Pleomorphic adenoma is the most common type of all. Conclusion reported to be 2045% with excisional biopsy 10. Many types of carcinoma are seen with adenocarcinoma being the most common. Management of the parotid pleomorphic adenoma, the problem of. It has epithelial, myoepithelial, and stromal components. Malignant transformation, though rare, has been reported. Pdf pleomorphic adenoma of the parotid gland in children. The objective of treatment of a parotid pleomorphic adenoma is to remove all tumour cells with minimal short and longterm morbidity and minimal recurrence. They may be broadly categorized into benign neoplasms, tumorlike conditions, and. They may be broadly categorized into benign neoplasms, tumorlike conditions, and malignant neoplasms.
This is a retrospective analysis of 25 patients treated. Recurrent pleomorphic adenoma poses a significant treatment challenge, considering its propensity for further recurrence and potential for malignant transformation. These tumors occasionally undergo malignant transformation, with potentially devastating consequences. Tumors of the salivary glands are uncommon and represent 24% of head and neck neoplasms. For this reason, preoperative planning is necessary pleomorphic adenoma of the parotid, while rare in to ensure the appropriate surgical management of the pediatric population, provides a therapeutic the tumor. Cns metastases of carcinoma ex pleomorphic adenoma of the. Carcinoma ex pleomorphic adenoma of the lacrimal gland.
Although pleomorphic adenomas most commonly occur in the parotid gland, it may also be encountered in the submandibular, lingual, and minor salivary glands. Mar 18, 2019 the use of radiation in t1 and t2 parotid gland tumors found that 5year diseasefree survival increased from 70% to 92% with postoperative radiation. The aim of this study is to report a case of an unusual minor salivary gland pleomorphic adenoma in the. Presently pleomorphic adenoma of the parotid gland is treated. Surgical treatment of recurrent pleomorphic adenoma of the. Fortyeight cases of recurrent pleomorphic adenoma treated at the university of michigan, ann arbor, between 1935 and 1975 were retrospectively analyzed. A second study investigated postresection radiotherapy for carcinoma ex pleomorphic adenoma and found a 26% improvement in 5year local control from 49% to 75%.
The current definition of ca ex pa became widely accepted in the second half of the. Pleomorphic adenoma of the cervical heterotopic salivary. Hence, the final diagnosis was of giant pleomorphic adenoma with negative surgical margins. Surgical treatment of pleomorphic adenoma of the parotid gland. The use of radiation in t1 and t2 parotid gland tumors found that 5year diseasefree survival increased from 70% to 92% with postoperative radiation. Pleomorphic adenoma an overview sciencedirect topics. Surgical excision with adequate margins is the principle treatment of pleomorphic adenoma to avoid recurrence. The prognosis and treatment options will be explored. Treatment of recurrent pleomorphic adenoma must be individualized. Pleomorphic adenoma benign mixed tumor is the most common neoplasm of the salivary glands. Parotid gland is affected from 80% to 90% of cases.
Pleomorphic salivary adenoma in an adolescent british. Prognostic factors affecting the clinical outcome of. Pleomorphic adenoma is the most common benign tumor affecting the major salivary glands and infrequently arises from the minor salivary glands. The epidemiology of pleomorphic adenoma can cover all ages and both genders but is more prevalent among women from thirty to sixty years of age. Dec 26, 2014 the stroma may be chondroid, myxoid, osteoid, or fibroid. Metastasizing pleomorphic salivary adenoma oncology. Pleomorphic adenoma develops as a lesion, which can slowly grow over the years. Pleomorphic adenoma pleomorphic adenoma is, by far, the most common benign salivary gland tumor, accounting for as many as 80% of all such tumors. Histologically, it is characterized by the presence of cellular pleomorphism and is composed of an epithelial and connective tissue component within a stroma of. It can be administered by pill or through a vein intravenously, or both. Pleomorphic adenoma symptoms, causes, treatment, surgery. Please remove adblock adverts are the main source of revenue for dovemed. Pleomorphic adenoma of the minor salivary glands most commonly occurs in the palate 16.
It is a benign tumour with a slow and continuous growth and without treatment can assume enormous dimensions. Discussion pleomorphic adenoma pa is a benign salivary gland tumour. Learn indepth information on pleomorphic adenoma of salivary gland, its causes, symptoms, diagnosis, complications, treatment, prevention, and prognosis. The neoplasms of the salivary glands account for 2% of head and neck tumors and the most common form is the pleomorphic adenoma pa. Pleomorphic adenoma, also known as benign mixed tumor is the most common tumor of the salivary gland accounting for 6080% of the benign variety. The results of surgical procedures for recurrence were determined with respect to tumor control and resultant facial nerve function. A case report of 28 year old male patient diagnosed of pleomorphic adenoma of palate, is presented here. Nerve integrity monitoring may reduce morbidity for recurrent pleomorphic adenoma. However, there is evidence to support the more conservative approach of. For tumors of deep lobe total parotidectomy is necessary.
