Salivary Gland Pleomorphic Adenoma Research Articles

An Unusual Case Report of Pleomorphic Adenoma of Minor Salivary Glands of Palate.

An Unusual Case Report of Pleomorphic Adenoma of Minor Salivary Glands of Palate.

Pleomorphic Adenoma of Hard Palate: A Case Report

Salivary gland tumors are rare and account for only 2-3% of head and neck tumors, most of which are benign. Pleomorphic adenoma is the most common salivary gland tumor. This tumor mostly involves the parotid gland. However, if it occurs in the minor salivary glands, the palate is the most common site, followed by the lips, buccal mucosa, floor of the mouth, tongue, tonsils, pharynx, retromolar trigone, and gingiva. It usually presents as a slow-growing, painless submucosal mass on the hard palate. For a definitive diagnosis, it is necessary to perform a preoperative core biopsy for histopathological examination and Computed Tomography to evaluate the erosion of the hard palate and the severity of the erosion. We aim to describe the clinical, and radiological features, as well as the management of this rare localization of pleomorphic adenoma. In this case, a 30-year-old Iranian male patient with pleomorphic adenoma of the small salivary glands of the hard palate with the chief complaint of painless swelling on the left side of the palate for the past 5 years was reported. Although pleomorphic adenoma is a common entity, it is still a challenging tumor for pathologists, radiologists and surgeons. Various histological and topographic features make this tumor unique. Computed tomography and correct histopathological diagnosis are necessary to establish an appropriate surgical treatment, to achieve complete removal of the lesion through extensive local excision with periosteum or bone removal if involved to prevent recurrence.

Predictive value of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and systemic inflammatory index for detection of recurrence of pleomorphic adenoma of the major salivary glands: a multicenter study

BackgroundThe aim of this study was to investigate the correlation between inflammatory biomarkers such as the systemic immune-inflammation index (SII), the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) and the recurrence of pleomorphic adenomas (PAs). MethodsRetrospective multicenter study. 608 patients diagnosed with PA and treated by tumor enucleation were included in the analyses. The patients. were extracted from a twenty-year database of two referral centers (January 2000 to January 2020). Data about age, sex, voluntary habits, tumor characteristics, tumor treatment and values of NLR, PLR and SII were collected. A receiver operating characteristic (ROC) curve was used to calculate the optimal cut-off values for SII, PLR and NLR. A linear regression model (LRM) and a non-linear logistic regression model (NLRM) were implemented for NLR, PLR and SII. ResultsAll three inflammatory parameters were statistically significant correlated to the recurrence of the tumor. The best performance was achieved by NLR (cut-off 2.960) with AUC = 0.91, accuracy of 96.1%, sensitivity of 78.4% and specificity of 97.2%, PPV = 64.4% and NPV = 98.6%. LRM and NLRM including all hematological parameters did not improve performance in terms of recurrence detection. ConclusionThe use of three inflammatory biomarkers could be a useful tool to predict recurrence of tumor in case of PA ≤ 3 cm. NLR in particular could be sensitive with a cut-off of 2.960. The use of NLR, PLR and SII could be a good reference point for surgical decision making and follow-up in clinical practice.

Tyrosine-Like Crystalloids Localize to Non-Neoplastic True Vocal Cord and Attachments.

