Pleomorphic adenoma of the palate

Pleomorphic adenoma, is the most common tumor (50%) of the major and minor salivary glands. Seventy percent of the tumors of the minor salivary glands are pleomorphic adenomas, and the most common intraoral site is the palate, followed by the upper lip and buccal mucosa. Pleomorphic adenoma appears as a painless firm mass and, in most cases, does not cause ulceration of the overlying mucosa. Generally it is mobile, except when it occurs in the hard palate. Intraoral mixed tumors, especially those noted within the palate, lack a well-defined capsule. Lesions of the palate frequently involve periosteum or bone. Approximately 25% of benign mixed tumors undergo malignant transformation. Treatment for the pleomorphic adenoma is radical surgery. Inadequate resection leads to local recurrence. The authors report a palate pleomorphic adenoma in a 67-year-old female patient.     

A retrospective study of 60 cases of salivary gland tumors in a Thai population.

Sixty cases of salivary gland tumors were diagnosed in the Oral Pathology Department, Faculty of Dentistry, Mahidol University, Bangkok, Thailand, from 1973 to 2002. Fifty-two cases (86.7%) involved the intraoral minor salivary glands, six cases (10%) were found in the major glands, and two cases (3.3%) were intrabony. The predominance of malignant over benign tumors was evident with 68.3% being malignant and 31.7% benign. Patients ranged in age from 9 to 75 years. The female to male ratio of benign intraoral salivary gland tumors was 1.4 to 1 and of malignant types was 1.1 to 1. The principle site of occurrence was the palate (65.4%), followed by buccal mucosa (13.5%). Pleomorphic adenoma (30%) was the most common benign tumor, and mucoepidermoid carcinoma (44.3%) was the most common malignant tumor. Comparing the data from the present study with other series, some discrepancies exist.     

Intraoral minor salivary gland tumors: a review of 75 cases in a Libyan population

Minor salivary gland carcinomas are uncommon but most often occur in the oral cavity, particularly the hard palate. Dental examination may provide an opportunity for early detection. During the period of 1977-2000 a group of 75 patients (31 males and 44 females, median age 44.2 years and range 15-86 years) with minor salivary gland tumors were diagnosed, based on the 1991 WHO classification. The peak occurrence of the tumors was in the fifth decade for males and sixth decade for females. The frequency of benign tumors was 38.6% (n = 29) and malignant tumors 61.3% (n = 46). Pleomorphic adenoma was the most common histological type of benign tumor identified whereas mucoepidermoid carcinoma and adenoid cystic carcinoma were the most common malignant tumors. The most common primary location of the tumors was the palate followed by the cheek. A benign tumor usually presented as an asymptomatic swelling and ulceration, pain being more frequently associated with the malignant tumors. This study shows that intraoral tumors of minor salivary glands vary widely in presentation, and should be taking into account by medical and dental practitioners in any differential diagnosis when assessing intraoral pathology. Any lesion arising from the hard palate (the most common site in this series) should be considered as a possible minor salivary gland tumor. Referral to a multidisciplinary head and neck clinic following diagnosis is strongly recommended.     

Polymorphous low grade adenocarcinoma: review and case report

Polymorphous Low-Grade Adenocarcinoma is a rare, malignant salivary gland tumor, which is found almost exclusively in minor salivary glands. It is more frequent in the age range from 30 to 70, with a clear female predilection in a 2:1 ratio. It is usually located in the hard or soft palate, although it may be found in the rest of the oral cavity too. It is rare in major salivary glands. In general it has good prognosis, with recurrence rates in the range of 17% - 24%. Although rare, metastasis to regional lymph nodes may occur in 9% of the cases. This report describes the case of a patient that consulted at the Military Odontological Center (Central Odontológica del Ejército) due to an esthetic alteration of her dental prosthesis, which had been made 8 years before. The patient was sent to the Maxillofacial Surgery Service, where the intraoral examination showed a big mass compromising the hard palate and the alveolar ridge. During examination, a dent in her prosthesis was found to correspond to the tumor mass; it was therefore concluded that the tumor had at least an eight-year-old evolution. An incisional biopsy was carried out, and once the polymorphous low-grade adenocarcinoma diagnosis had been stated, the patient was sent to the Head and Neck Surgery Service of the Military Hospital, where the lesion was treated by wide surgical excision followed by radiation therapy.     

