Pleomorphic adenoma of the palate

Pleomorphic adenoma is the most common mixed benign tumor of major salivary glands. Approximately 80% of these tumors arise in the parotid gland, whereas 7% arise in the minor salivary glands. The most common sites for minor salivary gland where pleomorphic adenoma arises are the palates followed by lips and cheek. We report a palate mass in a 46-year-old male patient. The initial cytologic diagnosis by fine-needle aspiration biopsy was pleomorphic adenoma. This report describes a case of pleomorphic adenoma regarding all distinctive diagnoses with the review of the literature.     

Diagnosis of systemic sarcoidosis prompted by orofacial manifestations: a review of the literature

BACKGROUND: Sarcoidosis is a multifactorial systemic inflammatory disorder of unknown origin characterized by many potential signs and symptoms, as well as by the presence of noncaseating granulomas in the organs involved. Sarcoidosis also may manifest in the oral and maxillofacial region. CASE DESCRIPTION: The authors describe a patient with xerostomia, dysgeusia, oral burning, xerophthalmia and bilateral parotid enlargement. She was diagnosed as having systemic sarcoidosis on the basis of the histologic findings of a biopsy of the labial minor salivary gland, as well as subsequent diagnostic evalutons. CONCLUSION AND CLINICAL IMPLICATIONS: Enlargement of major salivary glands may be the first sign of sarcoidosis in a patient with few other symptoms or clinical findings suggestive of the disease. This case emphasizes the importance of including sarcoidosis in the differential diagnosis of bilateral parotid swelling associated with xerostomia. It also highlights the dentist's potential role in the diagnosis and dental treatment of patients with systemic sarcoidosis.     

Chronic sclerosing sialadenitis of the submandibular and parotid glands: a report of a case and review of the literature

Chronic sclerosing sialadenitis (also known as Küttner tumor) is a chronic inflammatory condition of the salivary glands, first described by Küttner in 1896. Clinically, the disease cannot be distinguished from a true neoplasm. The submandibular gland is affected more commonly than any other salivary gland. This report is of a case of widespread swelling of the salivary glands in which histologic features of chronic sclerosing sialadenitis were seen in the submandibular and parotid glands. The etiology, pathogenesis, and differential diagnosis of this disease and the clinical outcome of this case are discussed and presented.     

Parotid gland biopsy for investigation of xerostomia

A technique is described for biopsy of the parotid salivary gland under local anaesthesia, which has been undertaken for a series of 59 patients who presented with suspected inflammatory exocrinopathy. The procedure is reliable and is associated with negligible postoperative discomfort. The advantages of the technique suggest that parotid gland biopsy is an acceptable alternative to conventional lower lip biopsy of minor salivary glands in the investigation of xerostomia.     

Alcoholic sialosis

Sialosis (sialadenosis) is a term used to describe a disorder that involves both secretory and parenchymal changes of the major salivary glands, most commonly the parotid. Seen often in a dental office, it is recognized as an indolent, bilateral, non-inflammatory, non-neoplastic, soft, symmetrical, painless and persistent enlargement of the parotid glands. Four major entities have commonly been associated with this disorder. They are alcoholism, endocrinopathy (particularly diabetes mellitus), maLnutrition and idiopathic. We are reporting a case of alcoholic sialosis with its clinical and diagnostic aspects. It is important for the dental practitioner to recognize sialosis, because it often indicates the existence of an unsuspected systemic disease.     

Parotid duct sialolithiasis in a patient with Down syndrome--case report

Sialolithiasis is the phenomenon of blockage of the salivary glands. It frequently is associated with swelling, pain, and infection of the affected gland. Clinically, sialolithiasis manifests as an increase in the size of the affected gland and increased salivary secretion that results in pain during eating. It occurs mainly in the submandibular gland and less frequently in the parotid gland. This article presents a case involving a 23-year-old woman with Down syndrome who demonstrated sialolithiasis in the parotid duct gland. The sialolith was radiographed and removed surgically.     

