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PubMedDate not supplied

The role of the p53 gene in the malignant transformation of pleomorphic adenomas of the parotid gland.

Pleomorphic adenoma (PA), the most common neoplasm of the parotid gland in adults, undergoes malignant transformation in only two to six percent of cases. In order to determine whether or not the p53 gene is involved in the malignant transformation of PA of the parotid gland, we have analyzed archival specimens from four patients with carcinoma ex-pleomorphic adenoma (CEPA) by immunohistochemistry and sequencing of the amplified DNA. Tissue specimens from each patient contained both the CEPA and the precursor PA. Immunostaining revealed that while all CEPA were p53 positive, only one of the four precursor PA was positive for p53. In this case, DNA was isolated from both the PA and CEPA and exons five through eight were amplified using the polymerase chain reaction. The same p53 mutation (single base substitution) was found in both the PA and the CEPA at codon 248. Adjacent normal tissue contained the wild-type p53 sequence. To our knowledge, this is the first report of the same p53 point mutation in both a PA and the associated CEPA of the parotid. These results strongly suggest a role for p53 gene mutation in the malignant transformation of some PA of the parotid gland.

Adenocarcinoma↗
PubMed1994

[Multifocal status and malignant transformation of pleomorphic adenoma].

A rare case of multifocal and malignant pleomorphic adenoma in 60-years--old male is presented. Its diagnosis was made on the basis of the case--history, clinical picture and biopsy. The clinical course and therapeutic tactics are briefly described. The conclusion of prognosis in this pleomorphic adenoma form is difficult.

Adenoma, Pleomorphic↗
PubMed1994

[Pleomorphic adenoma of the parotid gland. Results of surgical treatment].

Twenty years experience of lateral parotidectomy as suspical treatment for pleomorphic adenoma are reviewed. All cases were managed at the ORL Clinic of the University of Zürich. 167 patients were followed for the frequency of possible recurrent tumors. Three patients (3/123) operated primarily developed a recurrences. Recurrences appeared after an average of 10 years, ranging from 1-30 years. The follow-up time varied from 1 to 21 years (average, 8 years). 39% (13 of 33) of the patients, who were re-operated for a recurrent tumor, developed another recurrence. The second recurrence appeared after an average of 10 years, ranging from 1-22 years. A persistent partial paresis of the facial nerve was found in 1% of the patients operated primarily and in 9% of the patients operated more than once. No paralysis was seen. We now choose "en-bloc" resections of pleomorphic adenomas without intra-operative opening of the tumor capsule as the treatment of choice. This treatment was possible in 83% of all cases, using a lateral parotidectomy. If tumor extends into the medial parotid lobe, total parotidectomy is required.

Adenoma, Pleomorphic↗
PubMed1993

[Malignant pleomorphic adenoma of the salivary gland: a clinicopathological and immunohistochemical study].

Eighty three cases of malignant pleomorphic adenomas (MPA) of salivary glands were studied. Twenty tumors among of them were labeled with 4 kinds of antibodies including anti-CEA, anti-S 100 P, anti-CK12 and CK27 by immunohistochemical staining. Based on this study, it was concluded that the majority cases of MPAs derived from malignant transformation of benign pleomorphous adenomas. The author suggested that the MPAs might be classified as carcinomatous and carcino-sarcomatous subtypes according to the histologic appearances of malignant component in the tumor. The CEA positive reaction in the cytoplasm of tumor cells was a reliable marker of malignancy.

Adenocarcinoma↗
PubMed1994

[Adenoma pleomorphic (mixed tumor) in the nasal septum].

A pleomorphic Adenoma was found in the right side of the nasal septum of a 44-year-old female patient. After removal the pathologist's examination could diagnose the mass as a pleomorphic adenoma (mixed tumor) developed from ectopic salivary glands. Early symptoms were nasal obstruction and recurrent spontaneous epistaxis, sometimes preceded by local discomfort. Surgical removal. In this article are discussed some aspects of the these unusual tumors (sitting in the nasal cavity) and the AA. compare their findings with data reported by other publishers.

Adenoma, Pleomorphic↗
PubMedDate not supplied

[The recurrent multifocal pleomorphic adenoma].

