Keratinizing pleomorphic adenoma: An unusual case report

Tandon, Aanchal; Jaiswal, Rakesh; Siddiqui, Safia; Bordoloi, Bharadwaj

doi:10.4103/jomfp.jomfp_200_17

Cited by 18 publications

(3 citation statements)

References 10 publications

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“…Twenty-two full-text articles published in the English language were included for the review purpose, which met the inclusion criteria of the reviewers. Studies included in the review were Tandon et al, 8 Taiwo et al, 9 Farhat et al, 10 Panda et al, 11 Celik, 12 Balan et al, 13 Kaul et al, 14 Mittal et al, 15 Kamala et al, 16 Bagga et al, 17 Modak et al, 18 Jain et al, 19 Verma et al, 20 Dhir et al, 21 Saito et al, 22 Swarnagowri et al, 23 Nagaraj et al, 24 Rahnama, 25 Sunil, 26 Aggarwal et al, 27 Kumar et al, 28 and Shrestha et al 29 …”

Section: Resultsmentioning

confidence: 99%

Pleomorphic Adenoma: A Systematic Review

Almeslet

2020

International Journal of Clinical Pediatric Dentistry

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Background Pleomorphic adenoma (PA) is a commonly occurring benign tumor originating in the salivary glands. Objective The aim was to carry out a systematic literature of reports on pleomorphic adenoma from 2000 to 2018 to determine patient's age spread, gender, anatomical location, capsular invasion, histopathology, treatment and patient outcome. Materials and methods A PubMed search was conducted with the following key words: adenoma, pleomorphic adenoma, and mixed salivary tumor. Results Twenty-two articles in English were read in full after fulfilling the eligibility criteria. The mean age of PA occurrence was 44.14 years with a definite female predilection (M:F ratio = 13:8). It most commonly occurred in the facial region (42.85%), and surgical approach is the preferred intervention. Conclusion Pleomorphic adenomas are benign salivary gland neoplasms that can grow into extensive sizes if left untreated and hence need to be diagnosed early. Complete excision of the tumor is the definitive treatment, as enucleation can result in recurrence. Facial nerve has to be preserved if PA occurs in the parotid gland. How to cite this article Almeslet AS. Pleomorphic Adenoma: A Systematic Review. Int J Clin Pediatr Dent 2020;13(3):284–287.

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Section: Resultsmentioning

confidence: 99%

Pleomorphic Adenoma: A Systematic Review

Almeslet

2020

International Journal of Clinical Pediatric Dentistry

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“…The aforementioned findings are typical of neoplastic or reactive conditions of the salivary glands, such as chronic sialadenitis, radiation change of salivary glands and necrotizing sialometaplasia, MEC, pleomorphic adenoma, basal cell adenoma and Warthin's tumor. The presence of these features on FNAC can be misleading in the presence of a pleomorphic adenoma [13] as was present in our case, as further classification was not possible on the sample. Subsequently, it brought distress to the patient and a diagnostic dilemma to the clinical team as it was particularly challenging to exclude a malignancy of the parotid gland via FNAC.…”

Section: Discussionmentioning

confidence: 64%

A Diagnostically Challenging Parotid Gland Tumor With Hybrid Features

Hamilton¹,

Saleem²,

Ali³

et al. 2021

Cureus

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Salivary gland tumors are relatively uncommon with most being benign. When diagnosed the most common benign and malignant tumors are pleomorphic adenoma and mucoepidermoid carcinoma (MEC), respectively. However, not uncommonly, it is difficult to differentiate between the histopathological entities, leading to a diagnostic dilemma that can impact a patient's treatment and prognosis. A 24-year-old woman presented with a three-year history of asymptomatic left-sided facial swelling. She denied any prior history of head and neck radiation. There was no history of alcohol consumption or smoking exposure and there was no personal or family history of head and neck cancers. Additionally, she did not have any known occupational or environmental exposures. Due to the chronicity and painless nature of this facial mass, our patient did not pursue evaluation initially. Subsequently, she experienced an increase in size and pain for a few months exacerbated by swallowing. She had no other symptoms. On physical examination, a 3 x 3 cm left parotid gland mass was noted. There was no associated head or neck lymphadenopathy and compression of the left facial mass did not elicit secretions from the opening of Stensen's duct. Due to the rapid increase in size, she was sent for CT neck/soft tissue with contrast which confirmed a 3.56 x 2.67 cm solid nodule within the superficial portion of the left parotid gland. This was followed by an MRI orbit/face/neck with and without contrast, for further delineation, which demonstrated a 4 x 3.7 x 3 cm complex heterogeneous mass within the superficial left parotid gland. Thereafter the patient underwent an uncomplicated ultrasound-guided biopsy of the parotid mass. The histopathological appraisal concluded that this was a cellular pleomorphic adenoma, with mucinous and squamous metaplasia with reactive lymph nodes. Due to the new rapid increase in size and intense painful nature of this tumor, nerve-sparing left parotidectomy, fat grafting and reconstruction were completed. Cellular pleomorphic adenomas are benign low-grade neoplasms, typified as biphasic with both epithelial and myoepithelial components. However, they have increased cellularity and focally increased mitotic activity, not advanced enough to qualify as malignant. The presence of mucinous and squamous metaplasia is of diagnostic interest as it makes diagnosis on fine-needle aspiration (FNA) morphologically challenging. These findings are typical of MEC and on FNA can be misleading in the setting of a pleomorphic adenoma. However, on histopathological evaluation of the gross specimen along with immunohistochemical staining the diagnosis is made much easier. A diagnosis of MEC would have potentially required neck dissection and adjuvant therapy with a potential increased risk of morbidity and mortality. This case emphasises the importance of an adequate tissue biopsy in regards to parotid gland tumors to optimise a patient's care plan.

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“…While haemorrhagic degeneration in a parotid mass should always raise the index of suspicion for malignancy, our case and others like it suggest that central necrosis in benign tumours is rare only because most are resected while still small. [13,14] With surgery of this complexity, it is important to have a thorough knowledge of the anatomy of the local structures.…”

Section: Discussionmentioning

confidence: 99%

Giant pleomorphic adenoma of the parotid gland: a case report

Fernàndez¹,

J²,

Suàrez³

2021

SSMJ

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Pleomorphic adenomas account for the majority of parotid masses, typically arising in the tail of the gland and enlarging slowly. Most are 2 to 6 cm in size when resected. We report the resection of a benign mixed tumour of the left parotid gland with a history of bleeding. The resected tumour measured 21 cm in diameter, weighed 1.81 kg, and on pathologic examination was a benign mixed tumour without malignant degeneration. The implications of this unusual case for the management of mixed tumours are discussed with a review of the literature.

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Keratinizing pleomorphic adenoma: An unusual case report

Cited by 18 publications

References 10 publications

Pleomorphic Adenoma: A Systematic Review

Pleomorphic Adenoma: A Systematic Review

A Diagnostically Challenging Parotid Gland Tumor With Hybrid Features

Giant pleomorphic adenoma of the parotid gland: a case report

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