Adenomatoid hyperplasia of the palate mimicking clinically as a salivary gland tumor

This report describes an illustrative case of adenomatoid hyperplasia (AH) of the minor salivary glands on the palate of a 31-year-old man. The clinical features of the present lesion corresponded with those of pleomorphic adenoma, but histologically large lobules of normal-appearing mucous acini were found. The cell proliferative activity demonstrated in histological sections, by an immunohistochemical staining of proliferating cell nuclear antigen and Ki-67, showed no statistically significant differences among AH and a matched control group of normal palatal salivary glands. This case suggests that AH apparently exhibits an idiopathic, focal hypertrophic lesion of intraoral mucous glands with limited growth potential.     

涎腺恶性肿瘤治疗方法的研究进展

在口腔颌面部恶性肿瘤中,涎腺恶性肿瘤是一类较常见、发生率较高的恶性肿瘤.任何年龄都可发生涎腺恶性肿瘤,且性别发生率无显著差异.涎腺恶性肿瘤多为涎腺上皮组织来源的恶性肿瘤,可发生于大涎腺如腮腺、领下腺和舌下腺,也可发生于小涎腺如腭腺等,具有组织分型多、细胞成分复杂等特点.近年来国内外针对涎腺恶性肿瘤在诊断治疗方面取得了一些进展,本文就涎腺恶性肿瘤的手术治疗、放射治疗、化学药物治疗、生物治疗等手段作一.     

Tumours of the minor (oropharyngeal) salivary glands: a demographic study of 336 cases

There are 2410 primary epithelial salivary gland tumours in the files of the British Salivary Gland Tumour Panel. Of these tumours, 336 (14%) involved the minor (oropharyngeal) salivary glands, and these were studied in the present investigation. Individual tumours were diagnosed according to the WHO Classification. The percentage of malignant or potentially malignant tumours (46%) was much higher than in major glands (18%), and in some of the less common intraoral sites all the tumours were malignant. The principal sites were the palate (54%), lips (21%) and buccal mucosa (11%), and, in these sites, pleomorphic adenoma was the most common tumour. Monomorphic adenomas accounted for 6% of palatal tumours, but 30% of lip salivary gland tumours. The most common malignant tumour was the adenoid cystic carcinoma. The results are compared with several other large surveys and with tumours of major salivary glands.     

Tumours of the minor (oropharyngeal) salivary glands: a demographic study of 336 cases

There arc 2410 primary epithelial salivary gland tumours in the files of the British Salivary Gland Tumour Panel. Of these tumours, 336 (14%) involved the minor (oropharyngeal) salivary glands, and these were studied m the present investigation Individual tumours were diagnosed according to the W H O Classification The percentage of malignant or potentially malignant tumours (46%) was much higher than in major glands (18%), and in some of the less common intraoral sites all the tumours were malignant. The principal sites were the palate (54%), lips (21%) and buccal mucosa (11%), and, in these sites, pleomorphic adenoma was the most common tumour Monomorphic adenomas accounted for 6% of palatal tumours, hut 30% of lip salivary gland tumours. The most common malignant tumour was the adenoid cystic carcinoma The results arc compared with several other large surveys and with tumours of major salivary glands.     

