The term pleomorphic refers to both the histogenesis and histology of the tumor. Nov 10, 2000 carcinoma ex pleomorphic adenoma of the salivary gland is a relatively uncommon tumor that accounts for roughly 4% of all malignancies at this location. It was referred by different names like mixed tumor, enclavoma, branchioma, endothelioma, enchondroma, etc. Pleomorphic adenoma, benign mixed tumor, differentiation. Myoepithelial cells are the main component in pleomorphic. However, ultrastructural examination of low and intermediategrade mucoepidermoid carcinomas and pleomorphic adenomas reveals many common. Histogenesis of salivary gland pleomorphic adenoma mixed.
Notch as a possible cell differentiation factor in. Pleomorphic adenoma may show various architectural and cytologic features that resemble other salivary tumors identifying areas typical of pleomorphic adenoma with triphasic ductal, myoepithelial and stromal components is helpful to establish the diagnosis squamous cell carcinoma. Pleomorphic adenomas are the commonest tumors of the salivary glands. An unusual variant of a common palatal salivary gland tumor. Introduction pleomorphic adenoma pa, also known as benign mixed tumor, is the most common salivary tumor, constituting up to twothirds. Histogenesis of salivary gland neoplasms dwivedi n. Among these proposals, the extent of participation of the myoepithelial cell and the embryologic origin and functional role of this type of cell in this tumor have been controversial. Histogenesis of salivary gland neoplasms dwivedi n, agarwal a.
Sonographic imaging of a pleomorphic adenoma of the salivary. Pdf an uncommon recurrence of carcinoma ex pleomorphic. From ultrastructural studies some 0rker,0,7 have suggested that the myoepithelial cell plays a major role in the growth and develop ment of pleomorphic adenomas. Pleomorphic adenoma arising from heterotropic salivary. There was a thin layer of lymphoid tissue at the periphery of the pleomorphic adenoma. To our knowledge,no reportdescribingthe clinical and pathologicfeatures of this entity in the epiglottis or larynx has been previously reported. Carcinoma in pleomorphic adenoma ca in pa is a rare lesion which is composed of a malignant tumor or is transformed from a benign pleomorphic adenoma. Extensive lipomatous involvement of the tumor is, however, a very rare finding. Feb 27, 2018 how can pleomorphic adenoma of salivary gland be prevented. It is the most common benign salivary gland in children and adults.
Extensive lipomatous change of the tumor is, however, a very rare finding in pleomorphic. Studies relatingto the histogenesis of pleomorphic adenoma in salivary glands are controversial. Histogenesis of salivary gland pleomorphic adenoma mixed tumor with an evaluation of. Embryologic concepts explaining the histogenesis of ectopic salivary glands esgs are explored, and the problem of their con. Pleomorphic adenoma of the submandibular gland jama network.
Study of myoepithelial cell markers in pleomorphic adenoma. Differential diagnosis especially concerning lipoma pure lipomatous tumor is essential. The salivary gland pleomorphic adenoma is a benign. Olsen and lewis,12 in a study of 73 cases, found that the histologic subtype was not a signi. Roles of proteoglycans in the tumourigenesis and development. Lam rmy 1985 an electron microscopic histochemical study of the histogenesis of major salivary gland pleomorphic adenoma. Thus, complete surgical resection is the treatment of choice. Salivary gland tumors are rare, comprising less than 3% of all neoplasia of the head and neck region.
Aug, 2020 discussion nasal pleomorphic adenoma is seen predominantly in females 4 11 usually between the third and fifth decades of life conclusions in the presence of a slowgrowing unilateral mass of the nasal cavity, it is important to consider, among the various diagnoses, the presence plemoorfo pleomorphic adenoma, even if it is not frequently. All of these advances show that the search of a histogenetic and. Pleomorphic adenoma surgery, symptoms, causes, treatment. Ultrastructural analysis of salivary gland pleomorphic. An external file that holds a picture, illustration, etc. Oncocytic pleomorphic adenoma of the parotid gland. A case of lipomatous pleomorphic adenoma in the parotid gland. Pleomorphic adenomas are common benign neoplasms of the major salivary. Pleomorphic adenoma, also known as benign mixed tumor is the most common tumor of the salivary gland accounting for 6080% of the benign variety. Current medical research has not established a method of preventing the formation of pleomorphic adenoma of salivary glands regular medical screening at periodic intervals with blood tests, radiological scans, and physical examinations, for those who have already endured the tumor, are. Lipomatous component focally can be included in pleomorphic adenoma.
