Pedunculated pleomorphic adenoma of the tongue base manifesting with dysponea

Abstract

Pleomorphic adenomas of the minor salivary glands are rare. The most common site is in the palate. We have come across a case of pedunculated pleomorphic adenoma of the base of die tongue which came to us only when the tumour had caused respiratory distress. Case ReportK.D., a 35-year-old male patient, came to the Department of Otolaryngology and Head and Neck Surgery of B. Y. L. Nair Charitable Hospital with a complaint of dysphagia for three months. The dysphagia was gradually increasing and when he came to us he was on a semi-solid and liquid diet For one month the patient had been getting violent bouts of coughing along with attacks of suffocation. The patient used to feel comfortable in the lying position, but the attacks of suffocation had increased progressively and for two days he had been in respiratory distress.On examination of the oral cavity with the tongue depressor, the gag reflex resulted in the expulsion of a polypoidal, nodular, reddish mass approximately 4 cm. in diameter in the oral cavity, with bouts of coughing followed by attacks of suffocation (Fig. 1). On indirect laryngoscopy a nodular, reddish mass was seen to occupy the oropharynx, and the laryngeal inlet was not visible.The patient was in respiratory distress so we decided to remove the tumour by performing an emergency operation. The operation was done under general anaesthesia with nasotracheal intubatioa First, nasotracheal intubation was done and then general anaesthesia was administered. Doyen's mouth gag was applied and the tongue was pulled out by a tongue clip. The tumour was palpated. It was firm, nodular, pedunculated and approximately 4 cm. in diameter. The pedicle of the tumour was attached at the base of the tongue, one centimetre behind the sulcus terminalis, slightly to the right of the mid-line. The tumour was held with tissueholding forceps and the pedicle was clamped, cut and transfixed, using the chromic catgut The tumour was well capsulated and its cut section had a homogeneous appearance, with areas of haemorrhage (Fig. 2). The post-operative period was uneventful. HistopathologyMultiple sections showed a non-keratinized squamous epithelial lining, and a minor salivary gland. Just underneath the surface, tumour tissue was seen. The tumour cells were polyhydral in shape and were arranged in sheets. The cells had a moderate amount of eosinophilic cytoplasm with vesicular nuclei. The ducts were lined by cuboidal epithelium and some of the duct lumina contained mucin. A few areas of pseudocartilage were seen From the

Pleomorphic Adenoma of the Base of the Tongue––A Case Report

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Pedunculated Squamous Cell Carcinoma on the Tip of the Tongue

“…Histopathology showed that the lesion in our patient was not a verrucous carcinoma but a typical well-differentiated squamous cell carcinoma. Although pedunculated forms of basaloid squamous cell carcinoma and spindle cell carcinoma, as well as adenocarcinoma and pleomorphic adenoma, have been observed on the tongue [13,[19][20][21][22][23], squamous cell carcinoma is more likely [6].…”

Pleomorphic Adenoma of Base of Tongue: Is Midline Mandibulotomy Necessary for Approaching Benign Base Tongue Lesions?

“…Tumors of the salivary glands comprise 3% of all neoplasms [2]. The majority of salivary gland neoplasms are benign with pleomorphic adenomas being the most common.…”