Enucleation of a pleomorphic adenoma of the palate: a conservative choice

The benign mixed tumor (pleomorphic adenoma) is the most common intraoral salivary gland tumor: more than 50% occurs on the hard and soft palate. The epidemiological data, histopathological and clinical features, preoperative diagnostic methodologies, treatment options, recurrence rates and prediction published in the literature for this neoplasm are discussed. A case of minor salivary gland tumor of the palate in a 26 year old man is reported. The therapy chosen was a surgical conservative enucleation of the lesion. Histological examination showed pleomorphic adenoma; there is no recurrence after 2 years.     

A rare case of sialadenoma papilliferum with epithelial dysplasia and carcinoma in situ

Sialadenoma papilliferum is a rare benign tumor of salivary glands that predominantly affects intraoral minor salivary glands. It is characterized by a biphasic growth pattern of exophytic squamous component and endophytic glandular component. Malignant transformation of sialadenoma papilliferum has only been recently recognized. The present article reports a rare case of sialadenoma papilliferum with epithelial dysplasia and carcinoma-in-situ in the exophytic component.     

Clear cell carcinoma of the mandibular gingiva 'minor salivary gland': a case report with immunohistochemical study

Clear cell carcinoma is a rare neoplasm that arises in salivary glands. They are more frequent in the intraoral minor salivary glands than the major salivary glands. The present case involved a 44-year-old Japanese man with a slight reddish swelling on the mandibular gingiva. Initial clinical diagnosis was squamous cell carcinoma based on this erythroplakial lesion. All tumor cells displayed the expected pattern of immunoreactivity, with positive results for pancytokeratin and high molecular weight cytokeratin. This report examined the immunohistochemical characteristics of clear cell carcinoma, minor salivary gland, and reviewed the existing literature.     

Adenoid cystic carcinoma of the palate in a 9-year-old boy

Malignant tumors of salivary glands in children are extremely rare. A case of an adenoid cystic carcinoma affecting the palate in a 9-year-old child is described. This tumor has not previously been reported as affecting the minor salivary glands among patients in this age group.     

Multiple oral mucoceles treated with evening primrose oil: a report of two cases

Multiple mucoceles of the minor salivary glands are rare in the mouth. Typically, the minor salivary glands of the soft palate are affected. We report two cases that responded entirely following systemic therapy with evening primrose oil. No recurrence was reported over a two-year follow-up period. Evening primrose oil is postulated to have an effect on the composition and/or viscosity of minor salivary gland secretions.     

Mucoepidermoid tumor: a case report involving the operculum of an erupting permanent second molar

The mucoepidermoid tumor (carcinoma) accounts for approximately 6% to 8% of all salivary gland tumors. Although rare in children, it is the most common "malignant" salivary gland tumor, having been reported in major and minor (intraoral) salivary gland sites as well as in the maxilla and the mandible. In children, as in adults, it most often occurs in the parotid gland, but a significant percentage is found in the palate and retromolar pad area. Presently, there is no unanimity of opinion about whether to consider all mucoepidermoid tumors malignant or what the most appropriate treatment regimen is. The following is a case report of a mucoepidermoid tumor presumably arising from the reduced enamel epithelium in soft tissue overlying an erupting mandibular second molar in an 11-year-old boy. Theoretical origins of intraoral soft tissue mucoepidermoid tumors are discussed, as well as treatment philosophy. The importance of submitting, for microscopic diagnosis, all tissue removed during surgical procedure is illustrated in this case report.     

Chromosomal aberrations in adenomatoid hyperplasia of palatal minor salivary gland

Adenomatoid hyperplasia of minor salivary glands is rare, idiopathic, and benign, and typically presents as a tumour-like mass in the hard or soft palate. Its exact nature is not clear and histological examination usually shows an excess of normal-appearing minor salivary glands. To our knowledge, cytogenetic analysis of it in a minor salivary gland of the palate has not previously been reported. We present the cytogenetic analysis of adenomatoid hyperplasia in the hard palate of a 52-year-old woman.     

