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.     

Intraosseous pleomorphic adenoma of the mandible: report of a case and review of the literature

Salivary gland tumors constitute approximately 3% of all head and neck tumors. The most common neoplasm involving both major and minor salivary glands is pleomorphic adenoma. Salivary gland tumors are also known to develop within jawbones probably arising from ectopic salivary tissue. Pleomorphic adenomas arising within the jaws as primary central lesions are extremely rare with only a few cases reported. Clinically and radiographically these may resemble lesions of odontogenic origin. We present a rare case of intraosseous pleomorphic adenoma of the mandible mimicking a lateral periodontal cyst along with an extensive review of literature.     

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.     

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.     

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.     

腭部涎腺肿瘤116例临床分析

目的探讨腭部涎腺肿瘤的临床病理类型、诊断及治疗方法。方法对在1983年至2006年问住院治疗的116例腭部涎腺肿瘤病人的临床病理类型、诊断、治疗、预后进行分析和总结。结果116例中良性肿瘤71例（61．21％）,以多形性腺瘤最为多见。恶性肿瘤45例（38．79％）,以腺样囊性癌最多见,黏液表皮样癌次之。肿瘤发生在软腭者38例,硬腭者33例,软硬腭交界处者45例。114例经外科手术治疗,95例获3年以上随访,良性肿瘤复发率为7．4％,恶性肿瘤复发率为22．0％。结论腭部涎腺肿瘤治疗以手术切除为主,应重视术前组织学诊断,尽量避免术后复发及并发症的发生。     

涎腺肿瘤组织TN－CmRNA和CDgmRNA的表达及其意义

目的：探讨Tenascin-C（TN－C）mRNA和CD9mRNA在涎腺肿瘤的表达及其对涎腺肿瘤鉴别诊断的价值。方法：采用原位杂交技术检测10例正常涎腺组织、25例多形性腺瘤（PA）、25例腺样囊性癌（ACC）、20例黏液表皮样癌（MEC）、10例腺泡细胞癌（ACCa）中TN-CmRNA和CD9mRNA的表达。结果：TN-CmRNA在正常涎腺组织中呈阴性表达;CD9mRNA在正常涎腺组织中的阳性率为100％;TN-CmRNA、CD9mRNA在4种涎腺肿瘤中均有表达,TN-CmRNA在多形性腺瘤中的阳性表达率显著高于腺样囊性癌和黏液表皮样癌,差异具有统计学意义,而在多形性腺瘤与腺泡细胞癌中的表达差异无统计学意义。CD9mRNA在多形性腺瘤中的阳性表达率高于腺样囊性癌,差异有统计学意义,而在多形性腺瘤和黏液表皮样癌、腺泡细胞癌中的表达差异无统计学意义;在多形性腺瘤中TN-CmRNA和CD9mRNA的表达呈正相关,在腺样囊性癌、黏液表皮样癌和腺泡细胞癌中TN—CmRNA和CD9mRNA的表达无相关性。结论：TN-CmRNA和CD9mRNA与涎腺肿瘤的发生有一定相关性,对涎腺肿瘤之间的鉴别诊断有一定意义。     

Pleomorphic Adenoma of Minor Salivary Gland in a 14 year Old Child

Salivary gland tumours are rare in childhood, and almost all of them occur in parotid gland. Minor salivary gland tumours are even rarer, pleomorphic adenoma being the most frequently found tumour. Only seventeen cases of pleomorphic adenoma arising in the minor salivary gland tumour have been reported in children and adolescents. Pleomorphic adenoma of minor salivary gland represents about 45% of all the tumours of the minor salivary glands. Pleomorphic adenoma is slowly enlarging tumour indistinguishable from adenoid cystic carcinoma clinically, except for pain and ulceration, which is more common in the latter. Carcinoma arising from pleomorphic adenoma has been reported in 3% cases amongst the minor salivary gland tumours. This report presents a case of pleomorphic adenoma of minor salivary gland in a 14 year old female patient with a brief review of literature.     

