Pleomorphic adenoma of hard palate: an experience

Pleomorphic Adenoma of the Palate: Diagnostic and Surgical Strategy

Pleomorphic adenoma is a benign tumor of the salivary glands. It develops preferentially in the parotid gland. The authors report a localization of a pleomorphic adenoma on the palate and discuss the value of CT scan in therapeutic strategy.

Decoding a Rare Case of Pleomorphic Adenoma: A Case Report and Review of the Literature

Diagnosing palatal swellings is crucial for various reasons, mainly because these swellings can signal a range of health problems, from benign conditions to more serious diseases. Here, we have reported an interesting case of long-standing palatal swelling. Accurate diagnosis typically involves a combination of clinical examination, patient history, imaging studies, and possibly biopsy or other laboratory tests. Since each condition has unique characteristics and treatment approaches, differential diagnosis is essential for ensuring effective management. This case highlights the importance of considering pleomorphic adenoma in the differential diagnosis of palatal tumors and demonstrates the effectiveness of surgical management. A literature review is also presented, discussing the clinical, radiological, and histopathological features of this rare entity. Accurate diagnosis and timely intervention are crucial for effective treatment and maintaining overall oral health.

Clinical behavior of recurrent pleomorphic adenoma in the palate: a systematic review

PURPOSE

This systematic review analyzed the clinical behavior and odds of malignancy of the palatal recurrent pleomorphic adenomas.

METHODS

Systematic review of patients with recurrent pleomorphic adenoma arising in the palate. Database search: MEDLINE, Scopus, Web of Science, Cochrane, EMBASE, Virtual Health Library, Google Scholar, and OpenGrey. A binomial logistic regression was performed to assess the odds of detecting recurrence five, 10 and 20 years after the treatment of primary tumor.

RESULTS

Thirteen studies (n = 18 patients) out of 336 were included. The recurrent pleomorphic adenoma in palate was more common in females (61.6%), average age was 49 years old (range 9-73 years old). Four patients progressed to malignant transformation. The odds ratio (OR) of detecting a recurrence at 10 (OR = 5.57; 95% confidence interval - 95%CI 1.13-27.52), and 20 years (OR = 18.78; 95%CI 3.18-110.84) after treatment of primary pleomorphic adenoma was significantly higher than at one-year follow-up.

CONCLUSIONS

The recurrence of pleomorphic adenoma in palate remains a rare event of late occurrence. It mainly affects middle-aged female and carries a risk of malignant transformation. Although uncommon, patients with palatal pleomorphic adenoma should be warned about the possibility of recurrence or malignant transformation of tumor at advanced ages.

Efficacy of Collagen Membrane Graft in Intraoral Surgery - An Evaluative Study

Introduction

Bovine-derived collagen membrane is usually and regularly used as a temporary cover or dressing for extraoral wounds and burns. It has wide applications because of its usefulness and biocompatibility. This has provoked us to do a study with the use of collagen membrane even for minor intraoral surgical defects. The aim of this evaluative study was to evaluate the clinical efficacy of collagen membrane in intraoral wounds created by removal of various soft tissue lesions.

Materials and Methods

A total of 25 healthy patients (16 males and 9 females) were taken for this study. This study was confined to secondary defects of the oral mucosa, which occur after excision of premalignant lesions and other conditions, such as benign lesions, reactive proliferations, and incisional biopsy wounds. Only those lesions that were sufficiently large and could not be closed primarily were included in the study.

Results

The results were evaluated on the day of surgery and in the postoperative period. The usefulness of collagen membrane as an intraoral temporary wound dressing material to promote haemostasis, relieve pain, induce granulation, and assist in rapid epithelialization at the wound site and prevent infection, contracture, scarring, and donor-site morbidity was evaluated, and finally, the efficacy of collagen membrane was tested by the use of Chi-square test and P < 0.001, which is a statistically and clinically significant value.

Discussion

Collagen membrane was observed as both biological dressing material and drug carrier. It was found to be a suitable alternative to other graft materials mentioned for the repair of defects in the mucous membrane created by surgical excision of lesions. Therefore, when used judiciously in a controlled clinical situation, collagen membrane is biologically acceptable in nature. It is an alternative to autologous grafts rather than a replacement of other grafts used in the oral cavity.

