A case of giant sarcomatoid carcinoma ex-pleomorphic adenoma of the parotid gland

Abstract

Carcinoma ex pleomorphic adenoma is a rare malignant parotid neoplasm arising from primary or recurrent benign pleomorphic adenoma. Histologically, it can be sub-classified by upwards of eight different variations (e.g., myoepithelial carcinoma, salivary duct carcinoma, adenoid cystic carcinoma sarcomatoid carcinoma). We present the fourth case in the literature of sarcomatoid carcinoma arising from an underlying pleomorphic adenoma of the parotid gland. We present a case of a 47-year-old female who consulted for a left parotid mass of 15cm long axis. There was no facial paralysis. Fine needle aspiration cytology smears showed a pleomorphic adenoma. The parotid MRI showed a left parotid mass, with heterogeneous signal (hyposignal T1 and hypersignal T2 and in diffusion sequences). The patient underwent a total parotidectomy with a pleomorphic adenoma on extemporaneous examination. Histological examination of the part revealed a pleomorphic adenoma on which a sarcomatoid carcinoma developed. Therefore, a second operation occurred. We performed selective lymph node dissection carrying out the sectors I, II and III followed by radiotherapy. The evolution was favorable. In addition to its rarity, our case joins historical cases by its huge size.

Carcinosarcoma EX Pleomorphic Adenoma of Parotid: An Unusual Entity, A Report of Two Cases with Brief Review of Literature

“…A mucin rich salivary duct carcinoma ex pleomorphic adenoma has also been reported [13]. Rarer types of carcinomas arising from pre-existing pleomorphic adenoma include Adenoid cystic carcinoma, clear cell carcinoma, sarcomatoid carcinoma and large cell neuroendocrine carcinoma [14][15][16][17]. Occasionally, myoepithelial carcinoma occurring in CXPA has been reported [18] with its occurrence in CSXPA, a much more unusual event which is the histology in our first case.…”

Is Primary Poorly Differentiated Sarcomatoid Malignancy of the Parotid Gland Sarcomatoid Undifferentiated/Dedifferentiated Melanoma? Report of Three Unusual Cases Diagnosed by Fine-Needle Aspiration Combined with Histological, Immunohistochemical, and Molecular Analyses

“…Carcinoma ex pleomorphic adenoma may also be a subject of differential diagnosis, if carcinoma component presents as a sarcomatoid pattern [56,57]. Finally, an unusual case of melanoma in a carcinoma ex pleomorphic adenoma of the parotid gland has also been documented [39].…”