2489例涎腺上皮性肿瘤临床病理分析

目的:了解涎腺上皮性肿瘤的临床病理特点。方法:对2489例涎腺上皮性肿瘤临床病理资料进行统计分析。结果:涎腺恶性上皮性肿瘤840例,腺样囊性癌、黏液表皮样癌、癌在多形性腺瘤中居其前3位;涎腺良性上皮性肿瘤1649例,多形性腺瘤、Warthin瘤、基底细胞腺瘤居其前3位。涎腺恶性、良性上皮性肿瘤男女之比为1.13∶1和0.99∶1;平均发病年龄47.86岁和44.86岁;腮腺和腭部为好发部位。结论:腺样囊性癌和多形性腺瘤是最常见的涎腺恶性、良性上皮性肿瘤。     

Giant pleomorphic adenoma of the submandibular gland. Case report

Salivary glands are sites for a great variety of tumors. The parotid gland is the most common site followed by the submandibular gland. The pleomorphic adenoma represents the 60-70% of all tumors involving the major salivary glands, while the submandibular gland is involved in 8% of cases. The pleomorphic adenoma of the submandibular gland is rare and can present difficulty in diagnosis. The heterogeneous histology, a possible malignant transformation, an incomplete capsule that can determine a recurrence, are the most important characteristics of pleomorphic adenoma. A complete surgical removal of the tumor is the treatment of choice. In the case presented, the mass showed an unusual vascularization and remarkable dimensions.     

Synchronous mucoepidermoid carcinoma of tongue and pleomorphic adenoma of submandibular gland

Presentation with synchronous salivary gland tumors is rare, with the most typical combination being Warthin's tumor and pleomorphic adenoma of the parotid gland. Involvement of minor salivary glands in such occurrences is extremely uncommon. We report a case of simultaneous mucoepidermoid carcinoma of the tongue and pleomorphic adenoma of the submandibular gland in a 40-year-old woman. The submandibular mass was initially considered to represent regional lymph node tumor metastasis but later was shown to be an intraglandular primary neoplasm.     

2456例唾液腺肿瘤临床病理分析

目的探讨唾液腺肿瘤的发病、病理类型等临床特点。方法收集中山大学孙逸仙纪念医院口腔颌面外科1973年1月至2018年12月间确诊的唾液腺肿瘤病例2456例患者的相关资料,回顾分析其性别、年龄、病理类型、发病部位、良恶性构成比等特点。结果46年间收治的唾液腺肿瘤患者2456例,女性比例占41.9%,男性占58.1%,40~60岁年龄段为发病高峰,其中良性肿瘤1863例(75.9%),恶性肿瘤593例(24.1%),良恶性之比为3.1∶1。良性肿瘤构成比前2位是多形性腺瘤(58.7%)、Warthin瘤(33.6%),恶性肿瘤构成比前2位是黏液表皮样癌(27.7%)、腺样囊性癌(26.1%)。最常见的良性肿瘤多形性腺瘤的好发部位是腮腺、腭部、颌下腺,而恶性肿瘤中粘液表皮样癌则常见于腮腺和腭部的小唾液腺。本组资料中唾液腺肿瘤发病呈逐年递增的趋势,近10年病例占总病例数的53.3%。结论唾液腺肿瘤病人数量逐年增加;唾液腺肿瘤的总发生率男性高于女性;大唾液腺以良性肿瘤为主,小唾液腺恶性肿瘤多见;多形性腺瘤、Warthin瘤、黏液表皮样癌最常见;40~60岁是唾液腺良、恶性肿瘤高发年龄段。     

528例老年人涎腺肿瘤的构成比分析

目的 了解目前老年人涎腺肿瘤的构成现状,为早期诊断和治疗提供帮助。方法 对本科90年代老年人涎腺肿瘤住院患者的临床资料进行总结分析。结果 老年人涎腺肿瘤患者总数呈增长趋势,且多发于60－74岁;良恶性之比为1．7：1;良性肿瘤中腺淋巴瘤的构成比接近多形性腺瘤,恶性肿瘤中腺样囊性癌的构成比居首;腮腺区发病最多,其次为腭部;女性患病率有增高趋势。结论 老年人涎腺肿瘤的构成与80年代有所不同,在临床工作中须引起重视。     

Analysis of the proportion of salivary gland tumors in 528 elder patients]

OBJECTIVE: To analyse the clinical characteristic, evolution and prognosis of undifferentiated carcinoma with lymphoid stroma(malignant lymphoepithelial The purpose of this study was to investigate the present proportional ratio of salivary gland tumors in elder patients, to provide references for early diagnosis and treatment clinically. METHODS: The medical data of 528 elder patients with salivary gland tumors treated in our department in 1990s were reviewed and analyzed. RESULTS: The number of salivary gland tumors in elder patients had increased in recent years. These tumors were frequently found in patients of 60-74 years. The ratio of benign to malignant was 1.7:1. In benign tumors, the proportion of adenolymphoma approached pleomorphic adenoma. While in malignant tumors, adenoid cystic carcinoma accounted the most. These tumors were most commonly found in the parotid gland, followed by the palate. The prevalence of female had an increase trend. CONCLUSION: The proportion of salivary gland tumor in elder patients in 1990s was different from that in 1980s. This change should attract enough attention form the surgeons.     

