PLEOMORPHIC ADENOMA: A CASE REPORT
Abstract
background- World Health Organization (1972) defined PA as a well-defined tumor characterized by its pleomorphic or mixed appearance. There is intermixing of the clearly recognizable epithelial component with mucoid, myxoid and chondroid component. Surgical management of pleomorphic adenoma 50 years ago consisted predominantly of local excision or “enucleation technique”, a procedure that yields recurrence rates from 20% to 45%. The replacement of simple enucleation of tumor with other surgical approaches like: superficial parotidectomy (SP), total parotidectomy (TP), and extracapsular dissection (ECD) as treatment of choice reduced dramatically the incidence of tumor's recurrence and complications.
Material and method- This case report considers a 24 year female with a chief complaint of swelling in left side face since one and half years to two years. After clinical and radiological examination, provisional diagnosis of benign tumor of the left parotid gland was made. Excision of the superior lobe of the left parotid gland along with the tumor mass was made.
Conclusion- Enucleation, enucleoresection and superficial or total parotidectomy with preservation of the facial nerve are the main treatment modalities of pleomorphic adenomas. The replacement of simple enucleation of tumor with other surgical approaches like: superficial parotidectomy (SP), total parotidectomy (TP), and extracapsular dissection (ECD) as treatment of choice reduced the incidence of tumor's recurrence and complications.
Keywords
Full Text:
PDFReferences
J.W. Eveson, R.A. Cawson, Salivary gland tumours. A review of 2410 cases with particular reference to histological types, site, age and sex distribution, J. Pathol. 146 (1985) 51-58.
R.H. Spiro, Salivary neoplasms: overview of a 35-year experience with 2,807 patients, Head Neck Surg. 8 (1986) 177-184.
J.S. Wolf, A.N. Goldberg, D.C. Bigelow, Pleomorphic adenoma of the parotid, Am. Fam. Physician 56 (1) (1997 Jul) 185-192.
Traiger J, Rosen MB. Mixed tumor of the cheek; report of a case. Oral Surg Oral Med Oral Pathol, 1965; 19:711-714
Berdal P, Hall JG. Parapharyngeal growth of parotid tumours. Acta Otolaryngol Suppl, 1969; 263:164-6.
Carr RJ, Bowerman JE. A review of tumors of the deep lobe of the parotid salivary gland. Br J Oral Maxillofac Surg, 1986; 24:155-68.
Dalati T, Hussein MR. Juvenile pleomorphic adenoma of the cheek: a case report and review of literature. Diagnostic Pathology, 2009; 4(32): 1-5.
Alves FA, Perez DE, Almeida OP, Lopes MA, Kowalski LP. Pleomorphic adenoma of the submandibular gland: Clinicopathological and immunohistochemical features of 60 cases in Brazil. Arch Otolaryngol Head Neck Surg, 2002; 128:1400–1403.
Sergi B, Limongelli A, Scarano E, Fetoni AR, Paludetti G. Giant deep lobe parotid gland pleomorphic adenoma involving the parapharyngeal space. Report of three cases and review of the diagnostic and therapeutic approaches. Acta Otorhinolaryngol Ital, 2008; 28:261-265.
Mehle ME , Krause DH, Wood BG, Benninger SM, Eliachar I, Levine HL, et al. Facial nerve morbidity following parotid surgery for benign disease. The Cleveland Clinic Foundation Experience. Laryngoscope, 1993; 103: 386-388.
A. Huber, S. Schmid, U. Fisch, Pleomorphic adenoma of the parotid gland. Results of surgical treatment, HNO 42 (9) (1994 Sep) 553-558.
Y. Wen, R. Chen, C. Wang, The pathologic basis of partial parotidectomy in parotid pleomorphic adenoma treatment, Hua Xi Kou Qiang Yi Xue Za Zhi 21 (5) (2003 Oct) 359-360.
R.L. Witt, The significance of the margin in parotid surgery for pleomorphic adenoma, Laryngoscope 112 (12) (2002 Dec) 2141-2154.
F. Moccia, S. Dragoni, F. Lodola, E. Bonetti, C. Bottino, G. Guerra, U. Laforenza, V. Rosti, F. Tanzi, Store-dependent Ca2þ entry in endothelial progenitor cells as a perspective tool to enhance cell-based therapy and adverse tumour vascularisation, Curr. Med. Chem. 19 (34) (2012 Dec 1) 5802-5818.
Sanchez-Hernandez, U. Laforenza, E. Bonetti, J. Fontana, S. Dragoni, M. Russo, J.E. Avelino-Cruz, S. Schinelli, D. Testa, G. Guerra, V. Rosti, F. Tanzi, F. Moccia, Store operated Ca2þ entry is expressed in human endothelial progenitor cells, Stem Cells Dev. 19 (12) (2010 Dec) 1967-1981.
F. Moccia, F. Lodola, S. Dragoni, E. Bonetti, C. Bottino, G. Guerra, U. Laforenza, V. Rosti, F. Tanzi, Ca2þ signalling in endothelial progenitor cells: a novel means to improve cell-based therapy and impair tumour vascularisation, Curr. Vasc. Pharmacol. 12 (1) (2014 Jan) 87-105.
R. Berra-Romani, J.E. Avelino-Cruz, A. Raqeeb, A. Della Corte, M. Cinelli, S. Montagnani, G. Guerra, F. Moccia, F. Tanzi, Ca2þ-dependent nitric oxide release in the injured endothelium of excised rat aorta: a promising mecha- nism applying in vascular prosthetic devices in aging patients, BMC Surg. 13 (Suppl. 2) (2013 Oct 8) S40.
F. Moccia, S. Dragoni, M. Cinelli, S. Montagnani, B. Amato, V. Rosti, G. Guerra, F. Tanzi, How to utilize Ca2þ signals to rejuvenate the repairative phenotype of senescent endothelial progenitor cells in elderly patients affected by cardio- vascular diseases: a useful therapeutic support of surgical approach?BMC Surg. 13 (Suppl. 2) (2013 Oct 8) S46.
Refbacks
- There are currently no refbacks.