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PubMed · 8384048

[Pleomorphic adenoma].

S D Tran·E Cree
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Abstract

A clinical case involving a pleomorphous adenoma at a minor salivary gland of the palate is diagnosed and treated by the Department of maxillo-facial surgery at the Notre-Dame Hospital, in Montreal. The signs and symptoms of this adenoma are discussed together with the X-ray report and the histopathological examination. The treatment chosen is a surgical excision of the whole tumor, including the periosteum of the palate, followed by the installation of a prefabricated acrylic obturator.

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Adenoma, PleomorphicAdultHumansMalePalatal NeoplasmsSalivary Gland NeoplasmsSalivary Glands, MinorCase ReportsEnglish AbstractJournal Article

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S D Tran, E Cree. 1993. [Pleomorphic adenoma].. https://pubmed.ncbi.nlm.nih.gov/8384048/

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[Multiple primary pleomorphic adenomas of the unilateral parotid gland].

BACKGROUND: Classical lateral parotidectomy is the standard surgical procedure for the management of lateral lobe parotid pleomorphic adenomas in most clinical centres. Extracapsular dissection and subtotal lateral parotidectomy are alternatively discussed in current literature and preferred by many authors. CASE: We report on a 20-year-old patient with multiple primary pleomorphic adenomas in the unilateral parotid gland, which preoperatively presented as a solitary tumour node. CONCLUSION: Considering this case we focus on the distinctive surgical procedures for the management of parotid pleomorphic adenomas. We work out, why lateral or even total parotidectomy are justified in the treatment of solitary palpable tumours and why we account lateral parotidectomy as the standard surgical procedure for the management of lateral lobe parotid pleomorphic adenomas.

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Pleomorphic adenomas of the parotid gland can be slowly growing over the course of many years and may reach an enormous and disfiguring size associated with significant morbidity of the patients. To our knowledge, over the last 80 years 20 cases of giant pleomorphic adenomas (weight 1.2-26.5 kg) have been reported. These tumors occurred predominantly in women (90%). The mean period from initial clinical manifestation until definitive surgical treatment was 20.7 years. The mean age of the patients at the time of surgery was 58.9 years. Malignant transformation occurred in 15.8% of cases. It is likely that the reasons for delayed treatment are the patient's fear of surgery on the one hand, and insufficient medical advise on the other. We report on a 77 year old female who had a 40-year history of a growing parotid tumor that weighed 3.9 kg after resection. The implications of this case for diagnosis and treatment of giant pleomorphic adenomas, and a review of the world literature on these unusual parotid tumors, are presented.

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