Tyrosine-rich or tyrosine-like crystalloids (TC) were initially described in salivary gland pleomorphic adenoma. The presence of TC in non-neoplastic tissues is rare, and it has been reported exclusively in the larynx. This study aims to characterize the frequency and anatomical localization of TC in total laryngectomy specimens. Review of consecutive laryngectomy specimens in which the cassette summary documented parasagittal section sampling of the right and left vocal folds and the anterior commissure. Data collected included patient demographics, underlying diagnoses, history of radiation therapy, presence, and location of TC. Of 86 laryngectomy specimens, 16 (19%) contained amphophilic to eosinophilic TC. The study cohort included 11 males and 5 females, aged 37 to 85 years (mean 62, median 63). Laryngectomy surgery was performed for advanced untreated squamous cell carcinoma (SCCa) (7/16, 43.75%), recurrent post-treatment SCCa (7/16, 43.75%), previously untreated laryngeal large cell neuroendocrine carcinoma (1/16, 6.25%), and non-functional larynx post-chemoradiation (1/16, 6.25%). According to the macroscopic cassette summary, TC were predominantly found in the anterior commissure Sect.(13/16, 81.25%), with fewer cases in sections containing the left (2/16, 12.5%) or the right (1/16, 6.25%) vocal folds. Microscopically, TC localized to the anterior macula flava and/or adjacent vocal ligament (12/16, 75%) and the anterior commissure tendon (4/16, 25%). TCs are predominantly reported as admixed with a neoplasm, however this study confirms that TC can also occur in non-neoplastic tissues of the larynx. There was no clear relationship between the presence of TC and prior radiation therapy. TC in the specialized connective tissues of the macula flava and true cord tendinous insertions distinct from tumor may form in response to alterations in mechanical stress, though an age-related change within the spectrum of normal laryngeal microanatomy also remains a possibility.

Pleomorphic adenoma and carcinoma ex-pleomorphic adenoma tumorigenesis: A proteomic analysis.

To conduct a comprehensive proteomic analysis of normal salivary gland tissue, pleomorphic adenoma (PA), and carcinoma ex-pleomorphic adenoma (CXPA), and validate the proteomic findings using immunohistochemistry. Six normal salivary gland tissues, seven PA and seven CXPA samples underwent laser microdissection followed by liquid chromatography coupled to mass spectrometry. Protein identification and quantification were performed using MaxQuant software. Statistical analysis and functional enrichment were conducted using the Perseus platform and STRING tool, respectively. Immunohistochemistry was used for validation. Comparative proteomic analysis revealed 2680 proteins across the three tissue types, with 799 significantly altered between groups. Translocation protein SEC63 homolog, Annexin A6 and Biglycan were up-regulated in CXPA compared to PA. Decorin was markedly up-regulated in both PA and CXPA compared to normal salivary gland (log2 fold changes of 7.58 and 7.38, respectively). Validation confirmed elevated levels of Biglycan and Decorin in the extracellular matrix of CXPA compared to PA. Proteomic analysis identified differential protein expression patterns associated with malignant transformation of PA into CXPA. Findings indicate a crucial role for extracellular matrix proteins, specifically Biglycan and Decorin, in the tumorigenic progression of PA and CXPA.

Cellular Pleomorphic Adenoma of Minor Salivary Glands with Collagenous Crystalloids: A Peculiar Finding

Abstract Pleomorphic adenoma (PA) is a benign salivary tumor uncommonly seen in minor salivary glands. Collagenous crystalloids are an uncommon finding and may pose a diagnostic dilemma in cellular PA. We present a case of myoepithelial cell-rich PA of hard palate with paucity of chondromyxoid stroma and characteristic collagenous crystalloids.

Pleomorphic Adenoma of the Minor Salivary Gland on the Palate

Pleomorphic Adenoma of the Minor Salivary Gland on the Palate

Soft Palate Pleomorphic Adenoma of a Minor Salivary Gland: An Unusual Presentation

Tumors of salivary glands are less frequent in the head and neck region. Pleomorphic adenoma (PA) is a benign tumor of major and accessory salivary glands. The soft palate is one of the most frequent sites among accessory salivary glands. This tumor can increase in size and cause oropharyngeal obstruction with a risk of asphyxia, endangering the patient's life. Treatment is based on complete tumor excision and it’s sometimes difficult. Histopathological examination confirms the diagnosis. In this study, we present a case of a large pleomorphic adenoma of the accessory salivary glands located in the soft palate, successfully treated with intraoral excision surgery after an initial tracheostomy.

An ultrasound-based histogram analysis model for prediction of tumour stroma ratio in pleomorphic adenoma of the salivary gland.

