Submandibular Pleomorphic Adenoma Research Articles

Symptomatic pleomorphic adenoma of the submandibular gland in a malepatient: A case report and review of the literature

Salivary gland tumors represent only 1–4% of head-and-neck tumors, with submandibular gland tumors representing around 10% of salivary gland tumors. Although rarely seen, submandibular pleomorphic adenoma is the most common of the submandibular gland neoplasms (36%). These tumors have a female predominance and present as a painless mass. We report a 42-year-old male patient with a 6-month history of swelling in his left submandibular region due to submandibular pleomorphic adenoma in a hospital in North India. Many diseases in the submandibular region with overlapping clinical pictures make diagnosing difficult. Integrated clinical, radiological, and cytological approaches help in differential diagnosis and making a provisional diagnosis. However, the final diagnosis can be established only by histopathology.

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.

Pneumocytic Adenomyoepithioma: A Case Report

SESSION TITLE: Metastatic and Other Primary Lung Tumors SESSION TYPE: Affiliate Case Report Poster PRESENTED ON: Tuesday, October 31, 2017 at 01:30 PM - 02:30 PM INTRODUCTION: In 2007, Chang et al., described the first case reports of pneumocytic adenomyoepithelioma. We present a case of pneumocytic adenomyoepithelioma and describe the available literature regarding these rare tumors. CASE PRESENTATION: A 63 year-old female was seen for evaluation of bilateral pulmonary nodules. She was a lifelong nonsmoker and did not have any known occupational exposures. She had also been seen in our clinic eight years prior for bilateral pulmonary nodules which were felt to be benign. CT imaging in 2016 demonstrated a dominant slowly growing 14 mm right apical nodule. Bronchoscopy revealed an endobronchial lesion in the right upper lobe. Biopsy revealed a low-grade spindle cell neoplasm. Biopsied lymph nodes were negative for malignancy or infection. Her PET scan showed active hilar nodes. Video-assisted thoracoscopy with right upper lobectomy and lymph node dissection was pursued. Her pathology report revealed a 14 mm pneumocytic adenomyoepithelioma with an inner epithelial cell layer, which was surfactant A positive, alongside surrounding spindle cells which stained positive for mesenchymal markers. On follow-up imaging 2 months later, her bilateral pulmonary nodules were stable without evidence of interval change and she felt well overall. DISCUSSION: In 2007, Chang et al., described a new subset of 5 adenomyoepitheliomas of pneumocyte origin, which they termed pneumocytic adenomyoepithelioma1.Since this initial report, only one additional report has been described2. The initial report by Chang et al., encompassed cases from five hospitals, and only 3 had data regarding their presentation. Of these patients, 2 presented with incidentally discovered lung nodules and the third presented with pleuritic chest pain. In one subsequent case, the patient presented with a history of reported recurrent submandibular pleomorphic adenoma. All of these patients were female between 52-63 years of age and lesions ranging from 0.8-2.6 cm in size. The clinical course of the patients by Chang et al., was largely favorable without evidence of recurrence 13-78 months later. Our patient was unusual in that we had imaging data from 8 years prior, suggesting an indolent clinical course. Her long-term prognosis is likely quite good, but the drivers behind this unique and extraordinarily rare tumor have yet to be elucidated. CONCLUSIONS: This rare and poorly described lesion appears to portend to favorable clinical outcomes, but with only a very small subset of patients being described. Future studies are needed in order to better characterize and understand this unusual pulmonary tumor. Reference #1: Chang T, Husain AN, Colby T, et al. Pneumocytic adenomyoepithelioma: A distinctive lung tumor with epithelial, myoepithelial, and pneumocytic differentiation. Am J Surg Pathol 2007;31:562-8. Reference #2: Krishnamurthy A, Vaidhyanathan A, Majhi U. Pneumocytic adenomyoepithelioma in a case of myoepithelial carcinoma of the submandibular gland. Indian J Cancer 2015;52:216-U188. DISCLOSURE: The following authors have nothing to disclose: Brandon Nokes, Anjuli Brighton, Staci Beamer, Brandon Larsen, Prasad Panse, Rodrigo Cartin-Ceba, Karen Swanson No Product/Research Disclosure Information