大涎腺上皮性肿瘤212例临床分析

目的 总结大涎腺上皮性肿瘤的临床特点,指导临床实践。方法 按照WHO 1991年涎腺肿瘤组织学分类标准,对212例经病理确诊的大涎腺上皮性肿瘤进行回顾性临床分析,讨论良、恶性肿瘤的不同临床特征。结果 212例肿瘤中,腺瘤166例(78.3％),以多形性腺瘤为主;涎腺癌46例(21.7％),以腺样囊性癌最多见。腮腺是最主要发病部位。涎腺腺瘤临床多表现为无痛性肿块,涎腺癌常伴有疼痛和(或)神经麻痹等症状。结论 大涎腺良、恶性肿瘤具有不同的临床特征,有助于临床正确诊断。     

A clinico-pathologic study of 311 intra-oral salivary gland tumors in Thais

Background:  There have been several epidemiologic studies on intra-oral salivary gland tumors in several countries, but little is known of these tumors in Thailand.
Objectives:  To determine the relative frequency and distribution of various types of intra-oral salivary gland tumors in the Thai population.
Methods:  The files of the Department of Oral Pathology, Faculty of Dentistry, Chulalongkorn University, from 1969 to 2007 were searched for intra-oral salivary gland tumors. Histopathologic slides were reviewed and reclassified according to the 2005 WHO Classification of Head and Neck Tumors. The age, gender, race, and anatomical distribution of the tumors were collected from the patients' records.
Results:  Of the 16,358 accessioned cases, 311 cases (1.90%) were diagnosed as intra-oral salivary gland tumors. One hundred and forty-seven cases (47.27%) were benign tumors, while 164 cases (52.73%) were malignant tumors. The mean age of the patient ± SD = 41.57 ± 16.65 years. Females outnumbered male patients by a ratio of M:F = 1:1.38. Almost all except one patient were Thais. Pleomorphic adenoma was the most common intra-oral salivary gland tumor. The majority of cases occurred at the palate.
Conclusions:  Pleomorphic adenoma is the most common intra-oral salivary gland tumor and the most common benign intra-oral salivary gland tumor, while mucoepidermoid carcinoma is the most common malignant intra-oral salivary gland tumor. Intra-oral salivary gland tumors in Thailand elicit similar trend as in previous studies, with only minor differences such as the ranking of some tumors, the higher incidence of intra-bony location, and the lower incidence of polymorphous low-grade adenocarcinoma.     

Salivary gland tumors in an Iranian population: a retrospective study of 130 cases.

PURPOSE: Tumors of the salivary glands are uncommon, comprising 3% to 10% of head and neck neoplasia. In the absence of epidemiologic studies of these neoplasms in an Iranian population, we conducted a preliminary survey of 130 cases over the last 20 years in Hamedan, Iran. PATIENTS AND METHODS: The medical records and case notes of all patients with histologically confirmed salivary gland tumors were reviewed retrospectively from February 1984 to March 2003. This review found 89 patients with benign tumors and 41 patients with malignant tumors. The collection of data included gender, age, location, and histopathology of the tumor. Other recorded data included diagnostic procedures, operative reports, complications, additional treatment, and follow-up. RESULTS: We studied 78 females and 52 males with a mean age of 44.9 years. Patients with benign and malignant tumors presented with a mean age of 41.3 and 47 years, respectively. The frequency of benign tumors was 68.4% (n = 89) and 31.6% for malignant tumors (n = 41). Tumors were localized in the parotid gland (63%; n = 82), the submandibular gland (23%; n = 30), and in the minor salivary glands (14%; n = 18). The most common benign tumor was pleomorphic adenoma (65.4%; n = 85). Among malignant tumors, mucoepidermoid carcinoma was the most frequent (11.5%; n = 15), followed by adenocarcinoma (10%; n = 13). Greater than 63% of malignant tumors were treated surgically, and the remaining with combined therapy. Seven patients died over the follow-up period (6 with persistent disease), 5 were lost to follow-up, and 23 remained cancer-free. CONCLUSION: Between benign and malignant salivary gland tumors, frequency of pleomorphic adenoma and mucoepidermoid carcinoma was in keeping with studies reported previously. In other salivary gland tumors, however, diversity was obvious and showed significant difference, requiring further studies.     