Malignant transformation, though rare, has been reported. The signs and symptoms are similar to other malignant salivary gland tumours. A large pleomorphic adenoma can be disfiguring or exert mass effect on important structures. Jun 22, 2019 the epidemiology of this neoplasm indicates that it is more common in female patients with a ratio of 2. Pleomorphic adenoma, the most common salivary gland tumor, is also. From our clinical data and previous reports of pleomorphic adenomas with focal oncocytosis, it is concluded that such changes likely do not alter prognosis in affected patients. Pleomorphic adenoma arising from heterotropic salivary gland. C arcinoma ex pleomorphic adenoma of the salivary gland is a relatively uncommon tumor that accounts for roughly 4% of all malignancies at this location. Similar to histogenetic considerations 4, it may be argued that with regard to. 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. A case of pleomorphic adenoma mixed tumor of the breast is described. The histogenesis of pleomorphic adenomas of breast has included. To present a case of pleomorphic adenoma arising from heterotopic salivary gland tissue in a supraclavicular lymph node.
The histogenesis of lipomatous pleomorphic adenoma is not clear. The standard treatment of pleomorphic adenomas in the parotid gland is a surgical procedure. Conclusion this is the sixth case of lipomatous pleomorphic adenoma in the english. Carcinoma ex pleomorphic adenoma may present within pleomorphic adenoma without evidence of in. Pleomorphic adenoma of the larynx is most uncommon.
Twentytwo benign pleomorphic adenomas of the major salivary glands were studied by transmission electron microscopy and immunohistochemical techniques three cases in order to characterize the cell types comprising the epithelial and socalled mesenchymal regions of the tumors. Previous ultrastructural studies of pleomorphic adenoma have presented conflicting results with regard to the role of myoepithelial cells in the histogenesis of this tumour. This mass was examined with sonography, and the appearance suggested the presence of a pleomorphic adenoma. It arises from the benign tumour pleomorphic adenoma. Among all of them, the most common epithelial tumor is the lacrimal gland pleomorphic adenoma, which is a benign indolent tumor that usually affects adults in the third and fourth decades of life. Sep 21, 2019 pleomorphic adenoma, though a benign tumor of salivary gland, should be diagnosed at an early stage and surgically excised.
The intercalated duct origin histogenesis concept for pleomorphic adenoma and mucoepidermoid carcinoma proposed by dardick can be used as a platform to understand the strong positive expression of p27 in pleomorphic adenomas and mucoepidermoid cases 12. Histogenesis of benign pleomorphic adenoma mixed tumor. A 38yearold female consulted with a six month history of an enlarging right supraclavicular mass. This is the only example of an epiglottic pleomorphic adenoma among 391 cases seen at presbyterianuniversity hospital and the eye and ear hospital. Comparative histogenesis and morphogenesis of mucoepidermoid. Carcinoma ex pleomorphic adenoma shows diversity in its. They are benign except for a rare carcinoma ex pleomorphic adenoma but are not always completely encapsulated and show a definite tendency to recur after excision, in which case recurrence represents local growth because of incomplete excision and not malignancy.