Sialolithiasis of minor salivary glands: a clinical and histopathological study

Sialolithiasis is one of the most common disorders of particular major salivary glands. It is caused by sialolith within the ducts or parenchyma of particularly major salivary glands. Although sialolithasis is not uncommon, it often is clinically misdiagnosed when minor salivary glands are affected. This article describes the clinical and microscopic findings of nine cases of sialolithiasis of minor salivary glands. The lesions frequently appeared as single and asymptomatic nodules in middle-aged patients. Only three sites were affected: four lesions were found in the upper lip, three in the buccal mucosa, and two in the lower lip. The most common clinical hypotheses for diagnosis were mucocele, sialoadenitis, and benign salivary gland tumor. Sialolithiasis of minor salivary glands was misdiagnosed frequently. It should be considered as a possible diagnosis when swelling of the oral tissues is observed.     

A massive basal cell adenocarcinoma of the palatal minor salivary gland that progressed into the pterygopalatine fossa

Basal cell adenocarcinoma (BCAC) is a rare malignant neoplasm in the salivary glands and BCAC of the minor salivary glands is exceedingly rare. Only nine cases of palatal BCACs of the minor salivary gland have been reported. BCAC is a low-grade malignant tumour which shares many histologic characteristics with basal cell adenoma. Histological differentiation between the two is difficult and they are often discriminated only by invasion of local structures or by perineural or vascular invasive figures. The authors describe the case of a 69-year-old man with a massive BCAC of a palatal minor salivary gland that progressed into the nasal cavity and pterygopalatine fossa and was treated by a subtotal maxillectomy. This is a highly locally advanced case which required a wider surgical excision range than other previously reported BCAC cases of the palatal minor salivary glands. In this case, the proper diagnosis could not be made by local biopsy alone. It should be kept in mind that it may be difficult to distinguish BCAC from basal cell adenoma by microscopic examination of biopsy specimens alone.     

Sarcoidosis (Heerfordt syndrome): a case report

We report the case of a 22-year-old woman who is suspected of having primary Sj?gren s syndrome. She complaining of bilateral swelling of eyelids and the parotid glands of three weeks duration. Physical examination revealed a bilateral enlargement of both parotid glands, which were solid and painful. Sj?gren s syndrome was suspected at that stage, and the serologic and specific analysis were done. All these tests didn t find any autoimmune or visceral features typical of Sj?gren s syndrome and autoantibodies were negative. During follow-up time the right facial nerve palsy developed. Pulmonary radiography revealed bihilar lymphadenopathy and labial salivary gland biopsy revealed non-caseating granuloma. The patient was classified as having stage I sarcoidosis. This case demonstrates the importance of being aware of the leading clinical signs and symptoms in case of Heerfordt syndrome.     

Kaposi's sarcoma of the parotid gland in acquired immunodeficiency syndrome

A patient with acquired immunodeficiency syndrome complained of a dry mouth and bilateral swelling of the parotid glands. Kaposi's sarcoma (KS) was found within the tissue of the parotid gland. Although KS is a common manifestation of acquired immunodeficiency syndrome, the presence of KS in the salivary glands is very rare. The human immunodeficiency virus I (HIV-I) genome was not identified in parotid glandular cells or in KS cells in this case, although the virus was detected in infiltrating lymphocytes and in tissue macrophages.     

HIV-associated parotid lymphoepithelial cysts

BACKGROUND: An outstanding feature of the diffuse infiltrative lymphocytosis syndrome, or DILS, a subset of HIV-1 disease, is asymptomatic bilateral parotid swelling. Recognition of the entity is important because people with this disease will seek routine dental care. CASE DESCRIPTION: The authors present a classic case of DILS. The patient exhibited bilateral parotid swellings caused by lymphoepithelial cysts, cervical lymphadenopathy, a CD8 circulating lymphocytosis and a CD8 lymphocytic infiltration into the labial salivary glands. A right superficial parotidectomy had been performed several years previously. However, no intervention was advised for the remaining left parotid because of its benign course. CLINICAL IMPLICATIONS: Since patients with DILS can develop lymphomas, periodic observation is mandatory. Any change in the growth pattern requires that a fine-needle aspiration biopsy be performed.     

