity. Early diagnosis, accurate imaging, and surgical intervention are crucial for effective management and avoiding potential complications. Regular surveillance following treatment helps ensure optimal patient outcomes. Pleomorphic adenoma can grow to large sizes, if untreated and hamper normal function. Hence early diagnosis and treatment are needed. The varied histopathological presentation of pleomorphic adenoma makes the diagnosis challenging in certain cases. Timely diagnosis and prompt treatment planning require a detailed history and clinical evaluation with radiographic and histopathological investigations. Thus, by documenting these instances, healthcare providers can enhance their ability to recognize and manage unusual presentations of the disease. This, in turn, helps in early diagnosis and appropriate treatment selection. Keywords - Benign mixed tumor, Histogenesis, Histopathology, Pleomorphic adenoma, Salivary glands

Pleomorphic Adenoma Arising From Frontozygomatic Region: An Ectopic Localization

Study Design: Case report. Objective: Pleomorphic adenoma is pathologically characterized as an epithelial lesion intermixed with mesenchymal elements. It is characterized by being a slow-growing, asymptomatic, usually nodular, firm consistency lesion that can reach large dimensions, especially when it affects the parotid gland. The present study aims to report a case about an atypical presentation of pleomorphic adenoma found in frontozygomatic region. Methods: The tumor mass was removed through resection, under general anesthesia, by cutaneous approach, preserving aesthetics and noble structures as temporalis muscle, orbicularis oculi muscle and frontal branch of the facial nerve. Intra-operative macroscopic assessment showed an encapsulated tumor. After resection, the surgical specimen was sent to the pathology laboratory for histological analysis confirming the diagnosis of Pleomorphic Adenoma. Conclusions: After 1 year of follow-up the patient had an excellent evolution, without signs of disease recurrence. It demonstrates that, until now, the surgical approach constituted the resolving therapy, even for a lesion in a rare localization.

Differential Diagnosis of Lateral Neck Masses

Introduction: The neck and parapharyngeal space are one of the most vital regions in the body, encompassing multiple major blood vessels, nerves, spine and the airway itself. Lateral neck masses that present to an ENT practitioner may not only include a wide variety of differentials, but may present as emergencies in case of an airway compromise. In such situations, decision making and arriving at the diagnosis becomes important not only from a curative perspective but also from a lifesaving one. Here we discuss a few cases of lateral neck masses that had presented to us with unusual presentation or had a rare diagnosis, along with the line of management that was followed.
 Cases: We present a case of a giant pleomorphic adenoma presenting with stridor, an adult onset cystic hygroma, a schwannoma presenting with dyspnea, an isolated infiltrating lipoma and 2 other cases of schwannoma.
 Conclusion: Tumours of the neck and parapharyngeal region have a wide variety as this region contains almost every kind of tissue. Diagnosis of any lesion should be done with caution, using the appropriate history, examination and investigative tools available. Not only the common presentation, but also outliers and uncommon presentations of common tumours should be kept in mind.

Palatal swelling: Pleomorphic adenoma – A case report

Pleomorphic adenoma is a most common benign neoplasm of salivary glands that has the epithelial as well as the mesenchymal elements. The World Health Organization in 1972 defined pleomorphic adenoma as a “well-defined tumor characterized by its pleomorphic or mixed appearance.” There is intermixing of the clearly identified epithelial components with mucoid, myxoid, and chondroid components. Pleomorphic adenoma most commonly arises in the parotid or submandibular gland and infrequently occurs in minor salivary glands and presents as intraoral swellings on the palate or lip. The tumor shows a malignant transformation rate of about 9%, and a high recurrence rate has been reported. This case report highlights the clinical, radiological, and histopathological presentation of pleomorphic adenoma.

174. Intraductal carcinoma of the parotid gland – a rare salivary malignancy accompanied by a pleomorphic adenoma: case report and review of the literature

Low-grade intraductal carcinoma (LGIC) is an extremely rare salivary ductal malignancy. We present a case of an LGIC and pleomorphic adenoma presenting within the same parotid gland, and the potential challenges this uncommon situation poses.