Mucoepidermoid tumors of the intraoral minor salivary glands: A clinicopathologic study of 54 cases

Abstract. Clinical, gross and microscopic features of 54 mucoepidermoid tumors of intraoral minor salivary glands were studied. Thirty-four were further analyzed with regard to treatment and survival. Females predominated 2:1. The most common locations were palate, mandibular retromolar area and buccal mucosa. Mean duration was approximately 1 year, and most were asymptomatic. Fifty tumors were well-differentiated; four were poorly-differentiated. Growth pattern was generally infiltrative. Treatment was surgical in all cases. Mean follow-up duration was 47.1 months. Three well-differentiated tumors recurred once. One poorly-differentiated tumor recurred three times. No metastases or deaths occurred. Narrow or involved margins were common to recurrent but also to many non-recurrent tumors. Well-differentiated tumors behaved benignly and are best treated by modest local excision. Jaw resection is generally unnecessary. The practice of considering all mucoepidermoid tumors to be malignant is challenged.     

口腔乳头状唾液腺瘤1例临床病理分析

乳头状唾液腺瘤(sialadenoma papilliferum,SP)是一种无痛、乳头状外生性生长为特点的良性唾液腺肿瘤。在WHO最新的肿瘤分类中,SP被列为导管乳头状瘤。SP是一种罕见的唾液腺肿瘤,病变主要累及小唾液腺,以腭部最常见。本文报告1例罕见的发生于下颌磨牙后区的乳头状唾液腺瘤,并结合文献,探讨其临床和组织病理学特征。     

Paediatric intraoral mucoepidermoid carcinoma mimicking a bone lesion

BACKGROUND: Mucoepidermoid carcinoma of the salivary glands occurs most frequently in adults during the fifth and sixth decades of life. Although uncommon, it is the main malignant salivary gland tumour in children, particularly adolescents. CASE REPORT: A 14-year-old girl presented with a mass in her palate that had had a duration of one year. On panoramic X-ray, a well-delimited radiolucent area was observed on the left maxillary sinus region. The initial clinical diagnostic hypothesis was that this was a central giant cell granuloma. An incisional biopsy was performed and the final microscopic diagnosis was mucoepidermoid carcinoma. The tumour was removed by a wide transoral resection and the patient has been asymptomatic for 4 years. CONCLUSION: Mucoepidermoid carcinoma in paediatric patients is uncommon, but it must be considered in differential diagnoses of intraoral submucosal mass/nodules in children, particularly in the palate.     

小涎腺粘液表皮样癌临床病理及血管生成的研究

目的：研究小涎腺粘液表皮样癌（MEC）的组织学分级与血管生成及临床病理因素之间的关系。方法：采用Auclair量化分级标准对77例小涎腺MEC行组织学分级。免疫组织化学S-P法检测血管内皮生长因子VEGF的表达、计数CD34标记的肿瘤内微血管密度（MVD）,并行统计分析。结果：临床分期、组织学分级与肿瘤复发显著相关（P〈0.05）。MVD与组织学分级、临床分期及复发显著相关（P〈0.05）。VEGF表达与MVD呈正相关（P〈0.05）,与肿瘤复发无明显相关。结论：应用Auclair量化分级标准对小涎腺MEC行组织学分级及计数MVD有助于判断肿瘤的生物学行为。     

Polymorphous Low-Grade Adenocarcinoma––Management and Reconstruction with Temporalis Myofacial Flap

Polymorphous low-grade adenocarcinoma is a rare, malignant salivary gland tumor, which is found almost exclusively in minor salivary glands. It is more frequent in the third–seventh decade of life, with a clear female predilection in a 2:1 ratio. It is usually located in the hard or soft palate, although it may be found in the rest of the oral cavity too. It is rare in major salivary glands. In general it has good prognosis, with recurrence rates in the range of 17–24%. Although rare, metastasis to regional lymph nodes has been reported. We report a case of 38 year old female patient who reported with recurrent low grade polymorphous adenocarcinoma in the hard palate, who has been treated with wide excision of the lesion, with reconstruction of the defect using temporalis myofacial flap.