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PubMed1991

Implantation of parotid pleomorphic adenoma in the upper neck.

This paper presents a case of pleomorphic adenoma from an abnormal site in the right upper neck in a patient surgically treated 4 years previously for pleomorphic adenoma of the right parotid gland. The lack of normal salivary tissue in the neck growth oriented us towards a diagnosis of implantation tumor, resulting from surgery of the parotid mass, rather than towards one of heterotopic tumor. The literature concerning salivary heterotopias and salivary tumors arising from heterotopic foci is also reviewed.

Adenoma, Pleomorphic↗
PubMedDate not supplied

Clear cell carcinoma arising from pleomorphic adenoma of a minor salivary gland: Report of a case with fine needle aspiration, histologic and immunohistochemical findings.

BACKGROUND: Malignant changes in pleomorphic adenoma (PA) of the salivary gland (carcinoma ex pleomorphic adenoma) are not common. Clear cell carcinoma is a rare form of salivary gland tumor and involves mostly minor salivary glands, especially those of the palate. Only 3 cases of clear cell carcinoma arising in PA have been reported, 2 in submandibular glands and 1 in a minor salivary gland of the palate. CASE: A 53-year-old man presented with an enlarged mass on the left side of the palate. He had a history of palate mass about 30 years earlier; it was excised and reported as PA. Since then the tumor had recurred twice in the same place; it had been excised and was diagnosed as PA again. A few years later the mass showed rapid growth over a few months. Fine needle aspiration of the mass showed epithelial clusters with bland nuclear features and myxohyaline material typical of PA. Also noted were large and small papillary, trabecular and well-circumscribed clusters of neoplastic cells with a moderate amount offoamy, vacuolated cytoplasm with distinct borders. Glandlike and acinar structures with hyaline globule material resembling cannonballs were also noted. The cytology was suspicious for malignancy. Incisional biopsy was reported as PA. Due to the suspicion of malignancy, the whole mass was excised up to the floor of the orbit. The final diagnosis was clear cell carcinoma expleomorphic adenoma. CONCLUSION: Due to nonspecific cytologic findings in clear cell carcinoma and a mixture of elements of PA in this case, we did not consider clear cell carcinoma as the malignant component.

Adenocarcinoma, Clear Cell↗
PubMedDate not supplied

Metastatic minor salivary gland colloid carcinoma in the parotid region after parotidectomy for pleomorphic adenoma: a case report.

BACKGROUND: Primary colloid or mucinous carcinoma of the salivary glands is extremely rare. Only a few cases have been reported that originated in the minor salivary glands. an even more exceptional presentation is as a metastatic tumor in the parotid region subsequent to superficial parotidectomy for pleomorphic adenoma. The case presented here posed a diagnostic dilemma that could be resolved only after a thorough reevaluation of the previous cytologic and histologic material and detection of the occult primary tumor in the hypopharynx following an extensive clinical and radiologic workup. CASE: A 75-year-old female underwent fine needle aspiration of the left parotid and was diagnosed as having pleomorphic adenoma. A superficial parotidectomy removed the tumor completely, and the diagnosis was confirmed. Six months following the surgery, the patient developed an enlarged nodular mass in the ipsilateral parotid region, with fine needle aspiration showing colloid (mucinous) adenocarcinoma, which proved to be a metastatic colloid (mucinous) carcinoma on excisional biopsy. The clinical and radiologic workup in search of a primary lesion led to an occult tumor in the left hypopharyngeal mucosa. CONCLUSION: Unusual presentations of rare tumors can cause considerable diagnostic difficulties to both the clinician and cytopathologist. Awareness of these rarities is important to ensure the best patient care and to avoid unnecessary investigative and therapeutic procedures.

Adenoma, Pleomorphic↗
PubMedDate not supplied

Intravenous pyogenic granuloma mimicking pleomorphic adenoma in a fine needle aspirate. A case report.

BACKGROUND: Intravenous pyogenic granuloma (IvPG) is a rare, benign lesion occurring usually as a subcutaneous mass in the neck or upper extremity. The cytologic features of IvPG have not been described before. CASE: A patient presented with a subcutaneous nodule on the lower border of the left parotid area. The clinical diagnosis was bronchial cleft cyst or lymphadenitis, and the fine needle aspiration diagnosis was pleomorphic adenoma. The tissue section, however, disclosed IvPG. CONCLUSION: Evaluation of subcutaneous nodules presenting cytologically as spindle cell lesions may be problematic, particularly in the neck and head region. Such lesions occurring in the parotid area may be interpreted as pleomorphic adenoma of the salivary gland.

Adenoma, Pleomorphic↗
PubMedDate not supplied

Collagenous crystalloids in a fine needle aspirate of a pleomorphic adenoma of the minor salivary gland. A case report.

BACKGROUND: Collagenous crystalloids were previously observed in histologic sections of pleomorphic adenoma. However, to the best of our knowledge, there have been no English-language reports dealing with collagenous crystalloids in fine needle aspirates. CASE: A fine needle aspiration specimen obtained from a mass in the hard palate of a 52-year-old female revealed collagenous crystalloids. The crystalloids were yellow to green, measured 30-50 microns in diameter and were radially arranged. CONCLUSION: This case indicates that collagenous crystalloids in salivary gland aspirates may be a clue to the diagnosis of pleomorphic adenoma.