It progresses slowly and, left untreated, can produce sig. Fortyeight cases of recurrent pleomorphic adenoma treated at the university of michigan, ann arbor. The management, pathology and treatment are discussed with emphasis on the. Etiology and management of recurrent parotid pleomorphic. If yes, where can i get it done and what is the expected cost of the surgery. Additionally, pa appears radiographically as a radiolucent defect with welldefined cortical margins. These cancerous transformations are known as carcinoma ex pleomorphic adenoma or malignant mixed tumor. Pleomorphic adenoma, or benign mixed tumor, is the most common tumor of the parotid gland and represents 70% of all parotid neoplasms.
Pleomorphic adenoma pa is the most common benign salivary gland tumour, accounting for as many as 80% of all such tumours. The management, pathology and treatment are discussed with emphasis on. Pleomorphic adenoma of the parotid gland in children. Pleomorphic adenoma of the parotid gland in children kimsey h.
Wangthe pathologic basis of partial parotidectomy in parotid pleomorphic adenoma treatment. It progresses slowly and, left untreated, can produce significant morbidity and, rarely, death. Surgical management of pleomorphic adenoma of parotid gland. The treatment of pleomorphic adenoma is surgical excision. Imaging characteristics of recurrent pleomorphic adenoma of. Imaging features of recurrent parotid pleomorphic adenoma have been infrequently reported in the radiology literature. The patient presented excellent cosmetic and functional results, without signs of facial nerve palsy, damage or recurrence. Pleomorphic adenoma is the most common benign salivary gland neoplasm. The role of adjuvant radiotherapy in management of.
In the case of large tumors, the following symptoms may be experienced. Pleomorphic adenoma pa is the commonest benign neoplasm of salivary glands. Carcinoma ex pleomorphic adenoma of the lacrimal gland with. Of the six malignant pleomorphic adenoma, recurrence within the first ten years took place in four patients 66. It involves the parotid of the major salivary glands and the palate of the minor salivary glands. Magnetic resonance imaging is the imaging study of choice for recurrent pleomorphic adenoma. For pleomorphic adenomao of superficial lobe of parotid gland, superficial parotidectomy with preservation of facial nerve is done. The pathology at this time was ill understood and the tumour was. Most recurrent pleomorphic adenoma are multinodular. Pleomorphic adenoma is a benign, slowgrowing neoplasm that most commonly affects the parotid gland. This article presents a case of pleomorphic adenoma of the palatal minor salivary gland treated successfully by surgical excision.
Recurrent pleomorphic adenoma of the parotid gland request pdf. Management of pleomorphic adenoma of the parotid wiley online. Role of radiotherapy for pleomorphic adenoma request pdf. 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. If the pleomorphic adenoma is in your parotid gland it can be a delicate surgery due to the closeness to your facial nerves and the potential for the surgery to cause damage to these facial nerves. The role of adjuvant radiotherapy in management of recurrent. Pleomorphic adenoma is, by far, the most common benign salivary gland tumor, accounting for as many as 80% of all such tumors. Giant pleomorphic adenoma of the parotid gland med oral patol. A pleomorphic adenoma is a tumour of a gland that produces saliva in the mouth. With correct surgical removal, the prognosis is excellent.
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. The aim of this study was to determine whether adjuvant radiotherapy is more effective than surgical resection alone in patients with recurrent. Undifferentiated pleomorphic sarcoma diagnosis and. Surgical management of pleomorphic adenoma of parotid gland in elderly patients. 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. The role of adjuvant radiotherapy in its management is widely debated. Pleomorphic adenoma, also referred to as benign mixed tumors bmts, is a benign or a noncancerous growth in the salivary gland, the most commonly occurring parotid tumor. If the pleomorphic adenoma is in your parotid gland it can be a delicate surgery due to the closeness to your facial nerves and the potential for the surgery to. They originate from an uncommitted reserve cell of the intercalated duct which has the potential to differentiate into epithelial and myoepithelial cells 25. Surgery is the most common form of treatment for pleomorphic adenoma. Treatment of patients with recurrent pleomorphic adenoma of the parotid gland is a challenge for a surgeon due to frequent problems with complete resection of all tumour foci while preserving. Malignant conversion developed in three 6% of 48 cases.
The standard of treatment is nerveconserving, superficial parotidectomy. Presently pleomorphic adenoma of the parotid gland is. Surgical resection of the tumor or partoid gland usually partial is the mainstay of treatment. This case report presents the clinical and radiographic features of a rare case of biopsy proved brain and spinal cord metastases arising from carcinoma ex pa of the parotid gland. Carcinoma ex pleomorphic adenoma cxpa is an uncommon malignant tumor with highly aggressive biological behavior. Pleomorphic adenoma is the most common parotid neoplasm. Pleomorphic adenomas are treated by complete surgical excision. The tumor is almost always solitary and is usually found as a firm, mobile, painless slow growing mass. A pleomorphic adenoma is a benign overgrowth arising from the salivary gland tissue and it is a painless hard, mobile, solitary mass. 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. Pleomorphic adenomas pas, also known as benign mixed tumors, are common tumors of the parotid gland.
