Recurrent pleomorphic adenoma of the palate in a child

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.

Pleomorphic Adenoma of the Oral Cavity: Systematic Review

Pleomorphic adenomas are the most commonly presented salivary gland tumor; however, exact etiologies are unknown. We present a systemic review investigating the demographics, clinical presentations, characteristics, and anatomical locations of oral cavity pleomorphic adenoma. Three electronic databases (PubMed, MEDLINE, and Scopus) and one search engine (Google Scholar) were used to identify studies published in English with no restrictions on the year of publication up to the first week of August 2022. Studies retrieved from the literature involved clinical presentations, characteristics, and anatomical locations of oral cavity pleomorphic adenoma, data presented as frequencies and percentages. Our systematic review included 71 studies out of 2110 identified. Pleomorphic adenoma in the oral cavity was found more commonly in females [1508 (42.9%)] than males, with an age range of 6-83 years. The most common tumor location was the palate, followed by the lips; the jaw was the least common location identified. Most cases were not characterized of having a pleomorphic adenoma [(2,918 (83%))]. The most commonly mentioned characteristic was a painless mass [(561 (16%))] and the least common characteristics were dysphagia, change in sensation, and ill-fitting prosthesis. Pleomorphic adenoma of the oral cavity can have many presentations. In any oral cavity mass, pleomorphic adenoma should be included in the differential diagnosis and a complete surgical excision preferred treatment.

Pleomorphic Adenoma of the Palate: A Rare Case in an Adolescent With Cleft lip and Palate

Benign salivary gland tumors are rarely found in children and adolescents compared with adults. Pleomorphic adenomas (PAs), the most common benign salivary gland tumor, account for only 1% of all head and neck lesions and fewer than 5% of all salivary gland tumors in individuals under the age of 16 years. The data on palatal PA in the first 2 decades of life is confined to published case reports and case series. To date, there has never been a report of palatal PA in a patient with cleft lip and palate. Here we describe an adolescent female with bilateral cleft lip and palate with PA of the hard and soft palate who underwent wide local excision and reconstruction with a buccal fat pad and buccal myo-mucosal flap.

A juvenile pleomorphic adenoma of the palate

Salivary gland tumors in children are rare; involvement of accessory salivary glands is exceptional. We report a case of pleomorphic adenoma of the palate in a child (an 8-year-old girl) addressed by her dentist for discovering a swelling in the palate. Clinical examination revealed a firm, non-tender, nodular swelling in the left hard palate, measuring 1.5 cm × 1.5 cm, situated adjacent to the upper left second molar. Physical examination did not show signs of inflammation or surface ulceration. Oral cavity computed tomography scan did not show bone lysis. The tumor was removed with negative margins. No recurrence was noted. We aim to describe the clinical, radiological features, as well as the management of this rare localization of pleomorphic adenoma.

Recurrent Palatal Pleomorphic Adenoma: A Case Report With a Long-Term Follow-Up

Pleomorphic adenoma is the most common kind of major tumor of the major and minor salivary organs. Although pleomorphic adenoma is a benign tumor, it has a high chance of recurrence and malignancy. In the literature, lower rates of repetitive pleomorphic adenoma of the sense of taste have been detailed while the palate is a common location for an intraoral pleomorphic adenoma. Recurring tumors have been associated with a high risk of malignancy, and surgical excision is the basic treatment option for recurrent adenomas. Revision surgery is quite challenging and has never been standardized. We report a rare case of recurrent pleomorphic adenoma of the palate that occurred 7.5 years after primary ablation.

Pediatric Pleomorphic Adenoma of the Palate

Pleomorphic adenoma is the most common salivary gland tumor but is extremely rare in pediatric patients. The parotid gland is the most affected salivary gland, and the minor salivary glands are rarely affected. Here, we report a case of a 12-year-old boy with a pleomorphic adenoma of the palate.

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.

Pleomorphic adenoma: a rare intraoral pediatric tumor

Minor salivary gland tumors are rare in the pediatric population. The most common minor salivary gland neoplasm is pleomorphic adenoma of the hard palate. We report a case of a 7-year-old patient presenting with a slow-growing palatal lesion, which upon diagnosis we confirm to be a pleomorphic adenoma. These lesions require radical excision with careful dissection due to risks of malignant transformation, pain, interference with dentition, and tumor seeding. Given the risk of recurrence, it is important that these patients be monitored long term following extirpation. Our patient remains recurrence free at most recent follow-up, 5 years following initial extirpation. The addition of this case contributes further information regarding demographics, diagnosis, and treatment of these tumors.

Pleomorphic adenoma of hard palate: an experience

INTRODUCTION

Pleomorphic adenoma of minor salivary glands of hard palate is a rare benign tumour. It usually presents as slow growing submucosal mass on hard palate. The purpose of this study was to collect observational data regarding age, size, symptoms, CT findings and treatment of pleomorphic adenoma of hard palate.

MATERIAL AND METHODS

The prospective observational study was done in the Department of ENT, Department of Oral and maxillofacial surgery at SKIMS Medical College and at Peoples Care Polyclinic for a period of 2 years. Twenty cases were enrolled in the study. After clinical suspicion, computed tomography, FNAC and core needle biopsy was done in all twenty cases before any surgical intervention was done.

RESULTS

Most common age group seen to be involved was 16-30 years. Most common symptom was submucosal slow growing mass. Core biopsy was diagnostic with 100 % efficacy. On CT scan twelve patients (60 %) were seen to have intact hard palate even without minor erosions while four patients had full thickness erosion of hard palate. Surgical wide excision was done in all cases and one patient needed total maxillectomy. All treated patients were followed for one year and none showed signs of recurrence.