An uncommon presentation of pleomorphic adenoma

80-90% of tumours of the parotid gland are benign, the most common being pleomorphic adenoma. It is characterized principally by epithelial and myoepithelial components distributed in varied patterns through an abundant matrix of mucoid, and chondroid supporting tissue. Classically it presents as swelling in front, below and behind ear, Raises ear lobule and Retro mandibular groove is obliterated. Here we present a case of a swelling over left side of neck over submandibular triangle near the angle of the mandible. The case is presented as clinical presentation of pleomorphic Adenoma was not classical.

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.

Juvenile onset pleomorphic adenoma presenting as giant tumor of parotid gland in a young female

Salivary gland tumors are rare and carry diverse histologies. There is a paucity of clinical and biological details about pediatric salivary gland tumors and their clinical behavior in the literature. We present a case of 25-year-old female with giant pleomorphic adenoma of the parotid which started in her childhood at the age of 13 years. Presentation at such an early age is a rare entity. The patient underwent a superficial parotidectomy. Periodic follow-up was done for 1 year and there was no recurrence. For benign salivary gland tumor, surgical excision with preservation of neurovascular structure is the main treatment option.

Pleomorphic Adenoma Presenting as an Atypical Nasal Mass in a 26-Year-Old Female

Pleomorphic adenoma (PA) is a salivary gland tumor that may rarely occur in the nasal cavity. It can be a clinical diagnostic dilemma in many instances due to many possible differential diagnoses. We report the case of a 26-year-old female who presented with a 3-year history of a right nasal growth associated with ipsilateral nasal blockage, nasal pain, and rhinorrhea. Radiological image showed a mild enhancing lesion in the right nasal cavity. The patient underwent a lateral rhinotomy with wide excision of the mass. Histopathological exam was consistent with PA. Nasal PA is a rare entity and should be suspected as a diagnosis for intranasal tumors.

Pleomorphic adenoma of head and neck region: our institutional review

<p class="abstract"><strong>Background:</strong> Pleomorphic adenoma is the commonest benign salivary gland neoplasm but it has the tendency to reoccur if not properly removed and has ability to undergo malignant transformation. The aim of the study was to discuss the presentation and treatment of pleomorphic adenoma of the head and neck region.</p><p class="abstract"><strong>Methods:</strong> Retrospective chart review of patients treated for pleomorphic adenoma of the head and neck region between 2011 and 2018. Data assessed included demographics, clinical presentation, imaging, treatment, complications, recurrence and follow‐up. </p><p class="abstract"><strong>Results:</strong> Seventy nine patients with pleomorphic adenoma were identified. Major salivary gland lesions were most common (n=64, 81.0%); 67% (53 of 64) arising in the parotid and 14% (11 of 64) in the submandibular glands. Minor salivary gland lesions were removed from the palate (8 of 15, 53.3%), parapharyngeal space (3 of 15, 20%), nasal septum (2 of 15, 13.3%), lower lip (1 of 15, 6.7%) and base of tongue (1 of 15, 6.7%). Preoperative imaging done was mainly computed tomography in all the cases however in parapharyngeal space cases magnetic resonance imaging was also done. Surgical excision was performed in all patients except base of tongue case.</p><p><strong>Conclusions:</strong> Treatment of pleomorphic adenoma is mainly surgical with negative margin. Rate of recurrence is low, however long follow-up is recommended. </p>

Clinical profile and management of pleomorphic adenoma of head neck: our experience

<p class="abstract"><strong>Background:</strong> Pleomorphic adenoma constitutes one of the common salivary gland tumors. Our aim is to study the clinical presentation of pleomorphic adenoma, preoperative and postoperative histopathological findings and management of tumors.</p><p class="abstract"><strong>Methods:</strong> A retrospective study of 43 patients was conducted at department of ENT, Government Medical College and Hospital, Nagpur between January 2017 to February 2019. Data was collected and analysed. </p><p class="abstract"><strong>Results:</strong> Maximum patients were of age group 40-60 years with male preponderance. Parotid being most common gland involved, 35 cases of all 43 were post-operatively confirmed to be pleomorphic adenoma.</p><p class="abstract"><strong>Conclusions:</strong> Pleomorphic adenoma is most commonly diagnosed in age group 40-60 years. Surgical excision is treatment of choice. Long term follow-up of the cases is warranted owing to risk of late recurrences.</p>

