Symptoms and signs mainly depend on size, location, and potential to undergo malignant transformation. Histologically, it is characterized by the presence of cellular pleomorphism and is composed of an epithelial and connective tissue component within a stroma of. Pleomorphic adenoma is the most common benign salivary gland neoplasm. In the case of carcinoma ex pleomorphic adenoma, there should be some remaining pleomorphic adenoma present to substantiate the diagnosis. Carcinoma ex pleomorphic adenoma cxpa is an uncommon malignant tumor with highly aggressive biological behavior. The standard treatment for pleomorphic adenoma is surgical resection combined. Magnetic resonance imaging is the imaging study of choice for recurrent pleomorphic adenoma.
Prognostic factors affecting the clinical outcome of. Parapharyngeal space is one of potential facial planes for neoplasms and infections and represents less than 1% of all head and neck tumours. Here we report a case of a young female 25 years old with pleomorphic adenoma of the parotid gland. Ethics documents guidelines for the manuscript publishing process. Pleomorphic adenoma treatment aside from surgery, radiation therapy is prescribed to selected cases in order to suppress the cellular activity of the mass and prevent recurrence. Malignant pleomorphic adenoma, salivary gland tumors. We presented a 73year old woman with a giant pleomorphic adenoma in left parotid.
The presence of these different elements accounts for the name pleomorphic tumor or mixed one characteristic of a pleomorphic adenoma is the presence of microscopic projections of tumor outside of the capsule. It is the most common type of salivary gland tumor and the most common tumor of the parotid gland. Pleomorphic adenoma is the most common benign parotid gland tumor. If this procedure changes the management such as in the case of an. Although pleomorphic adenomas most commonly occur in the parotid gland, it may also be encountered in the submandibular, lingual, and minor salivary glands. While surgical excision should cure the patient, recurrence is not uncommon particularly if an en bloc removal is not done, and this may be difficult because of the.
Entire surgical excision and facial nerve preservation of the tumor are the chief principles of operation. Case report giant pleomorphic adenoma of the parotid gland with a. Pleomorphic adenoma surgery, symptoms, causes, treatment. Pleomorphic adenoma is the most common epithelial tumor of the lacrimalgland, and when this tumor is suspected, removal of the mass in its entiretywithout biopsy should be performed. Pdf surgical treatment of parotid gland pleomorphic adenomas. Recurrent pleomorphic adenoma of submandibular region. Pleomorphic adenoma is the commonest salivary gland tumor characterized by diverse histomorphological features.
Role of 18ffdg petct in management of highgrade salivary gland malignancies hansin jeong1, man ki chung1, youngik son1, joon young choi2, hyung jin kim3, young hyeh ko4, and chunghwan baek1 1department of otorhinolaryngologyhead and neck surgery, samsung medical center, sungkyunkwan university school of medicine. Pdf pleomorphic adenoma is the most common neoplasm of the parotid gland this study was carried out to evaluate tumor recurrence following. Treatment of recurrent pleomorphic adenoma must be individualized. It is found mostly in the parotid gland in middleaged women. Benign mixed tumors bmts, is a benign or a noncancerous growth in the salivary gland. Homeopathy is not in any way an effective or medical treatment. A pleomorphic adenoma is a benign overgrowth arising from the salivary gland tissue and it is a painless hard, mobile, solitary mass. What homeopathic treatments are there for pleomorphic. It progresses slowly and, left untreated, can produce sig. Recurrent pleomorphic adenoma of submandibular region aydin s1, demir mg2, akbulut s1, alt. Case report giant pleomorphic adenoma of the parotid gland. Pdf pleomorphic adenomas of the parapharyngeal space.
