Polymorphous low grade adenocarcinoma of lip clinically mimicking squamous cell carcinoma: An unusual presentation

Abstract

Polymorphous low grade adenocarcinoma (PLGA) is a malignant neoplasm that frequently occurs in the minor salivary glands in palate and oral cavity. We present a case of upper lip swelling with ulceroproliferative growth, clinically mimicking squamous cell carcinoma (SCC). Fine-needle aspiration cytology smears suggested PLGA, which was later confirmed on histopathology. Clinical presentation of PLGA may simulate SCC.

Classic polymorphous adenocarcinoma: Fine needle aspiration cytopathology of eight cases

“…The cytomorphology of aspirates from our series largely mirrors that described from prior reports of the relatively sparse literature regarding this tumor 7‐19 . Cell uniformity is constant in nearly all cases of PAC as is the presence of tightly aggregated cell clusters, a clean smear background, and architectural heterogeneity among cell collections.…”

“…In the literature review by Jiménez-Heffernan et al there were 35 cases (including 12 from their own series) where a specific FNA diagnosis was listed, 9 whereas three articles from that review failed to list a specific FNA diagnosis. 7,11,17 When one combines the diagnoses listed in that revew 9 and the diagnoses from two other PAC FNA cases, 19,22 an accurate FNA interpretation of PAC occurs in less than half (49%) of the cases. This includes both primary and metastatic FNA PAC cases, as well as two cases where the diagnosis was low-grade adenocarcinoma, rather than PAC specifically.…”

“…PAC has a predilection to affect minor SG sites of the oral cavity such as the hard and soft palate, buccal mucosa, base of tongue, and lip—sites where diagnostic FNA biopsy is not typically employed in most medical centres. To our knowledge, merely five cytologic series of PAC having greater than five patients have been published in the English literature 7‐11 with the rest consisting of single or dual case reports 12‐19 …”

“…To our knowledge, merely five cytologic series of PAC having greater than five patients have been published in the English literature [7][8][9][10][11] with the rest consisting of single or dual case reports. [12][13][14][15][16][17][18][19] The objective of our retrospective series was to further evaluate the cytomorphology and diagnostic accuracy in a series of PAC FNA biopsy cases.…”

Polymorphous low-grade adenocarcinoma with cavernous sinus involvement presenting as third nerve palsy

“…Polymorphous low-grade adenocarcinoma (PLGA) is a tumor of the minor salivary glands that classically presents as an intraoral painless mass of the hard palate, tongue, upper lip, or tonsils. 1 Extraoral presentations of PLGA are rare. We report a case of PLGA presenting as a left cavernous sinus mass causing third nerve palsy in a patient status post glaucoma surgery.…”