SYNCHRONOUS ORAL SALIVARY GLAND TUMORS: REPORT OF THREE NEW CASES AND REVIEW OF THE LITERATURE

Multiple synchronous or metachronous salivary gland tumors, benign or malignant, are rare yet more likely to occur in the major salivary glands compared to involvement of the minor salivary glands. In this poster we present three new cases of synchronous oral salivary gland tumors in minor salivary glands and review the previously reported cases. All three patients were female. Two of the patients aged 55 and 85, presented with submucosal nodules of the upper lip and left buccal mucosa, respectively. Histopathologically, both cases exhibited two separate encapsulated tumors identified as pleomorphic adenoma and canalicular adenoma presenting as a single nodule in the first case, but as two separated nodules in the second. The third patient was a 46-year old who presented with a grayish-blue, non-ulcerated, and painful nodule on the left soft palate. Histopathologic examination showed a nodule composed of two adjacent, yet separate tumors diagnosed as polymorphous adenocarcinoma demonstrating significant perineural invasion, and low-grade mucoepidermoid carcinoma. Conclusion Intraoral multiple synchronous salivary gland tumors are rare and unusual, with only a few cases reported in the literature. The diagnosis of such tumors would be significant from treatment, management, and prognostic standpoints. Cytogenetic studies might be useful in further clarification of these entities.

Clinical Presentation and Histological Variation of Pleomorphic Adenoma of Salivary Glands

Background: Pleomorphic Adenoma is the most common salivary gland tumour accounts 40-70% of all salivary gland tumour and about 60-80% of the benign tumours and 60- 70% of all parotid tumours. There is no study conducted in Bangladesh to observe the clinical and histological variation of the tumour. This study presents 36 cases of Pleomorphic adenoma collected over 11 months at the different territory hospital of Dhaka city. Design: Observational study (November’ 2011 to September’ 2012) Setting: Department of Oral and Maxillofacial Surgery (Dhaka Dental College and Hospital, Bangabandhu Sheikh Mujib Medical Universityl), Department of ENT and Head- Neck Surgery (Dhaka Medical College and Hospital, Bangabandhu Sheikh Mujib Medical University).
 Method: The entire patient clinically and cytologically diagnosed as Pleomorphic adenoma were selected. Data were collected in a summarized data sheet. Then histopathological types of them were analyzed from excisional biopsized tissue.
 Result: There were 36 patients of Pleomorphic adenoma of which 24(66.67%) in Parotid glands, 4(11.11%) in Submandibular glands and 8(22.22%) in minor salivary glands. Among the respondents, female was predominant 20(55.56%) with ages were between 29 years to 65 years old (mean age 44.83 ± 8.32 years) with most patients (44.44%) in 41 to 50 years of life. In histophathological study showed Stromal rich 38.89%, cell rich 36.11% and classic 25%. Cuboidal cells were the most commonly found cellular type followed by plasmacytoid and spindle.Trabeculae and duct like structures were the most frequent pattern by the epithelial cells.Myxoid and Hyalinization were the most frequently found mesenchymal like tissue.Cases presented with symptoms such as swelling (100%), limitation of mouth opening, paesthesia and pain.
 Conclusion: The knowledge about clinical presentation and the immense variety of cells, architectures and morphological characteristics present in Pleomorphic adenoma of the salivary gland is essential for correct diagnosis and prognosis. The need for improved diagnostic facilities and upgrading of infrastructure was stressed.
 J Bangladesh Coll Phys Surg 2019; 37(2): 72-77

English

Pleomorphic adenoma of the salivary gland is described as a slow growing painless benign tumor characterized histologically by its mixed appearance with epithelial and myoepithelial components. It occurs in both the major and minor salivary glands with the parotid gland as the commonest site for the major gland while the palate is the commonest site for the minor glands. This study was conducted to evaluate the clinical presentation of pleomorphic adenoma seen in the University of Nigeria Teaching Hospital Ituku/Ozalla, Enugu, Nigeria. Records of all the patients with pleomorphic adenoma seen in the clinics within a six year period (January 2009 to December 2014) were retrospectively reviewed. Relevant information retrieved from the patients’ file. Data was analyzed using SPSS version 23; qualitative variables were compared using chi-square test. A total of 37 cases (prevalence = 41.1%) of pleomorphic adenoma of the major and minor salivary gland met the required criteria for inclusion in the study. Majority of the cases occurred in females. The mean age of the patients was 38.2 and standard deviation was 16.4. The mean duration of the tumor at presentation was 39.4 months. Parotid gland was the commonest site. Postoperative complication seen was facial nerve palsy. Most of the tumors occurred on the left side. Pleomorphic adenoma present as a painless swelling is seen more in our environment among women. The peak age of occurrence is in the 4th decade of life. Surgical excision is the mainstay of treatment. Many of the patients presented years after the onset of tumor growth. Key words: Pleomorphic adenoma, salivary gland, benign tumors.

