Metastasizing mixed tumour of the parotid gland presenting as multiple lung metastases

Yoshizaki, Tomokazu; Kinsen, Hidenori; Minato, Hiroshi; Kita, Toshiyuki; Furukawa, Mitsuru

doi:10.1258/0022215042244750

Cited by 14 publications

(7 citation statements)

References 6 publications

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“…It has been suggested that metastasising tumours have a higher mitotic rate than non-recurring lesions, but this theory is not universally accepted and this feature was not seen in our patient (6)(7)(8)(9). The Patients (81%) with MPA have a history of at least one local recurrence of PA prior to the detection of distant metastasis of the tumour at the primary site is a characteristic feature of these metastasising pleomorphic adenomas; recurrence ocurring in about 90% of cases (5). There is often a long interval between the diagnosis of the primary mixed tumour and the metastasis (5,6).…”

Section: Discussionmentioning

confidence: 58%

“…Benign MPA is distinguished from truly malignant pleomorphic tumors (such as carcinomas arising from pleomorphic adenomas, and carcinosarcomas) by its benign histologic features. However, there are no agreed histopathologic parameters that can differentiate a non-metastatic pleomorphic adenoma from Mpa (4,5,8). It has been suggested that metastasising tumours have a higher mitotic rate than non-recurring lesions, but this theory is not universally accepted and this feature was not seen in our patient (6)(7)(8)(9).…”

Section: Discussionmentioning

confidence: 99%

“…The Patients (81%) with MPA have a history of at least one local recurrence of PA prior to the detection of distant metastasis of the tumour at the primary site is a characteristic feature of these metastasising pleomorphic adenomas; recurrence ocurring in about 90% of cases (5). There is often a long interval between the diagnosis of the primary mixed tumour and the metastasis (5,6). Paradoxical nature of MPA, with its benign histological appearance and its metastatic spread capacity, intrigues clinicians and academic scholars.…”

Section: Discussionmentioning

confidence: 99%

“…The World Health Organization (WHO) defines MPA as a "histologically benign pleomorphic adenoma that inexplicably manifests local or distant metastasis" (4). Although apparently benign, the MPA-associated mortality could be as high as 22% (5). The most common initial tumor site in MPA is the parotid gland (74%), followed by minor salivary glands (17%) and submandibular glands (10%).…”

Section: Introductionmentioning

confidence: 99%

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Benign Metastasizing Pleomorphic Adenoma: A Case Report

Ranjbari¹,

Panah²

2014

Jentashapir J Health Res

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Introduction: Pleomorphic adenoma (mixed tumor) is the most common neoplasm of the salivary gland. It is usually a benign, slowgrowing and well-circumscribed tumor. However, there are rare reports of a subset of these tumors metastasizing to distant sites without undergoing malignant transformation. Here we describe a case of pleomorphic adenoma of the parotid gland that metastasied to the cervical lymph node coincidentally with similar appearance of the primary lesion in the ipsilateral parotid gland. Case Presentation: A 78-year-old male with right sided cervical lymph node and ipsilateral parotid mass from one year ago came to Imam Khomeini hospital. Physical examination, a painless firm mass was found within year, the parotid and lymph node of the neck concomitantly with no other organs abnormalities. A diagnosis of pleomorphic adenoma was made from completion parotidectomy and cervical lymphadenectomy. No histologic characteristic of malignancy were seen in either specimen; therefore a diagnosis of benign metastasizing mixed tumor was rendered. Discussion: Benign metastasizing pleomorphic adenoma is a rare and controversial but distinct clinical entity. Although the definition of the term benign precludes metastatic disease, these tumors do not demonstrate any malignant features yet metastasized to distinct sites. It remains to be determined whether this benign metastasizing pleomorphic adenoma is really low grade salivary malignancy.

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Benign Metastasizing Pleomorphic Adenoma: A Case Report

Ranjbari¹,

Panah²

2014

Jentashapir J Health Res

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“…Some cases have presented to non-head and neck clinicians with distant metastases located in the kidney and lung and have been considered a malignant process, until FNAC or excision have proven pleomorphic adenoma metastases; only then had it transpired, on history or examination, that the patients had concurrently or previously had a salivary gland pleomorphic adenoma removed [13,15].…”

Section: Modes Of Presentationsmentioning

confidence: 99%

???Metastasizing pleomorphic salivary adenoma??? should now be considered a low-grade malignancy with a lethal potential

Bradley

2005

Current Opinion in Otolaryngology & Head and Neck Surgery

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Metastasizing Pleomorphic Salivary Adenoma

Nouraei

Ferguson²,

Clarke³

et al. 2006

Arch Otolaryngol Head Neck Surg

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Objective: To address questions about the etiology, behavior, optimal treatment, and prognosis of metastasizing pleomorphic adenoma (MPA), we undertook a review of the literature and constructed a virtual series of all identified cases of MPA, metastatic lesions that are very occasionally identified in patients with a history of pleomorphic salivary adenoma and, on detailed pathological evaluation, found to exhibit all the histological hallmarks of the preceding benign lesions. Data Sources: A review of the English-language literature between 1953 and 2005 using MEDLINE, secondary references identified from bibliographies of pertinent articles, and a further case from one of our institutions. Data Synthesis: A virtual case series was constructed and quantitatively analyzed. Forty-two patients with an average age of 33 years were identified. There were 20 male and 22 female patients. There was an overwhelming history of incomplete surgery for pleomorphic salivary adenoma. Most patients had locoregional recur-rences before metastasis, and the mean presentation-tometastasis latency was 16 years. Bone was the most common site for metastases (45%), followed by the head and neck (43%) and lung (36%). There was significant morbidity and mortality from distant disease, with 5-year disease-specific and disease-free survival of 58% and 50%, respectively. Developing distant lesions within 10 years of the primary tumor and presence of metastases in multiple sites were independent predictors of survival on Cox regression analysis. Metastasectomy conferred significant survival advantage over nonoperative treatment (logrank analysis, PϽ.02). Chemotherapy and radiotherapy were of limited value.Conclusions: Meticulous surgery is crucial in preventing MPA. Metastatic disease carries significant morbidity and mortality and should be treated surgically when feasible.

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Metastasizing mixed tumour of the parotid gland presenting as multiple lung metastases

Cited by 14 publications

References 6 publications

Benign Metastasizing Pleomorphic Adenoma: A Case Report

Benign Metastasizing Pleomorphic Adenoma: A Case Report

???Metastasizing pleomorphic salivary adenoma??? should now be considered a low-grade malignancy with a lethal potential

Metastasizing Pleomorphic Salivary Adenoma

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