PCNA, Ki-67 and p53 expressions in submandibular salivary gland tumours

Salivary gland tumours are uncommon with a broad heterogeneity. The most common benign tumour is the pleomorphic adenoma, whereas mucoepidermoid carcinoma and adenoid cystic carcinoma predominate among the malignancies. Most salivary gland tumours occur in the parotid, and consequently clinical and biological data are normally derived from this site. This work describes the expressions of PCNA, Ki-67 and p53 in 15 pleomorphic adenomas, 15 mucoepidermoid carcinomas and 15 adenoid cystic carcinomas of the submandibular gland. Our results showed that all pleomorphic adenomas were negative for p53 and Ki-67 with 66.6% being positive for PCNA. Conversely, p53 was positive in 53% of the mucoepidermoid carcinomas and in 20% of the adenoid cystic carcinomas. Ki-67 was expressed in 47.7% of the mucoepidermoid carcinomas and 40% of the adenoid cystic carcinomas. All malignant tumours were positive for PCNA. These results indicate that the proliferative rate analysed with PCNA and Ki-67 and the expression of p53 in pleomorphic adenoma and adenoid cystic carcinoma of the submandibular gland were similar to those described in the parotid and minor salivary glands. However, mucoepidermoid carcinomas showed higher expression of these markers than those of other salivary glands. This work is the first describing the expression of these immunohistochemical markers exclusively in submandibular salivary gland tumours.     

615例小涎腺上皮性肿瘤的临床病理分析

目的　探讨小涎腺上皮性肿瘤的临床病理特点。方法　对615例小涎腺上皮性肿瘤的部位分布、发病年龄、性别及组织学类型进行回顾性分析。结果　615例小涎腺上皮性肿瘤中腺瘤265例,癌350例,良恶性肿瘤之比为1∶1·3。良性肿瘤中以多形性腺瘤最为常见(81·1%),其次为肌上皮瘤(14·7%)。恶性肿瘤中以腺样囊性癌最常见(32·9%),其次为粘液表皮样癌(21·4%),腺癌(11·7%)。小涎腺上皮性肿瘤以腭部最为好发,分别占良、恶性肿瘤的77·0%和60.0%。腺瘤中女性患者(51·3%)稍多于男性(48·7%);小涎腺癌患者中男性(56·3%)多于女性 (43·7%)。小涎腺腺瘤患者平均发病年龄40·9岁,小涎腺癌平均发病年龄49·1岁,恶性肿瘤的发病年龄显著高于良性肿瘤(P<0·05)。结论　小涎腺上皮性肿瘤在病理类型构成比、部位、年龄、性别分布上具有其独到的特点。     

Perlecan-rich epithelial linings as a background of proliferative potentials of keratocystic odontogenic tumor

Background:  The intraepithelial deposit of perlecan, a basement membrane-type heparan sulfate (HS) proteoglycan, has been demonstrated in neoplastic conditions such as salivary gland tumors, odontogenic tumors, and oral carcinoma in situ . Our aim was to determine whether perlecan turnover was enhanced in the lining cells of keratocystic odontogenic tumor (KCOT), which had been recently renamed from odontogenic keratocyst because of its accumulated evidence of neoplasm, as a possible background for neoplastic proliferation.
Methods:  Ten surgical specimens from each of KCOT, dentigerous cyst, and radicular cyst were examined for the expressions of perlecan core protein, HS chains, heparanase, and Ki-67 by immunohistochemistry and in situ hybridization.
Results:  In KCOT, perlecan core protein and HS chains were localized on the cell border from the parabasal to subkeratinized layers of the lining epithelium. Heparanase was localized in a similar fashion to those for perlecan and HS chains but was within the cytoplasm. mRNA signals for perlecan core protein and heparanase were mostly compatible with their protein signals. Ki-67-positive cells were localized mainly in the second basal cell layers with definitely higher labeling indices (approximately 31.3%, second layer). In contrast to KCOT, dentigerous cysts and radicular cysts had no perlecan, HS chains, and heparanase deposition in their linings with extremely lower Ki-67 indices (0.4–0.8%).
Conclusion:  The result suggests that the characteristic intra-lining-epithelial deposit of perlecan in KCOT, which has never been seen in other cystic jaw lesions, is a new evidence supporting the neoplastic nature of KCOT.