Surgical management of pleomorphic adenoma of parotid. Most recurrent pleomorphic adenoma are multinodular. Our goal was to investigate the prognosis of cxpa in the major salivary glands and factors influencing it. Transsphenoidal approach has become the surgery of choice for pituitary adenomas. The continued clinical evaluation and longterm followup seems to be of utmost importance for better diagnosis and treatment of. Benign pleomorphic adenoma most common benign salivary gland tumor. Differential diagnoses of a palatal swelling in children and treatment of pleomorphic adenoma at the palate were also discussed. Etiology and management of recurrent parotid pleomorphic. Pleomorphic adenoma definition of pleomorphic adenoma by. Additionally, pa appears radiographically as a radiolucent defect with welldefined cortical margins. Surgical excision with adequate margins is the principle treatment of pleomorphic adenoma to avoid recurrence. She gave the history that the swelling had been there for 3 years, but grew quite rapidly in the past 3 months. Pleomorphic adenoma surgery recovery doctor answers.
Metastasizing pleomorphic adenoma the term currently preferred by the world health organization who is also known as metastasizing benign pleomorphic adenoma. Wangthe pathologic basis of partial parotidectomy in parotid pleomorphic adenoma treatment. Salivary gland pleomorphic adenoma in the netherlands rug. The treatment of pleomorphic adenoma is surgical excision. Usdj 2019 volume 3 issue 1 48 pleomorphic adenoma a diversified bizzare tumor bhardwaj n1, kaur s2 1pg student hids paonta sahib, 2 general dentist abstract pleomorphic adenoma is a lesion which accounts for the vast majority of all salivary tumors pleomorphic adenomas are benign salivary gland tumors, which predominantly affect the superficial lobe of the parotid gland. Immunohistochemical pattern of pleomorphic adenoma.
Pleomorphic adenoma of the cervical heterotopic salivary. Effective chemotherapy for submandibular gland carcinoma ex. Intraoral examination revealed a soft tissue mass 1. This article is from journal of surgical case reports, volume 20. S110 journal of the college of physicians and surgeons pakistan 2015, vol. Mixed tumor of the lacrimal gland pleomorphic adenoma definition. Malignant transformation, though rare, has been reported. While the upper lip is a common site, it is unusual to. Pleomorphic adenoma benign mixed tumor is the most common neoplasm of the salivary glands.
Role of ffdg petct in management of highgrade salivary. A case of pleomorphic adenoma of the parotid gland with. Usdj 2019 volume 3 issue 1 48 pleomorphic adenomaa diversified bizzare tumor bhardwaj n1, kaur s2 1pg student hids paonta sahib, 2 general dentist abstract pleomorphic adenoma is a lesion which accounts for the vast majority of all salivary tumors pleomorphic adenomas are benign salivary gland tumors, which predominantly affect the superficial lobe of the parotid gland. Although its local recurrence rate is known to be high, the recurrence extending to the cervical region is rare. Surgical treatment of recurrent pleomorphic adenoma of the. The growth is usually mobile unless found in the palate and when found in the parotid tail, it is present as an eversion of the ear auricle. A pleomorphic adenoma is a tumour of a gland that produces saliva in the mouth. Get detailed information about the treatment for newly diagnosed and recurrent salivary gland cancer in this summary for clinicians. Pleomorphic adenoma constitutes 50% of salivary gland tumors affecting mostly the parotid gland extraorally, and the palate intraorally. Pleomorphic adenoma of the palate in a child and she denied drug allergy. Treatment consists of surgical excision down to the underlying periosteum. Pleomorphic adenoma of the minor salivary glands most commonly occurs in the palate 16. The surgical approaches to the treatment of parotid pleomorphic adenomas.
There are three main patterns of malignant change that occur in pleomorphic adenoma. Doctors give unbiased, helpful information on indications, contraindications, benefits, and complications. Metastatic pleomorphic adenoma e195 authors such as czader 9 have described the metastatic mixed tumor as a link between a pleomorphic adenoma and a cepa and suggested that metastases of pleomorphic adenomas may be the first stage in the transformation of a tumor into a carcinoma, though this does not occur in. Case report primary carcinoma ex pleomorphic adenoma of.