Preoperative identification of different stromal subtypes of pleomorphic adenoma (PA) of the salivary gland is crucial for making treatment decisions. We aimed to develop and validate a model based on histogram analysis (HA) of ultrasound (US) images for predicting tumour stroma ratio (TSR) in salivary gland PA. A total of 219 PA patients were divided into low-TSR (stroma-low) and high-TSR (stroma-high) groups and enrolled in a training cohort (n = 151) and a validation cohort (n = 68). The least absolute shrinkage and selection operator regression algorithm was used to screen the most optimal clinical, US, and HA features. The selected features were entered into multivariable logistic regression analyses for further selection of independent predictors. Different models, including the nomogram model, the clinic-US (Clin + US) model, and the HA model, were built based on independent predictors using logistic regression. The performance levels of the models were evaluated and validated on the training and validation cohorts. Lesion size, shape, cystic areas, vascularity, HA_mean, and HA_skewness were identified as independent predictors for constructing the nomogram model. The nomogram model incorporating the clinical, US, and HA features achieved areas under the curve of 0.839 and 0.852 in the training and validation cohorts, respectively, demonstrating good predictive performance and calibration. Decision curve analysis and clinical impact curves further confirmed its clinical usefulness. The nomogram model we developed offers a practical tool for preoperative TSR prediction in PA, potentially enhancing clinical decision-making.

A rare ectopic localization of pleomorphic adenoma of lip

This case report described a rare and unusual lesion found in a 68-year-old male, which was diagnosed as pleomorphic adenoma of the minor salivary glands in the upper lip. The tumor was a circumscribed, large firm mass, about 2 cm in diameter, characterized by slow growth. Complete excision was performed and the histopathologic analysis showed pleomorphic adenoma.

Evaluation of Immunohistochemical Expression of P53 and Pcna in Pleomorphic Adenoma, Mucoepidermoid and Adenoid Cystic Carcinomas of Salivary Glands

Salivary gland tumours are uncommon with a broad heterogeneity. The most common benign tumour is the pleomorphic adenoma, whereas mucoepider moid carcinoma and adenoid cystic carcinoma predominate among the malignancies. The aim of this study was to describe the tissue expression of p53 and PCNA protein in pleomorphic adenoma, mucoepidermoid carcinoma and adenoid cystic carcinoma and to compare their expression among the studied tumors. The study enrolled (45)formalin –fixed, paraffin- embedded tissue blocks of salivary gland tumors, diagnosed as pleomorphic adenoma, mucoepidermoid carcinoma and adenoid cystic carcinoma (15 cases for each ) and evaluated the immunohistochemical expression of P53 and PCNA proteins. The study revealed positive p53 protein expression in (60%) of muocoepidermoid carcinoma cases and (20%) of adenoid cystic carcinoma cases, while only one case (6.7%) of pleomorphic adenoma was P53 posi tive. The immunopositivity of PCNA protein expression was f ound in (100%) of both mucoepidermoid carcinoma and adenoid cystic carcinoma cases and (66.7%) of pleomorphic adenoma c ases.The results of this study demonstrated that inactivation of p53 protein may play an im portant role in the activation of PCNA with increasing the proliferati on activity of MEC and ACC.

Recurrence Rate of Pleomorphic Adenoma in Minor Salivary Glands After Surgical Excision: A Retrospective Clinical Study

Background: Pleomorphic adenoma of the minor salivary gland is a rare benign tumor. It commonly occurs in the hard and soft palates. Treatment by surgical excision achieved success in improving the patient’s health. Objective: To evaluate the recurrence rate after surgical treatment of pleomorphic adenoma in minor salivary glands. Methods: This retrospective study included patients who attended the Maxillofacial Surgery Unit in Ghazi Al-Hariri Hospital, Baghdad, from 2019 to 2021, complaining of soft tissue lumps involving the soft and hard palate, buccal mucosa, and upper lip. After the provisional diagnosis of these lesions, a total surgical excision of the tumor with a safe margin of 1 mm was performed, and the biopsy was sent for histopathological examination. A follow-up evaluation was performed for all patients two years after surgery. Results: Twenty-three patient data sheets with minor salivary gland pleomorphic adenoma were screened and initially included in this study. Only 12 patients (8 males and 4 females) were eligible, and 11 were excluded. Out of the patients who had total surgical excision, two women experienced tumor recurrence during the follow-up period. One had an ulcerated pleomorphic adenoma in the hard palate, and the other had a pleomorphic adenoma in the soft palate with mucosal tethering. Conclusions: Wide surgical excision is a successful treatment to decrease the recurrence rate, especially in cases of ulceration and tethering.