Adenoma, Pleomorphic↗
PubMedDate not supplied

Fine needle aspiration cytology of cellular pleomorphic adenoma.

OBJECTIVE: To study the spectrum of cytologic changes seen in cellular pleomorphic adenoma (CPA) and to determine features that would allow a more specific diagnosis. STUDY DESIGN: We reviewed 11 fine needle aspirates of surgically confirmed salivary gland CPA in addition to three discrepant cases in which CPA was strongly considered in the cytologic diagnosis. RESULTS: Pleomorphic adenoma was considered in the differential diagnosis, but a difinitive cytologic diagnosis was not made in the 11 cases. Acinic cell carcinoma, basal cell adenoma, adenoid cystic carcinoma; myoepithelioma and spindle cell neoplasm accounted for most of the other diagnostic considerations. The three discrepant cases included a malignant myoepithelioma, acinic cell carcinoma and mucoepidermoid carcinoma. CONCLUSION: Familiarity with the variable aspirate appearance of CPA in addition to well-defined cytologic and architectural criteria can help establish the proper diagnosis in the majority of cases. There remain, however, few cases in which a definitive diagnosis is not possible.

Adenoma, Pleomorphic↗
PubMed2004

Pleomorphic adenoma of the nasal septum.

Pleomorphic adenoma may occur in any site in which there is salivary gland tissue. It has rarely been described arising in the nasal cavity. We report a case of septal pleomorphic adenoma and discuss the clinical presentation and surgical management.

Adenoma, Pleomorphic↗
PubMedDate not supplied

Benign pleomorphic adenoma of the larynx. A case report.

Minor salivary gland tumors of the larynx are relatively rare. Morphologically the majority of them are adenoid cystic carcinomas and the overwhelming location is the subglottic larynx. Benign pleomorphic adenomas are rare minor salivary gland tumors of the larynx which usually occur at the glottic and subglottic levels. We present only the sixth case of a supraglottic benign pleomorphic adenoma that we could find in the literature. A preoperative laryngogram localized the tumor to the supraglottic larynx and the intact mucosa suggested a specific differential diagnosis. The tumor was removed by a lateral pharyngotomy with retention of good laryngeal function. The relatively asymptomatic presentation of our case is a somewhat unusual finding which, however, was previously noted in similar case reports.

Adenoma, Pleomorphic↗
PubMed1997

Salivary gland double tumor: synchronous ipsilateral pleomorphic adenoma and acinic cell carcinoma of the parotid gland.

A 44-year-old woman underwent a partial parotidectomy for a slowly enlarging parotid mass diagnosed by fine needle aspiration biopsy as a pleomorphic adenoma. Though macroscopically recognized to be composed of two nodules, differing to some extent from one another, the mass appeared to constitute a single tumor. The microscopic examination disclosed two disparate neoplasms, which were separated from each other by a thin fibrous band. The larger of the two nodules was a pleomorphic adenoma and the smaller one an acinic cell carcinoma. The metachronous--and, even more, the synchronous--occurrence of two histologically different tumors in one major salivary gland is an exceptional and probably coincidental event.

Adenoma, Pleomorphic↗
PubMed2000

First insights into the molecular basis of pleomorphic adenomas of the salivary glands.

Pleomorphic adenoma, or mixed tumor of the salivary glands, is a benign tumor originating from the major and minor salivary glands. Eighty-five percent of these tumors are found in the parotid gland, 10% in the minor (sublingual) salivary glands, and 5% in the submandibular gland. It is the most common type of salivary gland tumor, accounting for almost 50% of all neoplasms in these organs. In fact, after the first observation of recurrent loss of chromosome 22 in meningioma, this was the second type of benign tumor for which non-random chromosomal changes were reported. The rate of malignant change with the potential to metastasize has been reported to be only 2 to 3%, and only a few cases of metastasizing pleomorphic salivary gland adenomas have been described to date. The fact that these tumors arise in organs located in an ontogenetic transitional zone, a region where endoderm and ectoderm meet, might be one of the reasons for the often-problematic histopathological classification. This type of benign tumor has been cytogenetically very well-characterized, with several hundreds of tumors karyotyped. In addition to the cytogenetic subgroup with an apparently normal diploid stemline (making up approximately 30% of the cases), three major cytogenetic subgroups can be distinguished. In addition to a subgroup showing non-recurrent clonal abnormalities, another subgroup is various translocations involving 12q15. By far the largest cytogenetic subgroup, however, consists of tumors with chromosome 8 abnormalities, mainly showing translocations involving region 8q12. The most frequently encountered aberration in this group is a t(3;8)(p21;q12).

Adenoma, Pleomorphic↗
PubMed2005

Biomarker analysis in carcinoma ex pleomorphic adenoma at an early phase of carcinomatous transformation.

