Oncocytic pleomorphic adenoma of the parotid gland pulitzer. Sep 21, 2019 among all of them, the most common epithelial tumor is the lacrimal gland pleomorphic adenoma, which is a benign indolent tumor that usually affects adults in the third and fourth decades of life. The submandibular gland is involved in only 5% to 10% of the salivary gland tumors, and pleomorphic adenoma pa is the most common tumor affecting it. Multiple or bilateral pleomorphic adenomas are rare. Histogenesis of salivary gland neoplasms dwivedi n, agarwal a 1, raj v, chandra s department of oral pathology and microbiology, saraswati dental college and hospital. These materials are the same as those produced by this cell in pleomorphic adenoma, which is evidence of differentiation and integrity furuse et al. Pleomorphic adenoma, the most common salivary gland tumor, is also known as benign mixed tumors bmts, because of its dual origin from. Histogenesis of salivary gland neoplasms dwivedi n. Roles of proteoglycans in the tumourigenesis and development. Pdf salivary gland tumors are one of the most complex and relatively rare group of. In the past a variety of cellular differentiation pathways have been proposed to account for the derivation of pleomorphic adenomas. It is histologically and ultrastructurally identical to that seen in the salivary gland and follows a similar benign course. During the surgery the part of the organ that is affected by the pleomorphic.
Pleomorphic adenoma the name of this tumour attempts to describe the unusual histopatholgy but terms are not correct. It is the most common type of salivary gland tumor and the most common tumor of the parotid gland. Histogenetic and morphogenetic concepts of salivary gland. If the pleomorphic adenoma is in your parotid gland it can be a delicate surgery due to the closeness to your facial nerves and the potential for the surgery to cause damage to these facial nerves. Nos is assumed to arise from either of these reserve cells and carcinoma ex pleomorphic adenoma is of uncertain histogenesis. Pleomorphic adenoma is the most common benign salivary gland tumor that most commonly affects the parotid glands. The epidemiology of pleomorphic adenoma can cover all ages and both genders but is more prevalent among women from thirty to sixty years of age. Pleomorphic adenoma, also known as benign mixed tumor is the most common tumor of the salivary gland accounting for 6080% of the benign variety. Salivary gland tumors are rare, comprising less than 3% of all neoplasia of the head and neck region. Benign tumour polymorphous low grade adenocarcinoma plga rare lesion 23% of benign s. The pleomorphic adenoma in this case resembles a typical adenoma of the parotid gland more closely than one of the nasal septum.
After surgical resection, up to 43% of patients are at risk of recurrence, even as late as 45 years after the initial surgery. Dec 01, 2015 the other 2 forms are carcinoma ex pleomorphic adenoma and metastasizing benign pleomorphic adenoma. Although pleomorphic adenoma was originally linked to the excretory duct reserve cell by. Comparative histogenesis and morphogenesis of mucoepidermoid. Although pleomorphic adenoma was originally linked to the excretory duct reserve cell by eversole 1971 without explanation or apparent rationale, the intercalated duct reserve cell are now the histogenetic source for this tumor in the modification proposed by regezi. Benign mixed tumor pleomorphic adenoma of the breast. A case of lipomatous pleomorphic adenoma in the parotid gland. Figure 1 a,b serial sections showed the tumor was surrounded completely by lymphoid tissues similar to those of the cortex of lymph. This type of tumor will usually occur in adults between the ages of fortyfive and sixty.
Introduction pleomorphic adenoma pa, also known as benign mixed tumor, is the most common salivary tumor, constituting up to twothirds. Histogenesis of benign pleomorphic adenoma mixed tumor. Erlandson ra, cardoncardo c, higgins pj 1984 histogenesis of benign pleomorphic adenoma mixed tumor of the major salivary glands. Discussion pleomorphic adenoma pa is a benign salivary gland tumour. Functional histology of salivary gland pleomorphic adenoma. Squamous metaplasia in a pleomorphic adenoma pa has been reported, but rarely has it been documented as being extensive enough to cause significant misdiagnosis. The myoepithelial immunophenotype in 5 benign and malignant. Conclusion a large pleomorphic adenoma of the nasal septum may show characteristic ct and mr. Role of proteoglycans in the histogenesis of adenoid cystic carcinoma and pleomorphic adenoma proteoglycans and the histogenesis of adenoid cystic carcinoma salivary acc is a malignant epithelial tumour composed of four major cell types. Surgical treatment consisted of a superficial parotid lobectomy. They originate from an uncommitted reserve cell of the intercalated duct which has the potential to differentiate into epithelial and myoepithelial cells 25. Pleomorphic adenoma is considered the most common benign salivary gland tumor in this location.