A case of lipomatous pleomorphic adenoma in the parotid. Numerous theories have been proposed regarding the histogenesis of pleomorhic adenoma. Clinical aspects of tumors of the major salivary glands. The expression of notch in 30 cases of pleomorphic adenoma was examined by immunohistochemistry. Pleomorphic adenoma usually develops as a nontender nodular lesion with a slow growth rate persisting for years. Diversity of collagen expression in the pleomorphic adenoma. The material was subjected to quantification using the stereological. As noted in the introduction, the recurrence rate of pleomorphic adenoma after surgery has been reported to be 1% 45% 1. A quantitative ultrastructural study of the pleomorphic. In the past a variety of cellular differentiation pathways have been proposed to account for the derivation of pleomorphic adenomas. Download pdf tumoral stroma of salivary pleomorphic adenoma. Histogenesis of benign pleomorphic adenoma mixed tumor of the major. About 90% of these tumors occur in the parotid gland and 10% of them occur in the minor salivary. The existence of epithelial or myoepithelial component is a diagnostic clue.
Diversity of collagen expression in the pleomorphic. Synchronous sebaceous lymphadenoma with squamous cell. The differential diagnosis includes cellular pleomorphic adenoma, basal cell adenocarcinoma. Histogenesis of salivary gland pleomorphic adenoma. Pleomorphic adenoma pa is the most common benign and mucoepidermoid carcinoma mec is the most common malignant salivary gland neoplasms. Twentytwo benign pleomorphic adenomas of the major salivary glands were studied by transmission electron microscopy and immunohistochemical techniques three cases in order to characterize the cell types. Evaluation of p27 expression in salivary gland neoplasms. Pleomorphic adenoma is the most common benign salivary gland tumor that most commonly affects the parotid glands.
Jun 21, 2020 an unusual presentation of lacrimal gland pleomorphic adenoma. Pleomorphic adenoma, the most common salivary gland tumor, consists of epithelial and. Prognostic factors affecting the clinical outcome of. Pleomorphic adenoma of the salivary gland george william shepherd, phd, rdms, rvt a patient presented with a painless palpable mass located just below the right ear. Case report herein, a rare case of lipomatous pleomorphic adenoma arising in the parotid gland of a 14yearold japanese woman is presented. Salivary gland tumors are relatively common in the junction of the hard and soft palate area of the oral cavity. Lam rmy 1984 an electron microscopic histochemical study of the histogenesis of major salivary gland pleomorphic adenoma. As the term pleomorphic shows, the tumor is characteristic of the diversity of the histology. 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. Squamous metaplasia in a pleomorphic adenoma pa has been reported, but rarely has it been documented as being extensive enough to cause significant misdiagnosis. According to ersner and saltzman, inthe precursors of the septal pleomorphic adenoma adenona ectopic embryonic epithelialised cells on the nasal septum mucosa, found during the migration of the nasal buds journal list acta otorhinolaryngol ital v. The significance of the margin in parotid surgery for pleomorphic adenoma.
The term lipomatous pleomorphic adenoma was first used by seifert et al. The term pleomorphic refers to both histogenesis and histology of the tumor. The wide range of the rate depends on the type of surgical. Pdf a case of lipomatous pleomorphic adenoma in the parotid. Salivary gland mixed tumor i i istogenesisdarimk rt al. The dominant tumour pattern was the tubular and solidinsular one.
The tumor is almost always solitary and is usually found as a firm, mobile, painless slow growing mass. Multiple or bilateral pleomorphic adenomas are rare. Carcinoma ex pleomorphic adenoma ca ex pa is a type of cancer typically found in the parotid gland. We describe immunohistochemical investigations of tumor markers in 5 cases of carcinoma in pleomorphic adenoma. Seven adenoid cystic carcinoma cases were part of this study since this tumor is not as.
The tumor developed within an ectopic parotidtype salivary gland. Pleomorphic adenoma, which is the most common benign tumor of the parotid gland, rarely develops in the trachea, with less than 50 patients being reported in the literature up to 2016. Some of the rarer subtypes of this tumor may have a misleading clinical presentation. The wide range of morphologic expression evident in pleomorphic adenoma would appear to be the result of a. Role of proteoglycans in the histogenesis of adenoid cystic carcinoma and pleomorphic adenoma proteoglycans and the histogenesis of adenoid cystic carcinoma salivary acc is a malignant epithelial tumour composed of four major cell types. Jun 26, 2019 recurrent salivary gland pleomorphic adenoma. Comparing the results of our study with previous literatures, from the partial ck7 expression and substantial notch expression in ductal epithelial cells as well as the notch expression in solid tumor nests, it can be inferred that notch is involved in cell differentiation. Histogenesis of salivary gland pleomorphic adenoma mixed tumor with an evaluation of the role of the myoepithelial cell. The possible significance of this lesion in regard to the histogenesis of salivary gland pleomorphic adenomas is discussed.