Diagnostic criteria for intracapsular carcinoma ex pleomorphic adenoma (CXPA) are subjective and vary among authors. Biomarker analysis, which could provide more objective evaluation of these tumors, has rarely been studied in intracapsular CXPA. Immunohistochemical evaluation of c-erbB-2, p53 protein, bcl-2, and Ki-67 was performed in 8 cases of CXPA at an early phase of malignant transformation (4 intracapsular and 4 minimally invasive) and in 17 pleomorphic adenomas (PA). In all cases of CXPA, p53 and Ki-67 were demonstrated predominantly in luminal cells of benign and malignant areas, significantly more in the latter. Few benign myoepithelial cells were p53 positive. c-erbB-2 reactivity was strongly associated with atypical luminal cells. Bcl-2 expression was weak and focal in malignant areas from 2 cases. In conclusion, both p53 and c-erbB-2 proteins appear to be involved at an early stage of malignization of PA. In PA with atypical cells, evaluation of the expression of these 2 markers provides more objective criteria for the diagnosis of intracapsular CXPA.

Adenoma, Pleomorphic↗
PubMedDate not supplied

Pleomorphic adenocarcinoma of the ciliary epithelium: a clinicopathological, immunohistochemical, ultrastructural, DNA-ploidy and comparative genomic hybridization analysis of an unusual case.

PURPOSE: To describe detailed phenotypic and genotypic analysis of a pleomorphic adenocarcinoma of the ciliary epithelium (CE). CASE REPORT: An 86-year-old white woman developed an enlarging mass protruding from her previously eviscerated left eye 2 months postoperatively. Based on light and ultrastructural microscopy, the final diagnosis was a pleomorphic adenocarcinoma of the ciliary epithelium (CE). DISCUSSION: Cell proliferation indices confirmed the unusually rapid growth rate of this tumor; the peridiploid DNA content might explain the relatively low incidence of distant metastases. An imbalance of the chromosome 6 was also found by Comparative Genomic Hybridization (CGH).

Adenoma, Pleomorphic↗
PubMed2000

Pleomorphic adenoma of tongue base causing dysphagia and dysphasia.

A case of an 87-year-old female with pleomorphic adenoma of the tongue base is reported, with a review of the literature. The tumour had enlarged gradually over a period of three years, causing dysphagia and dysphasia. Computed tomography and magnetic resonance imaging showed that the tumour was exophytic and occupy the oropharynx with little extension into the muscle tissue. The tumour was resected by CO2 laser. Histological examination revealed a benign pleomorphic adenoma that originated from the minor salivary gland of the tongue base.

Adenoma, Pleomorphic↗
PubMed2001

Simultaneous primary pleomorphic adenoma in parotid gland and minor salivary gland in the parapharyngeal space.

The majority of salivary gland tumours present as a single mass in one gland. Sometimes multiple primary neoplasms can be seen in more than one salivary gland. The most common tumour is Warthin's tumour. Multiple primary pleomorphic adenomas are extremely rare. Most of them are in the major salivary glands. The author reports the first case of simultaneous pleomorphic adenomas in the parotid gland and minor salivary gland at the parapharyngeal space.

Adenoma, Pleomorphic↗
PubMed2005

Pleomorphic adenoma and severe obstructive sleep apnoea.

Two cases of deep lobe parotid tumours extending into the parapharyngeal space and causing obstructive sleep apnoea are described. Post-operatively, marked improvements in nocturnal hypoxic episodes and the symptoms of obstructive sleep apnoea were seen. Although minor salivary gland pleomorphic adenomas have been described as a cause of airway compromise, pleomorphic adenomata arising from the deep lobe of the parotid, causing proven obstructive sleep apnoea, have not previously been documented. The anatomy and common pathologies of the parapharyngeal space are discussed.

Adenoma, Pleomorphic↗
PubMed2006

Pleomorphic adenoma presenting low T2 signal-intensity on magnetic resonance imaging.

We report an unusual case of pleomorphic adenoma of the submandibular gland in a 48-year-old female. The present case appeared as a relatively homogeneous, low to intermediate signal-intensity on the T(2) weighted magnetic resonance (MR) images. To our knowledge, the MR feature of low T(2) signal-intensity of pleomorphic adenoma has not been reported in the literature.

Adenoma, Pleomorphic↗
PubMed1991

Preservation of the facial nerve in the management of recurrent pleomorphic adenoma.

Whether to preserve or sacrifice a facial nerve involved with benign neoplasm is one of the most difficult intraoperative decisions confronting the head and neck surgeon. We reviewed 21 cases of recurrent pleomorphic adenoma treated with subtotal excision and facial nerve preservation, followed by postoperative radiation therapy. Of the 17 patients with microscopic residual tumor at completion of surgery, 16 (94%) remain free of recurrence with an average follow-up of 5.9 years. Only one of four patients (25%) with a large postoperative tumor load remains free of disease. Facial nerve function is normal in 20 of 21 patients. Preservation of the facial nerve with postoperative irradiation should be considered as an alternative to nerve sacrifice in selected cases of recurrent pleomorphic adenoma.

Adenoma, Pleomorphic↗