Aggressiveness and extent of the tumor mass and its relation with the facial nerve form the important criteria which dictate the choice of treatment of pleomorphic adenoma of the parotid gland. Enucleation, enucleoresection and superficial or total parotidectomy with preservation of the facial nerve formed the mainstay of surgical treatment. In such cases, it is critical to make a definite diagnosis as each of these tumors has an entirely different treatment protocol. Pleomorphic adenoma is the most common salivary gland tumor and accounts for approximately 80% of parotid tumors. Pdf pleomorphic adenoma is a benign epithelial tumor of adenoid structure preferentially arising from the parotid. Eighty per cent of pleomorphic adenomas of this particular gland are benign, and 20 per cent are cancerous. If yes, where can i get it done and what is the expected cost of the surgery. Salivary gland cancer treatment options include surgery with or without postoperative radiation therapy, radiation therapy, and chemotherapy. Pleomorphic adenoma of the lacrimal gland with extensive.
They originate from an uncommitted reserve cell of the intercalated duct which has the potential to differentiate into epithelial and myoepithelial cells 25. Pleomorphic adenoma, or benign mixed tumor, is the most common tumor of the parotid gland and represents 70% of all parotid neoplasms. The chart showing pdf series, word series, html series, scan qr codes. Neoplasms that arise in the salivary glands are relatively rare, yet they represent a wide variety of both benign and malignant histologic subtypes as seen in the image below. Treatment is by radical excision, often followed by irradiation therapy. Abstractwe present a case of a 62yearold male patient with pleomorphic adenoma and. The usual treatment is complete excision by lateral orbitotomy. However, there is evidence to support the more conservative approach of. Nerve integrity monitoring may reduce morbidity for recurrent pleomorphic adenoma. Pleomorphic adenoma an overview sciencedirect topics. The main symptom was a swelling in the submandibular region, and the duration of symptoms before treatment varied from 2 to 240 months, with a mean of 54. Surgery with safety margins is the therapy of choice.
Primary pleomorphic adenoma of minor salivary gland in the. Pleomorphic adenoma is, by far, the most common benign salivary gland tumor, accounting for as many as 80% of all such tumors. S110s111 introduction salivary gland tumours are relatively rare, comprising less than 3% of all neoplasia of head and neck region. The stroma may be chondroid, myxoid, osteoid, or fibroid. Received is a single container consists of a rubbery nodule weighing 26 g and measuring 5 x 4. Management and prognostic factors of recurrent pleomorphic adenoma of the parotid gland. Pdf pleomorphic adenoma is the most common type of all benign and malignant. Management and prognostic factors of recurrent pleomorphic. Pleomorphic adenoma is a common benign salivary gland neoplasm characterised by neoplastic proliferation of parenchymatous glandular cells along with myoepithelial components, having a malignant potentiality. Lutfi kirdar kartal education and research hospital, ent department, istanbul, turkey. Common side effects of this regimen include xerostomia or dryness of the mouth and oral mucositis or mouth membrane inflammation. Rodrigueza, sara vargasb, caroline robsonc, antonio perezataydeb, robert shambergerd, trevor j. Imaging characteristics of recurrent pleomorphic adenoma.
Pleomorphic adenoma of the submandibular gland jama network. On the 1 year followup there is no recurrence or complaint detected. Recurrent pleomorphic adenomas of the parotid gland warrant consideration because of the potential for facial nerve injury occurring with surgical treatment a. Cases of giant pleomorphic adenomas gpa are rare, according to previous medical literatures, the majority of which were involving in the parotid gland. Some prefer to verify the diagnosis prior to surgery with fine needle aspiration. It is generally accepted that the standard treatment of pleomorphic adenoma of the parotid gland is a formal parotidectomy or at least the removal of the tumor with a surrounding cuff of normal parotid. Many types of carcinoma are seen with adenocarcinoma being the most common. This paper describes a case of a pleomorphic adenoma of the hard palate, which was diagnosed in a 46yearold female patient.
909 43 447 815 351 1269 988 922 1162 1192 904 368 1460 1407 49 1091 566 30 576 461 1305 1497 901 514 777 633 822 1097 765 980 658 376 417 606 331 230 1233 808 979 90 1213 1483 1011