Ca ex pa has been named as carcinoma ex mixed tumour, carcinoma ex adenoma, and carcinoma ex benign pleomorphic adenoma. Sep 04, 2019 tumors of the salivary glands are uncommon and represent 24% of head and neck neoplasms. Salivary gland tumors are rare, comprising less than 3% of all neoplasia of the head and neck region. This case report presents the clinical and radiographic features of a rare case of biopsy proved brain and spinal cord metastases arising from carcinoma ex pa of the. Salivary gland pleomorphic adenoma in the netherlands rug.
Pleomorphic adenoma is the most common parotid gland tumor. Recurrent pleomorphic adenoma of the parotid gland. In the case of carcinoma ex pleomorphic adenoma, there should be some remaining pleomorphic adenoma present to substantiate the diagnosis. This case study illustrates an unusual condition in childhood, pleomorphic salivary adenoma in a 12yearold. Chemotherapy is most often used to treat undifferentiated pleomorphic sarcoma that comes back after initial treatment or that spreads to other areas of the body. Nov, 2018 recurrent pleomorphic adenoma poses a significant treatment challenge, considering its propensity for further recurrence and potential for malignant transformation. Pdf clinical profile and management of pleomorphic adenoma of.
Giant presentation of pleomorphic adenoma in major. Although pa most commonly occurs in the parotid gland 85% cases, it may involve submandibular 8%, lingual and minor salivary glands. Intraoral pleomorphic adenoma happens when a tumor affects the minor salivary gland. Pleomorphic adenoma surgery, symptoms, causes, treatment. Enucleation, enucleoresection and superficial or total parotidectomy with preservation of the facial nerve formed the mainstay of surgical treatment. Pleomorphic adenoma pa is a benign tumour that mainly arises from salivary glands, and pa of the external auditory canal eac is very rare. Our goal was to investigate the prognosis of cxpa in the major salivary glands and factors influencing it. Rodrigueza, sara vargasb, caroline robsonc, antonio perezataydeb, robert shambergerd, trevor j.
Although an mri may be sufficient for differentiating a pleomorphic adenoma from other growths, dual isotope imaging by a singlephoton emission ct spect may be preferred in this regard. Imaging characteristics of recurrent pleomorphic adenoma. Pleomorphic parotid adenoma benign tumor of the parotid. Primary pleomorphic adenoma of the external auditory canal. Chemotherapy is a drug treatment that uses chemicals to kill cancer cells. Eighty per cent of pleomorphic adenomas of this particular gland are benign, and 20 per cent are cancerous. The risk of recurrence of pleomorphic adenoma is 3.
Surgical management of pleomorphic adenoma of parotid. Recurrent pleomorphic adenomas of the parotid gland warrant consideration because of the potential for facial nerve injury occurring with surgical treatment and the risk of malignant conversion. Pleomorphic adenoma of buccal minor salivary gland. May 27, 2000 this case study illustrates an unusual condition in childhood, pleomorphic salivary adenoma in a 12yearold. The aim of this study was to update our experience in treating pleomorphic adenoma with radiotherapy rt. The most predominant site of pleomorphic adenoma is palate. Most of them are benign and pleomorphic adenoma is the commonest among them that involves both major 90% and minor 10% salivary glands. Pictures of pleomorphic adenoma benign mixed tumor of. The aim of this study was to determine whether adjuvant radiotherapy is more effective than surgical resection alone in patients with recurrent pleomorphic. Treatment is by radical excision, often followed by irradiation therapy. Pleomorphic adenoma is the most common salivary gland tumor and accounts for approximately 80% of parotid tumors.
The objective of this study was to clarify the clinical presentation and treatment of pa of the eac. A biopsy should be conducted to exclude malignancy. Herein the presentation, radiography, histopathology, and treatment outcome of a rare case of lacrimal gland epithelialmyoepithelial carcinoma ex pleomorphic. The hypothesis for recurrence of pleomorphic adenoma using this type of surgical approach is that microscopic portions of tumor perforate the capsule and are. 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.
It is found mostly in the parotid gland in middleaged women. It accounts for 7080% of all benign parotid tumors. The prognosis is generally good after the surgical removal, however, there is an increased incidence of recurrence particularly if the parotid gland is affected. Over 84% of pleomorphic adenomas occur in the parotid gland, 8% occur in the submandibular gland, and 6. The stroma may be chondroid, myxoid, osteoid, or fibroid. Following a negative systemic workup, the patient underwent radiation therapy and remains free of clinical or radiographic disease 24 months following surgery.
1271 1265 906 1532 713 463 977 1562 1175 722 823 659 1347 967 1627 136 1420 331 741 1527 471 1086 281 475 1465 1444 317 1496 893 556 1327 650 1028 318 241 626