Pleomorphic adenoma of submandibular gland: not so common occurrence

Abstract

INTRODUCTIONSalivary gland tumors are uncommon and comprise only 1-4% of head-face-neck tumors. Majority of the salivary gland tumors affect parotid gland with more than 70% of the cases. Several studies have been conducted on the tumors of the parotid and minor salivary glands, but very few reports in the literature have focused on submandibular gland tumors as they are rare and are usually grouped with other salivary glands. Submandibular gland is affected in 5-10% of the cases with pleomorphic adenoma being the most common tumor. 1The most frequent neoplasms in the submandibular glands are: pleomorphic adenoma (36%), adenoid cystic ABSTRACT Background: The salivary glands tumour are relatively rare, yet they represent a wide variety of both benign and malignant histologic subtypes. Several studies have been conducted on the tumors of the parotid and minor salivary glands, but very few reports in the literature have focused on submandibular gland tumors as they are rare and are usually grouped with other salivary glands. Approximately 70% of the salivary gland tumors affect parotid gland with the submandibular gland being affected in 5-10% of the cases, sublingual gland in 1% and minor glands in 5-15% of the cases. So, author describe a series of 50 patients of pleomorphic adenoma affecting submandibular gland. Methods: The prospective study was conducted at Department of General Surgery, Indira Gandhi Government Medical College, Nagpur between January 2008 to December 2017. Results: Out of the 50 patients, 10 were male and 40 were female. Thus, male to female ratio is 1:4. Most of the 42 (84%) patients presented with painless swelling in submandibular region. Clinically the tumour has the texture of cartilage and has an irregular and bosselated surface observed in all the patients. The size of tumour was 3 to 6 cm in 32 (64%) patients observed in the present study. Fine needle aspiration cytology was performed in all the patients. All patients were managed by surgical excision. Recurrence occurred in a single patient who was managed with radical excision including a neck dissection with postoperative radiotherapy. Conclusions: Submandibular gland pleomorphic adenoma being common benign tumor, occurring commonly between the 3 rd and 5 th decade of life and presenting as slow growing asymptomatic swelling with female preponderance. The precise surgical excision along with whole submandibular salivary gland and postoperative radical radiotherapy required for recurrence as the accepted mode of management. However, further long-term studies involving submandibular gland have to be carried out to know the pattern of tumor recurrence.

Uncommon occurrence of pleomorphic adenoma in submandibular salivary gland in old age males: case series

“…Temporary paralysis may resolve spontaneously within a period of 3 months. 7 Parag et al study showed, complications like neuropraxia/paresis developed in marginal mandibular branch of facial nerve in 5 (10%) patients within first 24 hours postoperatively and while it completely resolved within 3-6 month. Other complications which developed were hematoma (2%) and surgical site infection (6%).…”

“…Other complications which developed were hematoma (2%) and surgical site infection (6%). 7 Osunde et al study showed malignant changes can occur in PA and include three distinct pathologic entities: Carcinoma arising in PA, which has been reported to occur in about 3-4%, carcinosarcoma, and benign metastasizing PA. Malignant changes were found in only 10% of the giant PA cases reviewed by Schultz-Coulon. The incidence of malignancy frequently shows a correlation between the length of the history of PA and the development of a carcinoma.…”