"Pleomorphic adenoma in salivary glands: Insights from a 100-patient analysis".

Pleomorphic adenoma (PA) is a benign epithelial tumour originating from the salivary gland, specifically the parotid gland. This study aims to comprehensively analyse the clinical and pathological features of PA by examining the characteristics of the tumour, including its histological structure and immunohistochemical profile. Over 8 years, beginning in October 2015 and ending in October 2023, an exhaustive retrospective study was conducted in the Department of Pathology, Kasturba Medical College, Mangalore, Manipal University, Karnataka, India. The research focused on 100 cases of pleomorphic adenoma and involved a meticulous examination of the clinical and pathological characteristics obtained by retrieving the pertinent files. Out of all the primary tumours, the majority (n = 70) was found in the parotid gland, followed by PA that developed from the minor salivary glands of the palate (n = 07), the submandibular gland (n = 17), and the lacrimal gland (n = 04). Only two cases had a primary tumour located in the lips. Females were more susceptible to these tumours than males. The parotid gland tumours showed a distinct trend in laterality, with 73 cases observed on the right side. In 85%, the initial symptom of the condition was painless swelling. Salivary gland PA is typically a benign tumour. However, a subset of these tumours can exhibit a malignant phenotype. The preferred treatment is surgical excision with adequate margins.

Retrospective Analysis of Histopathological Reports of Salivary Gland Pleomorphic Adenomas in Tanzania.

Pleomorphic adenoma (PA) is the most common benign tumor representing about 80% of all salivary gland tumors. Despite this, there is limited documentation of the demographic information and pattern of PA in Tanzania. This study retrospectively determines the demographic information and the pattern of presentation of pleomorphic adenomas of the salivary gland among patients managed at a tertiary hospital in Tanzania. This was a retrospective study of histological results of salivary gland pleomorphic adenoma diagnosed between 2016 and 2021. The information gathered included the age and sex of the patient and the anatomical location. Data analysis was done using Statistical Package for the Social Sciences version 27 computer program. Out of 1824 reports of patients with oral and maxillofacial lesions retrieved from the archives of the department, 62 (3.4%) had the diagnosis of pleomorphic adenoma of the salivary glands. The patients' ages at diagnosis ranged from 7 to 72 years, with a mean age of 39.9 (SEM = 2.3) years. The male-to-female ratio of patients diagnosed with pleomorphic adenoma was 1:1. There were 31 (50%) cases of pleomorphic adenomas affecting major salivary glands. The palatal minor salivary glands were the most (n=31, 50%) affected followed by the parotid gland (n=16, 25.8%). Pleomorphic adenomas have no sex predilection, most of these lesions occur during the 3rd to 5th decade of life. The majority of pleomorphic adenomas occur in the palatal minor salivary glands.

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.

Pleomorphic Adenoma of the Soft Palate: The Pillars of Reconstruction

Salivary gland tumour contributed less than 5% of all head and neck tumours. The most common benign tumour of the salivary glands is pleomorphic adenoma. Palate is the common subsite in the oral cavity affected by this tumour. We herein discussed a case of pleomorphic adenoma of the soft palate and the reconstruction dilemma. A 41-year-old male presented with soft palate swelling, which gradually increasing in size in the last 5 years. Intraoral examination revealed well defined, 3x3 cm circumscribed mass at the soft palate, not crossing the midline, encroaching the hard palate, but spared the retromolar trigone and gingivobuccal sulcus. Incisional biopsy performed and histopathological examination showed features of pleomorphic adenoma. He underwent wide local excision of the pleomorphic adenoma with reconstruction using buccal myomucosal flap. Buccal flap was an excellent choice due to its proximity with good recovery. Pleomorphic adenoma of minor salivary gland of the soft palate was managed by complete excision but reconstructing the palatal defect was the cornerstone of managing this tumour. The aim was to preserve functionality and to prevent velopharyngeal insufficiency. Buccal myomucosal flap offered both advantageous, in addition to its proximity to the defect with negligible donor morbidity.