Pleomorphic adenoma (P.A.), the most common tumor of the salivary gland, demonstrates a peculiar clinicopathological behaviour for numerous reasons: the high recurrence rate following primary surgery (up to 50%), the appearance of malignancy (2-9%), the reported number of distant metastases histologically identical to the primary P.A. From among 71 cases of benign parotid tumors treated from Nov. 89 to Nov. 92 in the ENT Department of "Regina Elena", the National Cancer Institute in Rome, six particular cases showed multiple force of P.A. recurring after primary surgery performed from 3 to 32 years previously and are object of discussion in this study. All of these six cases had multiple recurrences, usually manifest as nodular clusters in the parotid area, while in three cases appeared as well a recurrence in the soft tissue of the neck, far removed from the parotid space, with no involvement of neck nodes as was revealed through histological examination following neck dissection. A hypothetical mechanism of diffusion is discussed. The Authors agree with the opinion which holds the surgeon's inability to successfully eradicate primary tumors responsible for the high frequency of recurrences. The surgical technique of "enucleation" is, in fact, inadequate in P.A. excision owing the high risk of mishandling or rupturing the tumor capsule with a consequent seeding of the tumor onto the surgical bed. Lateral lobectomy, with identification of the facial nerve, or total conservative parotidectomy (for deep lobe adenoma) are correct techniques in treating primary P.A.. The Authors also discuss management of recurrent P.A. in relation to facial nerve involvement. Preservation of the seventh nerve with eventual post-operative radiation should be considered an alternative to nerve sacrifice in selected cases of recurrent pleomorphic adenoma.

Adenoma, Pleomorphic↗
PubMed1993

Septal pleomorphic adenoma masquerading as squamous cell carcinoma.

A 43-year-old woman had left midfacial pain and a left intranasal mass. Pathologists from three different institutions agreed that the biopsy specimens from the mass represented squamous cell carcinoma. The final pathologic diagnosis made from the resected specimen was pleomorphic adenoma of the septum. This report describes a case which was initially misdiagnosed on the basis of misleading tissue biopsy results, but the excised tumor was finally diagnosed as pleomorphic adenoma. Otolaryngologists treating an intranasal mass must be aware of the difficulty of correctly diagnosing the initial tissue biopsy specimen in order to guard against unnecessary radical surgery.

Adenoma, Pleomorphic↗
PubMedDate not supplied

[Pleomorphic adenoma of the nasal wall. Revision].

The pleomorphic adenoma is the most common neoplasm of the salivary glands, especially the parotid. It can also be originated from minor salivary glands and may appear in nasal cavities and paranasal cavities. We showed a case of pleomorphic adenoma of nasal septum and, at the same time, we reviewed all related bibliography.

Adenoma, Pleomorphic↗
PubMed1995

Metastatic pleomorphic adenoma.

We report a case of pleomorphic adenoma of the parotid with metastasis to the liver, following resection for local recurrence, which has only been described once before. The diagnosis was made by fine needle aspiration and the lesion was resected without complications. The patient is free of disease 4 years later. Histological features of malignancy were not present in any specimens from the original resection, the local recurrence and the metastatic lesion. It is difficult to say which patients with pleomorphic adenoma should be observed for the development of treatable metastases, but metastases have been reported to occur mainly after repeated resections for local recurrences.

Adenoma, Pleomorphic↗
PubMedDate not supplied

[Paranasal sinus pleomorphic adenoma].

Pleomorphic adenomas with atypical facial presentation, specifically, in the nasal sinus region, were studied. A patient who presented with malignant tumor of the nasal sinus was diagnosed as pleomorphic adenoma after histologic misdiagnosis. The surgical technique and outcome at one year are described.

Adenoma, Pleomorphic↗
PubMed1996

[Reoperation and recurrence of pleomorphic adenoma of the parotid. A propos of 62 cases].

Between 1967 and 1994, 344 patients were treated with total conservative parotidectomy for benign pleomorphic adenoma of the parotid gland. Our retrospective study focuses on a sixty-two patients group treated for recurrence after biopsy, enucleation or total parotidectomy. Twenty-two patients underwent a systematic total parotidectomy after biopsy (n = 7) or enucleation (n = 15). Twenty-nine patients were treated with total parotidectomy for local recurrence after enucleation. The mean time before this treatment was 8 years-9 months. In the third group, 11 patients, (7 patients from our institution), were surgically treated for recurrence after total parotidectomy. After enucleation, the recurrence rate was high and insufficient margins were found in 27% of the cases. In this group, a multicentric recurrence was found in 45% of the cases. In our own experience, recurrence after total parotidectomy was noted in 2.4%. The surgical salvage was performed with enucleation after identification of the branches of the facial nerve. The operative microscope was usefull. In 1 case, a second recurrence occured, and in 1 case iterative recurrence was noted. The local control rate after total parotidectomy was 99.6% (292/293). Total conservative parotidectomy is, for us, the treatment of choice for pleomorphic adenoma of the parotid gland.

Adenoma, Pleomorphic↗
PubMed1996

[A case of gigantic pleomorphic adenoma of the parotid gland].