Conventional MRI findings for predicting submandibular pleomorphic adenoma

Although pleomorphic adenomas account for over 90% of all benign submandibular gland tumors, the imaging features of submandibular pleomorphic adenomas have not been reported in a large number of cases. To assess the conventional magnetic resonance imaging (MRI) findings for predicting the submandibular pleomorphic adenoma. MR studies of 42 pleomorphic adenomas and 28 other types of tumor were reviewed. MR images were assessed for the presence of hyperintense areas on T2-weighted images (first sign), a well-defined margin (second sign), and presence of crescent-shaped compression of the ipsilateral normal submandibular gland (third sign). For identifying submandibular pleomorphic adenoma, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 97.6%, 50.0%, 74.5%, 93.3%, and 78.6% for the first sign, 95.2%, 46.4% 72.7%, 86.7%, and 75.7% for the second sign, and 23.8%, 100%, 86.7%, 46.7%, and 54.3% for the third sign, respectively. Combining the first and second findings achieved to 85.7% specificity and 90.9% accuracy. Although non-specific, submandibular pleomorphic adenomas usually have hyperintense areas on T2-weighted images and well-defined margins. In addition, crescent-shaped compression of the ipsilateral normal gland seems to represent a highly specific sign.

DNA aneuploidy as a topographic malignant transformation pattern in a pleomorphic adenoma of long-term evolution: a case report

IntroductionWe present a case of long-term evolution of a submandibular pleomorphic adenoma. There is little information about topographic malignant transformation patterns of pleomorphic adenomas.Case presentationWe extensively analyze a giant submandibular mixed tumor of 25-year evolution in a 57-year-old Caucasian woman. Deoxyribonucleic acid ploidy was evaluated in different superficial and deep areas using flow cytometry analysis and correlated with pathological and immunohistochemical characteristics. Superficial areas exhibited a typical histological pleomorphic adenoma pattern and were deoxyribonucleic acid diploid. Deep samples showed deoxyribonucleic acid aneuploidy, atypical histological benign features and expression of markers involved at an early-stage of malignant transformation, such as tumor protein 53 and antigen Ki67.ConclusionThese findings revealed that deep tumor compartments may be involved in the initial stages of malignant transformation. Deoxyribonucleic acid ploidy analysis may provide an additional diagnosis tool and indicate 'uncertain' areas that require careful study to avoid diagnostic errors. Larger studies are needed to confirm our results and to evaluate the usefulness of the technique.

A case of submandibular pleomorphic adenoma with multiple lung and bone metastases

A case of submandibular pleomorphic adenoma with multiple lung and bone metastases

A CASE OF A Huge Submandibular Pleomorphic Adenoma

Pleomorphic adenoma is the most common salivary gland tumor and submandibular pleomorphic adenoma accounts for only 8 % of them. They are seen in middle aged women and present as a painless slowly growing mass. Large masses appear heterogeneous on imaging secondary to hemorrhage, necrosis and cystic changes. Lobulated contour of the tumor favors the diagnosis of pleomorphic adenoma and they appear as multiple adjacent masses rather than single on CT scan. Treatment is essentially surgical with post operative radiotherapy is advisable in larger masses to prevent recurrence.

顎下部に発生した多形腺腫由来癌の1例

This report describes a case of carcinoma ex pleomorphic adenoma originating from a recurrent pleomorphicadenoma in a 67-year-old woman. She was referred to our department because of a swelling in the rightcervical region. At presentation, a painless elastic hard tumor measuring 40 X 30mm was located in the right sideof the upper neck.Computed tomography and magnetic resonance imaging showed enhancement of a nodule and a segmentedmass. The biopsy diagnosis was a carcinoma ex pleomorphic adenoma.A radical neck dissection, including the tumor, was performed. Histological examination revealed a rare undifferentiatedcarcinoma. The final diagnosis was a carcinoma ex pleomorphic adenoma because the patient had previouslyundergone a resection of a ipsilateral submandibular pleomorphic adenoma showing atypia and intracapsularinvasion.There has been no sign of recurrence or metastasis for 4 years 8 months postoperatively.