Basal Cell Adenoma of Submandibular Salivary Gland: A Case Report and Literature Review

Abstract

Background Salivary gland tumours constitute about 3-4 % of all head and neck neoplasms. Approximately 80 % originate in the parotid gland and they are rarely present in the submandibular gland. Basal cell adenoma is a benign epithelial salivary gland tumour that appears to have unique histologic characteristics. The diagnosis of this entity must be established by histological study. Case report The literature revealed only four reported cases of basal cell adenoma of submandibular salivary gland. This article presents a rarely occurring basal cell adenoma as a fifth reported case in submandibular salivary gland in a 23 year old female. Discussion A rare case of basal cell adenoma of submandibular salivary gland is reported with clinical features, diagnosis, histopathological features and treatment modalities. When there is involvement of submandibular gland with a tumour the histopathological confirmation is mandatory instead of relying on FNAC and it must be differentiated from pleomorphic adenoma, adenoid cystic carcinoma, adenocarcinoma due to its prognostic implications.Conclusion Entities like basal cell adenoma can only be established by histopathological examination after excisional biopsy. The treatment done also affects the ultimate prognosis. As such the surgeon has to make his clinical decision based on many factors like history, clinical examination, histopathological examinations, radiological examination and immunohistochemistry study. No single criteria should be relied upon. We recommend to carry out genetic pattern study in a person with basal cell adenoma to rule out pathogenesis and establish a correct diagnosis of it for better understanding and prognosis.

Basal Cell Adenoma in the Parotid Gland: A Case Report of Rare Salivary Gland Tumor

“…Histopathologically, BCA is composed of basaloid cells, classified based on their morphologic pattern into four subtypes: solid with most common type, trabecular, tubular, and membranous [5]. The recurrence and malignant transformation are more common in the membranous type than in other subtypes [9,11,12]. In the present case, the tumor was histopathologically classified as tubular-trabecular mixed type BCA.…”

“…Clinically, BCA frequently occurs in people aged more than 50 years as a unilateral tumor with round or oval swelling. This tumor tends to be an asymptomatic, slowly growing and movable mass with a maximum diameter of 3 cm [9,10].…”

“…The differential diagnoses of BCA are pleomorphic adenoma (PA), adenoid cystic carcinoma (ACC), and basaloid cell adenocarcinoma (BCAC). BCA has no rich stroma and the myxoid or chondroid elements as characteristics of PA [8,9,13]. Although ACC and BCAC have clinical and histological similarities with BCA, these malignant tumors exhibit invasive, unencapsulated growth into adjacent soft tissue, often with associated vascular or perineural invasion [7][8][9].…”

Potential Difficulties in Cytological Approach of Basal Cell Adenoma of Salivary Glands: The Experience of a Single Institution

“…Kleinsasser and Klein [8] were the first to designate the term basal cell adenoma and to establish it as distinct clinical and pathological entity in 1967. Although BCA is not a novel entity, its etiopathogenesis still remains unclear: recently some authors have hypothesized that intercalated duct cells/intercalated duct hyperplasia may represent a precursor lesion of BCA [9,10].…”

Biopsy Techniques for Parotid Neoplasms

“…FNAC is unable to differentiate Warthin's tumours from squamous cell carcinoma ( Figure 1) when there is more than one tumour cell type in the same mass, or to differentiate adenoid cystic carcinoma from pleomorphic adenoma. 13,14 UltRASOUND-GUiDED CORE NEEDlE BiOPSY USCB using a spring-loaded automated device is commonly performed in the breast 15 and liver. 16 A smaller bore 18-gauge or 20-gauge needle is generally used for the parotid gland ( Figure 2).…”