The case of big size pleomorphic adenoma of the partoid gland was presented. Attention was paid on the necessity of the surgical treatment of pleomorphic adenomas by superficial or total parotidectomies. Possibility of the post operative complications avoidance, even in such big cases was emphasized.

Adenoma, Pleomorphic↗
PubMed1997

Surgical management of 246 previously untreated pleomorphic adenomas of the parotid gland.

BACKGROUND: Recent modifications of surgical technique may have influenced outcome following parotidectomy. This retrospective study compares the results of the different surgical methods with regard to recurrence rate and the effects on morbidity between 1974 and 1994. METHODS: A total of 246 primary surgical parotid procedures were performed on 245 patients for pleomorphic adenoma. These included 131 'partial' superficial parotidectomies, 61 'total' superficial parotidectomies, 30 partial superficial/deep lobe parotidectomies, eight total parotidectomies, and 16 'selective' deep lobe parotidectomies. In the recent past, the posterior branch of the greater auricular nerve was preserved in the majority of patients. Eleven patients received postoperative radiotherapy. Median follow-up was 95 months. Fourteen patients died without recurrent tumour. RESULTS: Two patients (0.8 per cent) developed local recurrence, both after total parotidectomy for a deep lobe tumour. No patient experienced permanent facial nerve palsy. The incidence of gustatory sweating for partial superficial parotidectomy was 6.9 per cent (nine of 131) compared with 13.1 per cent (eight of 61) for total superficial parotidectomy. CONCLUSION: Partial parotidectomy is an effective treatment for the majority of pleomorphic adenomas; local recurrence is rare and morbidity is low. Prolonged follow-up is unnecessary.

Adenoma, Pleomorphic↗
PubMed1996

[Relationship between cellular DNA and expression of epidermal growth factor receptor in pleomorphic adenoma of lacrimal gland].

OBJECTIVE: To obtain the information about whether expression of epidermal growth factor (EGF) receptor is related to the proliferative activity of tumor. METHODS: The expression of EGF receptor and DNA content of pleomorphic adenoma of lacrimal gland in 32 cases were detected by an immunohistochemical avidin biotin peroxidase complex method and determined by an image analysis technique, respectively. The relationship between the expression of EGF receptor and DNA content was analyzed. RESULTS: 10 tumors were stained positively with anti-EGF receptor antibody, the DNA contents of 14 cases were increased, their DNA ploidy distribution pattern showed two or several peaks. Good correlation has been found between the expression of EGF receptor and DNA ploidy distribution pattern, and the DNA distribution pattern of tumor with positive EGF receptor expression showed mainly two or several peaks (P < 0.01). CONCLUSION: The expression of EGF receptor of pleomorphic tumor of lacrimal gland is related to the proliferative activity of tumor cells.

Adenoma, Pleomorphic↗
PubMed1997

[A carcinoma arising from benign pleomorphic adenoma of the trachea].

A 69-year-old female complained of husky voice and dyspnea. Bronchofiberscopic examination revealed a tumor at the left side of the trachea, which obstructed approximately 80% of the tracheal lumen. Benign pleomorphic adenoma was diagnosed by biopsy. The tumor was removed by circumferenctial resection of the trachea with partial sternotomy adding to the 3 th intercostal transverse resection. Historical finding of the resected specimen revealed a carcinoma arising from benign pleomorphic adenoma of the trachea and residue of malignancy at the margin of the trachea and esophagus. Additional radiotherapy was performed (60 Gy). The postoperative course was uneventful for 4 months and one year.

Adenocarcinoma↗
PubMed1996

[Metastasizing pleomorphic adenoma of the parotid. Apropos of a case].

A case of metastasizing pleomorphic adenoma of the parotid in which both the primary tumor and metastasis were composed of benign pleomorphic structures is reported in a 55 year-old white woman. The pulmonary metastasis developed nine years after excision of the primary tumor without local recurrence. No mitotic activity or infiltrative growth pattern were present in the primary tumor. By flow cytometry, DNA content was diploid in both the parotid tumor and the pulmonary metastasis. Previously reported cases are reviewed.

Adenoma, Pleomorphic↗
PubMed1998

[Pleomorphic adenoma of the nasal septum].

Pleomorphic adenoma is the most frequent form of tumor in the major and minor salivary glands. It can occasionally appear in other sites corresponding to areas with ectopic salivary tissue. A case is presented of pleomorphic adenoma of the nasal septum recently observed by the authors. Complete removal of the tumor lesion, with the entire support base, careful histopathological evaluation, a battery of immunohistochemical tests and a long-term follow-up constitute the correct approach to this pathology.

Adenoma, Pleomorphic↗