A case of sarcoidosis presenting with diffuse, bilateral swelling of the salivary glands

This paper reports a case of a 50-year-old male with systemic sarcoidosis presenting initially with a dry mouth and bilateral swelling of the parotid salivary glands. Sarcoidosis is a multisystem granulomatous disease in which there may be multiple exocrine involvement, including the salivary and lachrymal glands. CLINICAL RELEVANCE: The diagnosis and management of this case highlights important clinical issues for dental practitioners.     

Radionuclide scan imaging of bilateral Warthin’s tumor and chronic inflammation in the submandibular glands of a patient with a history of heavy smoking

Papillary cystadenoma lymphomatosum, or Warthin’s tumor, is a benign tumor, primarily localized in the parotid glands. The tumor is more common in men than women, and it occurs usually in the fifth and sixth decades of life. Smoking seems to be one of the predisposing factors. The case of a 65-year-old man is described; he presented with a chief complaint of swelling in the bilateral parotid and submandibular glands. Imaging revealed a benign tumor in the right parotid gland, but only inflammation in both submandibular and the left parotid glands. A biopsy was carried out after rapidly increased swelling of the left parotid and left submandibular glands. Histopathological examinations revealed chronic sialadenitis. Superficial parotidectomies were performed 7 and 21 months after the initial visit on the right parotid and the left parotid glands, respectively. Histopathological examination revealed Warthin’s tumor in both parotid glands, with fibrogenesis and chronic sialadenitis in the submandibular glands.     

Pleomorphic adenoma with extensive necrosis: report of two cases

Pleomorphic adenoma (PA) is the most common neoplasm for both the major and minor salivary glands. While PA is occasionally associated with cystic change or hemorrhage necrosis, spontaneous infarction appears to be very uncommon. We report two unusual cases of extensive necrosis of PA; one occurred in the palate with the necrotic tumor mass slipping into the oral cavity. This phenomenon, possibly associated with incision biopsy, has never been described previously. A second case, arising in the parotid with spontaneous tumor necrosis, poses some dilemma in differential diagnosis.     

下颌下腺涎石病伴发黏液表皮样癌1例报告

黏液表皮样癌是最常见的唾液腺恶性肿瘤之一,最常发生于腮腺（约占2/3）,其次为腭部、小唾液腺（特别是磨牙后腺）及下颌下腺,而发生于由涎石病导致的慢性炎性下颌下腺者极为罕见。本文报告1例发生于慢性炎性下颌下腺中的黏液表皮样癌病例,并对其诊断和治疗方法进行讨论。     

Pleomorphic Adenoma of Soft Palate: Unusual Occurrence of the Major Tumor in Minor Salivary Gland—A Case Report and Literature Review

Salivary gland tumours constitute about less than 4 % of all head and neck tumours. Pleomorphic adenoma, also called benign mixed tumour, is the most common tumour of the salivary glands. About 80–90 % of these tumours occur in the major salivary glands mainly parotid gland and 10 % of them occur in the minor salivary glands. The most common site for pleomorphic adenoma of the minor salivary glands is the palate, followed by the lips and the cheeks. Other rare sites include the floor of the mouth, tongue, tonsil, pharynx, retromolar area and the nasal cavity. Here, we are reporting a case of pleomorphic adenoma of the minor salivary glands of the soft palate in a 36-year-old Indian female. The mass was removed by wide local excision with adequate margins under general anesthesia. There was no recurrence seen after a follow-up period of 1 year.     