CONCLUSION

Pleomorphic adenoma of hard palate is usually seen in adults. Definitive diagnosis lies on histopathological examination. CT is necessary for ruling out any bony erosion. Treatment is by wide local excision.

Pleomorphic adenoma in an adolescent

Pleomorphic adenoma generally occurs in the 4^thand 5^thdecade of life. The adenoma is an uncommon presentation and is exceedingly rare in children and young adolescents. This case report deals with the diagnosis and surgical management of pleomorphic adenoma in the soft palate region in a young adolescent patient.

A clinical analysis of nine new pediatric and adolescent cases of benign minor salivary gland neoplasms and a review of the literature

INTRODUCTION

Minor salivary gland neoplasms of epithelial origin are rare in children and adolescents and most are not well documented, except for a few small series and case reports. This study represents a retrospective clinical analysis of nine cases of benign epithelial salivary gland neoplasms accessioned over a 35-year period at the Louisiana State University School of Dentistry and combines the data with well-documented cases from the English-language literature.

METHODS

A retrospective clinical analysis of nine cases of benign epithelial salivary gland neoplasms was performed over a 35-year period at the Louisiana State University School of Dentistry and combined with data of well-documented cases from the English-language literature.

RESULTS

The nine benign salivary gland neoplasms in patients aged 19 months to 18 years accounted for 2.3% of the Louisiana State University School of Dentistry accessioned salivary gland tumors. These nine cases comprised eight pleomorphic adenomas and one cystadenoma. There were 40 cases in the literature, of which 34 were pleomorphic adenomas. Combining the data for the 42 pleomorphic adenomas resulted in a mean age of 12 years with a 2.8:1 female predilection. The hard palate and/or soft palate were the most common site (69.1%). The average duration and size was 2.1 years and 2.4cm, respectively. Bone involvement occurred in seven cases. Wide local excision was the treatment most often employed. Cases followed for two years or more had a recurrence rate of 13.0%. The remaining seven neoplasms in the combined data comprised myoepithelioma, cystadenoma and sialadenoma papilliferum.

CONCLUSIONS

A relatively long duration (2 years) of a submucosal mass in a minor salivary gland-bearing area with or without bone involvement occurring in a child or adolescent should raise the question of a possible salivary gland neoplasm. A pleomorphic adenoma is the most common benign salivary gland neoplasm in the first and second decade of life. Complete surgical excision affords the best chance of preventing recurrence for pleomorphic adenomas. The recurrence rate of pleomorphic adenomas with two or more years follow-up is 13.0%. Other types of minor salivary gland neoplasms are exceedingly rare and therefore data is sparse, precluding any valid conclusions.

Simultaneous palatal pleomorphic adenoma and mandibular keratocystic odontogenic tumor in a pediatric patient

BACKGROUND

Neoplasms of the salivary gland account for 3% of all head and neck tumors; most of these occur in the parotid gland and are benign; 80% of them are pleomorphic adenomas. Benign neoplasms of the salivary gland are rare in children compared with adults. Keratocystic odontogenic tumor (KCOT) is considered the second most frequent neoplasm of all odontogenic tumors after the ameloblastoma. In the present report, we introduce the unusual presentation of a child with a simultaneous pleomorphic adenoma of the right hard palate and a KCOT of the left mandibular angle.

DISCUSSION

The case is significant for 2 reasons; according to the literature, there are few reports of pleomorphic adenoma arising from a minor salivary gland of the palate in a patient younger than 18 years. This is to our knowledge the first recorded instance of simultaneous palatal pleomorphic adenoma and mandibular KCOT occurring in a child.

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.

Pleomorphic adenoma (benign mixed tumour) of the minor salivary glands of the upper lip

Pleomorphic adenoma is the benign tumor of salivary glands, which originates from the myoepithelial cells and intercalated duct cells. This tumor is more common in major salivary glands. This case report describes a rare and unusual lesion in a 55-year-old female, which was diagnosed as pleomorphic adenoma of the minor salivary glands in the upper lip. The tumor was a circumscribed, submucosal nodule, about 2.0 cm in diameter and was characterized by slow growth and rubbery consistency. Complete excision was performed and the histopathological analysis showed an epithelial salivary gland tumor with islands of plasmacytoid cells, duct like structures, in a variable stroma with chondroid, fibrous and myxoid appearance. No recurrence was observed 1 year after the surgery.

Pleomorphic adenoma of the nasal columella

Pleomorphic adenoma (mixed tumor) is the most common benign neoplasm of the salivary glands. It is considered to occur primarily in the major salivary glands, such as the parotid and submandibular glands. It is much less common in the minor salivary glands, and rarely occurs at other sites, such as larynx, pharynx, trachea, lacrimal gland, and sinonasal tract. An external nose localization of this lesion is very rare. Irrespective of the site where the lesion originates, its preferred treatment should be surgery. We describe a very rare case of recurrent pleomorphic adenoma originating from the columella.

Paediatric salivary gland epithelial neoplasms

Salivary gland epithelial neoplasms in children are rare. Clinicians of all disciplines need to have a high level of suspicion when a non-inflammatory single mass lesion presents in the parotid or submandibular glands. There is high likelihood of malignancy when such a mass presents. Surgery is the primary treatment of choice in the majority of cases, with the addition of adjuvant radiotherapy +/- chemotherapy when the diagnosis is a high-grade tumour and/or when the malignancy presents as a large mass or is associated with local tissue invasion. Minor salivary gland neoplasms also present, the oral cavity is most frequent, with pleomorphic adenoma and mucoepidermoid carcinoma being most common, other malignant neoplasms have been reported in other sites.