Plag1 gene alterations in salivary gland pleomorphic adenoma. Thus, when a multilobular tumor of the nasal septum exhibiting curvilinear enhancement and small. The cd34 marker did not provide significant elements in relation to histogenesis and malignancy of pleomorphic adenoma. Pleomorphic adenoma, salivary gland tumor introduction the term pleomorphic adenoma was suggested by willis 1. Salivary gland tumors are relatively common in the junction of the hard and soft palate area of the oral cavity. Herein, a rare case of lipomatous pleomorphic adenoma arising in the parotid gland of a 14yearold japanese woman is presented.
Pleomorphic adenoma benign mixed tumor is the most common neoplasm of the salivary glands. Capsulated excision in early stage rarely reduces the chance of reoccurence and malignant transformation. Salivary gland basal cell and canalicular adenomas archives. Recognition of these variants is important since longstanding pleomorphic. Pleomorphic adenoma arising from heterotropic salivary. Immunohistochemical aspects in pleomorphic adenoma. Salivary gland mixed tumor i i istogenesisdarimk rt al. The treatment of pleomorphic adenoma is surgical excision. Some of the rarer subtypes of this tumor may have a misleading clinical presentation. The complex microstructure of salivary gland pleomorphic adenoma. The patient presented excellent cosmetic and functional results, without signs of facial nerve palsy, damage or recurrence. Malignant transformation, though rare, has been reported.
Extensive lipomatous involvement of the tumor is, however, a very rare finding. An epithelial cell component a myoepithelial cell component a stromal mesenchymal component identification of these 3 components, which may vary quantitatively from one tumor to anot. Pleomorphic adenoma of the breast is a rare, benign tumor accounting for 68 cases in the literature. Discussion pleomorphic adenoma appears as a painless slowly growing firm mass.
Pleomorphic adenoma, though a benign tumor of salivary gland, should be diagnosed at an early stage and surgically excised. This study describes the clinicopathological features and immunohistochemical expression of ki67 and p53 in 60 cases of submandibular salivary. By definition, carcinosarcoma is a biphasic malignant tumor with a carcinomatous component and a sarcomatous component. A pleomorphic adenoma will usually grow slowly over time and is a painless hard, mobile, solitary mass. A patient is presented with a benign mixed tumor pleomorphic adenoma of the breast. It is most commonly seen in postmenopausal women and is characterized by an admixture of epithelial and myoepithelial cells embedded in abundant myxomatous stroma. It is the most common salivary gland tumor, with a slight. Pleomorphic adenoma may show various architectural and cytologic features that resemble other salivary tumors identifying areas typical of pleomorphic adenoma with triphasic ductal, myoepithelial and stromal components is helpful to establish the diagnosis squamous cell carcinoma. Histogenesis of salivary gland pleomorphic adenoma mixed. Introduction pleomorphic adenoma pa, also known as benign mixed tumor, is the most common salivary tumor. A rare case of salivary gland pleomorphic adenoma, in which the majority of cells were oncocytic, is reported. Klacsmann pg, olson jl, eggleston jc 1979 mucoepidermoid carcinoma of the bronchus. T rise within sg tissue, common parotid 78% composed of cellular elements oncocytes.
It progresses slowly and, left untreated, can produce signi. Pleomorphic adenoma is a common benign salivary gland neoplasm characterised by neoplastic proliferation of parenchymatous glandular cells along with myoepithelial components, having a malignant potentiality. Although pleomorphic adenoma was originally linked to the excretory duct. Most of these tumors arise in the background of pleomorphic adenoma. Histogenesis of salivary gland neoplasms dwivedi n, agarwal a. In addition to carcinoma ex pleomorphic adenoma, true malignant mixed tumors of the salivary glands usually arise from preexisting pleomorphic adenomas 1,3. Pleomorphic adenoma, also referred to as benign mixed tumors bmts, is a benign or a noncancerous growth in the salivary gland, the most commonly occurring parotid tumor. Pleomorphic adenoma is the most common salivary gland tumor and accounts for approximately 80% of parotid tumors. Plag1 gene alterations in salivary gland pleomorphic adenoma and carcinoma expleomorphic adenoma. An electron microscopic study of the low grade and the high grade variants. Plag1 gene alterations in salivary gland pleomorphic adenoma and carcinoma ex pleomorphic adenoma. Pathology of true malignant mixed tumor carcinosarcoma.