In this series,pleomorphicadenoma has occurredmostfrequentlyintheparot id glands, and the present case represents the only example in the larynx. A case of pleomorphic adenoma of the parotid gland with. Mucoepidermoid carcinoma ex pleomorphic adenoma klijanienko. In 8 cases of typical pleomorphic adenomas, the epithelial component was dominant, being 7080% of the tumour mass.
Pleomorphic adenoma, salivary gland tumor introduction the term pleomorphic adenoma was suggested by willis 1. Recognition of these variants is important since longstanding pleomorphic adenomas have the potential to become malignant. Immunohistochemical aspects in pleomorphic adenoma, related to its histogenesis and malignization. In the present study specimens of ten major salivary gland pleomorphic adenomas were examined ultrastructurally and a number of cell types identified. We present a case of a 37yearold man presenting with a 1. Pdf mucoepidermoid carcinoma ex pleomorphic adenoma. Pleomorphic adenoma is considered the most common benign salivary gland tumor in this location. The average age of these patients was 48 years old range, 2671 years old and the sex distribution was almost equal 8. More importantly, they have a proven risk 515% of undergoing malignant transformation carcinoma ex pleomorphic adenoma, or malignant mixed tumor 3.
Pleomorphic adenomas, salivary gland tumors, myoepithelial cells. Our goal was to investigate the prognosis of cxpa in the major salivary glands and factors influencing it. Figure 1 a,b serial sections showed the tumor was surrounded completely by lymphoid tissues similar to those of the cortex of lymph. Pleomorphic adenoma is also called benign mixed tumor. Pleomorphic adenoma american cancer society journals. Dec 24, 20, adenocarcinoma, not otherwise specified nos adc nos is assumed to arise from either of these reserve cells, and carcinoma ex pleomorphic adenoma is of uncertain histogenesis. Oncocytic pleomorphic adenoma of the parotid gland pulitzer. Sep 12, 2015 1 chromosomes 3p21, 8q12 and 12q15 rearrangements and the plag1 and hmgic genes in pleomorphic adenomas 2 translocations of chromosomes 11q21 and 19p in both warthin tumour and mucoepidermoid carcinoma. Pleomorphic adenoma presenting a 2x2cm well circumscribed lesion on the palate of a 67year old female iarc screening group. Histogenesis of benign pleomorphic adenoma mixed tumor of.
Fine needle aspiration biopsy was negative for malignant cells. Functional histology of salivary gland pleomorphic adenoma. Pleomorphic adenoma pa, the most common salivary gland tumor, accounts. Histogenesis of benign pleomorphic adenoma mixed tumor of the major salivary glands. Many investigations have showed that myoepithelial cells play a major role in histogenesis of pleomorphic adenomas and may also be important in many mucoepidermoid carcinomas 35. Awpphillips mj histogenesis of salivary gland pleomorphic adenoma mixed. An unusual variant of a common palatal salivary gland. The histogenesis of pleomorphic adenomas of breast has includ. Introduction pleomorphic adenoma is the most common benign neoplasm of the salivary glands.
Tumors of the lacrimal gland are rare in clinical practice. As the term pleomorphic shows, the tumor is characteristic of the. Clinical characteristics of pleomorphic adenoma of salivary. The treatment of pleomorphic adenoma is surgical excision.
892 313 1045 246 515 917 779 1453 1360 1167 1174 1492 582 141 1145 54 59 568 1547 843 117 335 201 1497 565 879 524 1043