Ossifying pleomorphic adenoma presenting as a nasopalatine mass

<p class="abstract"><span lang="EN-IN">Pleomorphic adenomas are benign tumors that are uncommon in the nasal cavity. However, they can rarely arise from septum, erode hard palate and thus masquerade a bone tumor. We report one such rare case of septal pleomorphic adenoma with hard palatal extension and ossification. A combined endoscopic intranasal and transpalatal surgical approach was performed and tumor was excised completely. A high index of clinical suspicion and biopsy can diagnose such swellings.</span></p>

Episodic facial edema as a presentation of pleomorphic adenoma – case report

Episodic facial edema as a presentation of pleomorphic adenoma – case report

An unusual presentation of pleomorphic adenoma: A case report

Pleomorphic adenoma of the submandibular gland is rare and can present difficulty in diagnosis. The heterogeneous histology, a possible malignant transformation, and an incomplete capsule that can determine a recurrence are the most important characteristics of pleomorphic adenoma. This paper illustrates one such atypical case resembling lymphadenopathy in the submandibular gland.

Multimodality Imaging of Metastasizing Pleomorphic Adenoma Presenting as a Solitary Pulmonary Nodule without Local Tumor Recurrence: A Case Report

Malignant mixed tumors of the salivary glands are classified into three distinct histologic types: carcinoma ex pleomorphic adenoma, carcinosarcoma (malignant mixed tumor), and metastasizing pleomorphic adenoma. Metastasizing pleomorphic adenoma, a subset of pleomorphic adenoma that spreads to distant sites, is rare; very few cases have been recorded. So far, there has been no case report of metastasizing pleomorphic adenoma focusing on radiologic features of the tumor using multiple imaging tools. Previous reported cases of metastasizing pleomorphic adenoma presenting as pulmonary metastasis involved multiple pulmonary metastases. Also, most patients with metastasizing pleomorphic adenoma have a history of at least one local recurrence of pleomorphic adenoma prior to the detection of distant metastasis (1-7). Therefore, metastasizing pleomorphic adenoma presenting as a solitary pulmonary nodule without a history of local tumor recurrence is a rare manifestation of the disease. This article presents a case of this very rare condition with a discussion of the clinical presentation and a review of the literature; we focus on the radiologic features of the adenoma visualized with multiple imaging modalities.

Atypical presentation of lacrimal gland pleomorphic adenoma with necrotic foci

Clinical caseThe case is presented of 48 year-old male complaining of a painful left upper eyelid and swelling of the lacrimal gland, with a suspicion of dacryoadenitis. Removal was decided after dacriops suspicion. Histopathology diagnosed a pleomorphic adenoma of the lacrimal gland, with areas of necrosis. DiscussionLacrimal gland pleomorphic adenoma usually presents as a slowly progressive painless mass. However, painful presentation in this case might be related with necrotic foci found in the histopathological examination. Although not described in lacrimal glands, pleomorphic adenomas have already been reported in the major and minor salivary glands, and these patients also presented with a painful mass.

Atypical Presentation of an Upper Lip Pleomorphic Adenoma: Case Report.

The pleomorphic adenoma (PA) or mixed tumor is the most common neoplasm of the salivary glands, usually presenting with a non-specific clinical manifestation and a diverse histopathological pattern. The region of the lips is the second most common site for minor gland neoplasms. The aim of this paper is to report the case of a 39 year old caucasian woman presenting with a swelling on the right side of the upper lip combined with a history of trauma in the region of the upper right central incisor, eight years ago. The swelling was attributed to the periapical lesion of the upper right central incisor that was observed on the orthopantomography. Intraoperatively the surgeon came upon a nodule of firm consistency in the mucolabial fold. The histopathologic diagnosis of this lesion was benign mixed tumor of salivary gland. This report discusses the deviation in frequency of mixed salivary gland tumor between upper and lower lip, the clinical differential diagnosis, the histopathological pattern and the appropriate treatment.