Giant Parapharyngeal Space Pleomorphic Adenoma of the Deep Lobe of Parotid Presenting as Obstructive Sleep Apnoea: A Case Report & Review of the Diagnostic and Therapeutic Approaches

Introduction

Salivary gland tumours constitute about less than 4 % of all head and neck tumours. Pleomorphic adenoma, also called benign mixed tumour, is the most common tumour of the salivary glands. About 80–90 % of these tumours occur in the major salivary gland mainly parotid gland and 10 % of them occur in the minor salivary glands.

Aims and Methods

Aim of this case report is to discuss the unique case of giant parotid pleomorphic adenomas arising in the deep lobe involving the parapharyngeal space and difficulty in respiration at sleep during nights repoted at this institute. The patient was undergoing treatment for obstructive sleep apnea syndrome when she reported at this institute for disturbed sleep. Diagnosis was based on computed tomography scan and magnetic resonance imaging and cytology by means of fine needle aspiration biopsy.

Conclusion

An exhaustive pre-operative diagnostic algorithm is mandatory before approaching such lesions involving parapharyngeal space. Fine needle aspiration biopsy is, in our opinion, mandatory to avoid histological surprises. The surgical approach varies according to the location of the tumour and should provide excellent visibility with wide surgical exposure to secure local neurovascular structures.     

Intraparotid mucous retention cyst in an infant: a rare case report

Mucocoeles can be defined as benign lesions that have resulted from extravasation or retention of saliva in the extraglandular spaces, and commonly affect the minor salivary glands. This case details a mucous retention cyst within the parotid gland of an infant, and its management.     

Epithelial–myoepithelial carcinoma of a minor salivary gland in the buccal mucosa

Epithelial–myoepithelial carcinoma (EMC) is a rare tumor constituting less than 1 % of all salivary gland tumors. This neoplasm most often involves the parotid glands, with less frequent involvement of the submandibular or minor salivary glands. This case report describes EMC arising from a minor salivary gland in the buccal mucosa. A 71-year-old Japanese man with a painless submucosal mass in the left buccal region was referred to our hospital. The patient stated that the tumor had been present for more than 4 years and was painless but increasing in size. Oral examination showed a mobile, well-defined mass of approximately 19 × 15 mm; its surface was covered mostly by normal mucosa. Magnetic resonance imaging showed a mass with well-defined borders and relative homogeneity internally. Incisional biopsy led to a histological diagnosis of a suspected pleomorphic adenoma or low-grade malignant tumor originating from the salivary gland. The patient underwent surgical excision under general anesthesia to obtain a definitive diagnosis, and EMC was diagnosed based on histopathological and immunohistochemical examination of the whole specimen. Because the surgical margins were positive in some areas, the patient underwent external postoperative radiotherapy (total of 60 Gy at 2 Gy/day). Recovery was uneventful, and good function returned after postoperative treatment. Four years after tumor resection and radiotherapy, no recurrence had been detected and no other lesions had developed.     

Secretion from minor salivary glands following ablation of the major salivary glands in rats

Since minor salivary glands are tiny and dispersed, ductal cannulation cannot be used when studying their function. The present study was devised to develop a method of measuring minor salivary gland function by excision of the major glands. Female rats (230–280 g) were anaesthetized with sodium pentobarbital. Ablation of the submandibular, sublingual and parotid glands was performed through a sagittal neck incision. Sham-operated rats served as controls. Groups of sialadenectomized animals were investigated immediately and after 1 week, 2 weeks and 3 months. To study secretory function, the mouth was rinsed with 250 μl water in every 5 min and protein and amylase concentrations were measured. After an initial 50 min of basal secretion pilocarpine (1 mg/kg, i.p.) was given. Bilateral ablation of both submandibular, sublingual and parotid glands led to a moderate loss of body weight and a considerable increase in water intake. No other obvious abnormality was observed for periods up to 90 days following surgery. We deduce that the minor glands secrete approximately 14% of protein and 1% of amylase in whole saliva. Secretion is maintained even after 90 days following removal of the major glands. Surgical removal of the major salivary glands allows the secretory function of the minor glands in rats to be studied in vivo.