Canalicular adenoma: palatal presentation of an uncommon lesion

Canalicular adenoma is a unique, rare, benign salivary gland neoplasm whose reported prevalence varies in different studies. According to literature, this neoplasm has a marked predilection to occur in the upper lip of elderly women. Histological features are usually distinctive and diagnostic. This neoplasm has good prognosis after conservative surgical management but the propensity of multifocal nature and recurrence of this lesion mandates regular follow-up. This case report illustrates the case of a canalicular adenoma in the palate in a 71-year-old male patient. Here, we discuss the differential diagnosis with a brief review of literature.

Surgical Management of Palatal Pleomorphic Adenoma (PPA) Recurrence After 10 years, Treated at a Brazilian Center - A Case Report

Pleomorphic adenoma, considered the most frequent benign mixed neoplasm of the minor salivary glands, occurs mainly in the region of the hard palate, with slight predilection in females and peak of incidence between the third and fifth decades of life. An increase in recurrence rates has been associated with the histopathological variants of the tumor, cellular characteristics, stroma, and capsule rupture during surgical removal of the lesion. The present case report aims to describe the surgical approach performed on the patient, a 45-year-old woman with a recurrent Pleomorphic Adenoma (PA) in the region of the hard palate on the right side, 10 years after initial enucleation of the lesion; her main complaint was an increase in volume in the palatal region. After extensive local surgical excision of the tumor and 2 years of follow-up, there were no signs of recurrence. Computed tomography and a correct histopathological diagnosis are essential to enable the establishment of an appropriate surgical treatment, with the purpose of achieving complete removal of the lesion, with wide surgical margins, including the lining mucosa and the underlying periosteum, as described in the present case.

Surgical Management of the Palatal Pleomorphic Adenoma

INTRODUCTION

Surgical excision is the basic treatment option of the palatal pleomorphic adenoma (PA), it is generally accepted to prevent for recurrence. The purpose of this study was to determine the decision criteria for the management of the palatal PA through evaluating the postoperative results of palatal PA correlation with the clinical appearance.

MATERIALS AND METHODS

All of patients were evaluated the mucosal ulceration, palatal erosion, and size with CT images in all 18 palatal PAs. The clinical features, surgical methods, and surgical results of these 18 PAs were reviewed.

RESULTS

The most common age was 51 to 70 years. One patient was in pediatric age (14 years). Females were involved more commonly than males (F:M ratio was 5:1) Mucosa was normal in 16 patients. Ulcerations of the overlying mucosa were seen in 2 cases. On the coronal CT images, hard palate was erosion in 14 patients who had involved hard palate. The size of tumors was from 7 mm to 33 mm in CT scans. Two patients were ruptured the tumor during the operation, and 1 out of 2 patients was recurred.

CONCLUSIONS

For the definitive diagnosis is necessary to perform the preoperative core biopsy for the histopathological examination, and CT is necessary for evaluating the erosion of the hard palate and severity of the erosion. Hard palatal PA can be managed by surgical enucleation and removal of the periosteum or involved bone. Soft palatal PA can be managed by surgical enucleation without mucosal resection. Rupture of the tumor is related to the recurrence.

Pleomorphic Adenoma of the Palate: A Case Report

Pleomorphic adenoma is the most common benign tumor affecting the major salivary glands and infrequently arises from the minor salivary glands. It involves the parotid of the major salivary glands and the palate of the minor salivary glands. This article presents a case of pleomorphic adenoma of the palatal minor salivary gland treated successfully by surgical excision.

The Le Fort I osteotomy as surgical approach of an extensive pleomorphic adenoma of the palate

Pleomorphic adenoma (PA) is the most common benign mixed salivary gland tumor. We describe here a peculiar case of a 72-year-old woman with a PA of the palate resected with palatal approach combined with Le Fort I osteotomy, adding to the currently limited scientific literature on intraoral approach for removal of extensive tumors of the midface. The Le Fort I osteotomy approach allows direct visualization of the tumor and ensures a wide excision, increasing safety and minimizing the possibility of recurrence.