Treatment outcome and prognostic factors analysis of carcinoma ex pleomorphic adenoma of major salivary glands

Treatment outcome and prognostic factors analysis of carcinoma ex pleomorphic adenoma of major salivary glands

PLAG1 Rearranged Soft Tissue Tumor in an Adult

Abstract Introduction/Objective PLAG1 rearranged soft tissue tumor is a recently described entity in the pediatric population. Less than 10 cases have been reported identifying PLAG1 gene fusions with various gene partners. This tumor is characterized by spindled cells with low cellularity in fibromyxoid stroma, expressing CD34 and desmin. PLAG1 gene fusions have been identified in various other tumors, including lipoblastoma, salivary gland pleomorphic adenoma, myoepithelial tumors, uterine epithelioid and myxoid leiomyosarcomas, and chondroid syringoma. To our knowledge, we report the first case of a PLAG1 rearranged soft tissue tumor in an adult. Methods/Case Report A 32-year-old female with no significant medical history presented with a left thigh mass. MRI showed a 9.8 cm mass involving subcutaneous fat and causing marked sartorius muscle displacement. Resection showed a well-circumscribed, spindle cell tumor of low cellularity in a myxo-collagenous stroma. Bland, elongated, and ovoid-shaped spindled cells with occasional punctate nucleoli were seen. No mitoses or necrosis were identified. The tumor cells expressed CD34 and androgen receptors, partially expressed desmin and estrogen receptors, and focally expressed S100. MUC4 and beta-catenin were negative. Next-generation sequencing performed at Mayo Clinic Labs identified UBC::PLAG1 gene rearrangement. Results (if a Case Study enter NA) NA Conclusion To our knowledge, we describe the first case of PLAG1 rearranged soft tissue tumor in an adult. This case is also unique as the fusion partner gene, UBC, was not previously identified. All other cases reported occurred in those four years of age or younger, with one report in a 15-year-old female. Our patient has had less than six months of follow-up with no recurrence. With few cases reported, and relatively short follow-up periods thus far, the behavior of these tumors remains undetermined.

BubR1 and cyclin B1 immunoexpression in pleomorphic adenoma and polymorphous adenocarcinoma of minor salivary glands

The immunoexpression of BubR1 and cyclin B1 in pleomorphic adenoma (PA) and polymorphic adenocarcinoma (PAC) in minor salivary glands is poorly studied. Thus, a retrospective and observational study was performed to provide a better understanding of the role and immunopositivity patterns of these proteins in these lesions. Sixteen cases of PA and 16 cases of PAC were selected. Parenchyma cells were submitted to quantitative immunohistochemical analysis through the labeling index. Cytoplasmic immunoexpression of BubR1 was observed in neoplastic cells from all analyzed PA and PAC cases. All PA cases and 93.7% of PAC exhibited nuclear immunoexpression of BubR1. Higher cytoplasmic and nuclear immunoexpression of BubR1 was observed in PAC (p = 0.001 and p = 0.122, respectively). Cytoplasmic immunoexpression of cyclin B1 was observed in all cases of PA and PAC, with a higher labeling index in the latter (p < 0.001). There was a significant positive correlation between nuclear and cytoplasmic BubR1 immunoexpressions (p < 0.001) in PA and a significant negative correlation between BubR1 and cyclin B1 cytoplasmic immunoexpressions (p = 0.014) in PAC. The higher cytoplasmic and nuclear immunoexpression of BubR1 in PACs suggests the continuous maintenance of neoplastic cells in the cell cycle and migration. Higher immunoexpression of cyclin B1 supports this lesion's enhanced proliferative and migration ability.

Retracted: Knockdown of lncRNA ENST00000603829 Inhibits the Proliferation and Invasion of Salivary Gland Pleomorphic Adenoma through Regulating Cyclin D1

Retracted: Knockdown of lncRNA ENST00000603829 Inhibits the Proliferation and Invasion of Salivary Gland Pleomorphic Adenoma through Regulating Cyclin D1