This is considered to be a function of the neoplastic myoepithelium, which shows histological and. Request pdf monomorphic adenomas of the parotid glands their ultrastructure and histogenesis three cases of monomorphic basal cell adenoma of the parotid glands were studied with light. There was a thin layer of lymphoid tissue at the periphery of the pleomorphic adenoma. If you continue browsing the site, you agree to the use of cookies on this website. Pleomorphic adenoma is, by far, the most common benign salivary gland tumor, accounting for as many as 80% of all such tumors. Pleomorphic adenoma surgery, symptoms, causes, treatment. Pleomorphic adenoma of the cervical heterotopic salivary.
It is considered that some alterations in the activity of p53 are involved in the development of pa and its evolution to malignancy, 14, 15. Pathogenesis and histogenesis of salivary gland tumours by. An unusual variant of a common palatal salivary gland tumor. Pleomorphic adenoma a common entity to find in literature but difficult to diagnosis clinically in early stage. Wt1 expression in salivary gland pleomorphic adenomas.
A central role of the ductal myoepithelial cell is proposed for the histogenesis of this tumor. Although basic pattern of the tumour is variable, individual cells are not pleomorphic. Among all of them, the most common epithelial tumor is the lacrimal gland pleomorphic adenoma, which is a benign indolent tumor that usually affects adults in the third and fourth decades of life. Pleomorphic adenoma of the breast archives of pathology. Hence, the final diagnosis was of giant pleomorphic adenoma with negative surgical margins. The wide range of morphologic expression evident in pleomorphic adenoma would appear to be the result of a number of factors. Immunohistochemical pattern of pleomorphic adenoma. Pdf histogenesis of salivary gland neoplasms researchgate. Histogenesis of benign pleomorphic adenoma mixed tumor of the major salivary glands. In such cases, it is critical to make a definite diagnosis as each of these tumors has an entirely different treatment protocol. Pleomorphic adenoma of the minor salivary glands most commonly occurs in the palate 16.
Pleomorphic adenoma, the most common salivary gland tumor, consists of epithelial and. The other 2 forms are carcinoma ex pleomorphic adenoma and metastasizing benign pleomorphic adenoma. A case of pleomorphic adenoma of the nose in a 28 year old female. Surgery is the most common form of treatment for pleomorphic adenoma. Immunohistochemical aspects in pleomorphic adenoma adenoma.
Abstract a rare case of salivary gland pleomorphic adenoma, in which the majority of cells were oncocytic, is reported. We have previously demonstrated specificity of these markers for myoepithelial differentiation in normal salivary glands and pleomorphic adenomas. Pleomorphic adenoma is the most common benign neoplasm of the salivary glands. Histogenesis, cellular differentiation, tumor marker.
We present a case of a 37yearold man presenting with a 1. It is proposed that this class of salivary gland tumor forms a spectrum with monomorphic adenoma and myoepithelioma at the extremes and a wide range of pleomorphic adenoma between, depending on the type and degree of gene expression that is coupled with neoplastic transformation. Metastasizing pleomorphic adenoma is the third type of malignant mixed tumor of salivary glands and is the rarest. Histogenesis of salivary gland pleomorphic adenoma. Pleomorphic adenoma of the salivary glands radiology. Here we report a case of recurrent pleomorphic adenoma in a 34 yearold male patient on the right side. Pleomorphic adenoma is a benign salivary gland neoplasm with a diverse morphology. Pleomorphic adenoma is the most common benign salivary gland neoplasm.
A case report of 28 year old male patient diagnosed of pleomorphic adenoma of palate, is presented here. Similar tumor arising in a benign mixed tumor has only been reported once. Pleomorphic adenoma is a benign salivary gland tumor that exhibits wide cytomorphologic and architectural diversity. This is the sixth case of lipomatous pleomorphic adenoma in the english literature. Pleomorphic adenoma an overview sciencedirect topics. The overlapping histomorphologic structure of the basal cell adenoma variants with other recognized adenomas, such as pleomorphic adenoma and myoepithelioma, emphasizes relative differentiation toward 3 phenotypes, eg, ductal luminal, basal, and myoepithelial cells in varying proportions. The results suggest that intermediate cells of mucoepidermoid carcinoma are the counterpart of the modified myoepithelial cells of pleomorphic adenoma. Pleomorphic adenoma symptoms, causes, treatment, surgery. Histogenesis of benign pleomorphic adenoma mixed tumor of. Histogenesis of salivary gland pleomorphic adenoma mixed tumor. It is found mostly in the parotid gland in middleaged women. Histologic localization of plag1 pleomorphic adenoma gene 1 in pleomorphic adenoma of the salivary gland. The tumor can occur at any age but it is most common in young and middle aged adults between the ages of 30 60.
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