Pleomorphic Adenoma in the Lower Lip: A Case Report and a Review

The Diagnostic Considerations and Clinical Management of Lower Lip Swellings in Adolescents: A Narrative Review

This article outlines a systematic workflow for the clinical management of lip swellings, ensuring an accurate diagnosis and appropriate treatment plan. The process involves a thorough clinical examination and necessary diagnostic investigations such as imaging and biopsy, which will guide treatment decisions. Depending on the findings, treatment may range from conservative management to surgical excision. Further, we have covered a range of potential conditions including benign lesions such as fibroma, hemangioma, and pyogenic granuloma, as well as malignant neoplasms such as mucoepidermoid carcinoma and adenoid cystic carcinoma. This comprehensive approach will ensure that both common and serious causes of lip swellings are addressed in clinical practice.

Clinicopathological characteristics of pleomorphic adenoma from the labial gland: A 20-year experience with 173 cases in one single institution

OBJECTIVE

Pleomorphic adenoma (PA) of the lip is not a common phenomenon, and existing literature provides limited information on the clinicopathological features of labial PA.

STUDY DESIGN

Patients diagnosed with labial PA at our single institution over the past 20 years (2001-2020) was retrospectively screened and analyzed to investigate the epidemiologic and clinicopathological features of these tumors.

RESULTS

A total of 173 cases were screened out, and the average age was 44.3 (range 7-82) years, with a peak incidence rate during the third decade. A slight predilection for men (52%) was observed, and PA occurs more frequently in the upper lip than in the lower lip, with a ratio of 14.7:1. On clinical examination, labial PAs usually present as painless masses that develop slowly with no systemic symptoms. Histologically, labial PAs contain myoepithelial and polygonal epithelial cells in myxoid, hyaline, fibrous, chondroid, and even osseous tissues, similar to those in other sites. Specifically, 15 of 173 patients with labial PA presented with cutaneous PA.

CONCLUSION

Labial PA presents over a wide age range and dominantly occurs at the upper lip. Surgical resection is the major treatment strategy, and postoperative recurrence or malignant transformation of labial PA was extremely rare.

Pleomorphic adenomia of lower lip: A case report

Pleomorphic adenoma is a benign tumor of the salivary glands. It commonly occurs in the parotid gland, palate, upper lip and cheek. The authors present a rare case of a pleomorphic adenoma of the lower lip in a 30 years old female admitted on 20th of July, 2022 at Akbar Niazi Teaching Hospital, Islamabad with a complaint of painless, slightly itchy swelling on the lower lip for the last four months. Careful history and examination revealed a swelling of the lower lip which had gradually increased in size but was static for the last three months. As the patient complained of cosmetic and social inconvenience, it was surgically managed. Any post-operative complications were ruled out and the patient was sent home in a good condition. Much research is warranted to know the exact etiopathogenesis and appropriate management of pleomorphic adenoma of the lower lip.

Lipoma in Parotid Gland: A Rare Case Report

Lipoma is a benign, rare, mesenchymal tumor found in the head and neck region, especially in the parotid gland. It thus requires a careful and precise examination to establish a diagnosis. A surgical procedure of the parotid gland is challenging due to the associated risk factor of facial nerve injury. We report a rare case of head and neck region lipoma between the superficial and deep lobe of the parotid gland. A 44-year-old female patient was presented with the chief complaint of a painless lump on the left front ear to the left cheek for about 1 year. There were no complaints of tooth pain before the lump appeared, and there were no lumps in other regions. A fine-needle aspiration biopsy, ultrasonography, and magnetic resonance imaging were all performed to establish the preoperative diagnosis and to plan the correct surgical approach. Lipoma was the initial clinical diagnosis, and a surgical excision with superficial parotidectomy and facialis nerve preservation was performed. Follow-up examinations were conducted to assess any facial nerve injury complications. Conclusion Lipoma rarely grows in the parotid gland. Careful diagnosis should be performed to establish a precise surgery for parotid dissection and facial nerve preservation.

Lip pleomorphic adenomas: case series and literature review

BACKGROUND

Pleomorphic adenoma (PA) is the most frequent benign salivary gland tumor, but a lip PA is rare. Although this tumor may be definitively diagnosed by imaging or a tissue biopsy if it is reasonably large, PAs on the lip are relatively small, and they present findings that are similar to those of other lip lesions, which can make a preoperative diagnosis difficult.

METHODS

We analyzed all PAs in the oral region and lesions on the lips treated in our department over the past 20 years, and we discuss them together with the relevant literature.

RESULTS

We found that 11.8% (n=6) of the PAs occurred on a lip (upper lip: 9.8%, lower lip: 2.0%), and ~1% of all mass lesions of the lips were PAs. The average size of the lip PAs was 1.5±0.7 cm (range, 0.7-2.2 cm). For preoperative diagnostic assistance, ultrasonography (US) (n=4), magnetic resonance (MR) (n=3), or no imaging (n=2) was used. An excisional biopsy was performed in all cases, and to date, no recurrence or malignant transformation has been observed.

CONCLUSIONS

Lip PA is relatively rare. Because almost all of these lesions are small, a preoperative diagnosis is more difficult compared to palatal lesions. This tumor is also prone to long-term neglect and has the potential for recurrence and malignant transformation. It is thus necessary to perform an excision that includes the capsule and surrounding tissues, and careful postoperative follow-up should be continued.

Solitary Angiokeratoma of the Labial Mucosa: Report of a Rare Case and Literature Review

Oral angiokeratoma is a rare vascular lesion that has various clinical presentations. It usually occurs as part of generalized angiokeratoma and rarely appears as a solitary lesion with no underlying systemic diseases. Only 33 cases were reported so far worldwide. In this case report, we present a rare case of isolated solitary oral angiokeratoma in a 22-year-old female patient, which is the first case to be reported in the labial mucosa that has been treated successfully by surgical excision.

Comprehensive characterization of pleomorphic adenoma at intraoral unusual sites

OBJECTIVE

The present study aimed to comprehensively characterize the epidemiologic characteristics, clinicopathologic characteristics, clinical treatments, and prognoses of pleomorphic adenoma (PA) identified at unusual intraoral sites.

STUDY DESIGN

Patients diagnosed with PA in oral and maxillofacial regions at our institution in the past 16 years (2005-2020) were screened from the inpatient disease registry. All data concerning patients with PA found at unusual intraoral sites (defined as intraoral locations except sublingual gland and palate) were retrieved. Previously published cases with adequate clinicopathologic data were collected from PubMed and Embase. Eligible cases were further reviewed and included for statistical analyses.

RESULTS

Among 1039 cases of PA diagnosed at our institution, 52 lesions were found at unusual intraoral sites. A literature review identified another 63 eligible cases from 32 articles. The upper lip was the most common sites for these lesions (n = 57), followed by buccal mucosa (n = 34), tongue (n = 8), lower lip (n = 8), and retromolar area (n = 2). Recurrence and malignant transformation after surgical resection were extremely rare for these lesions.

CONCLUSIONS

PA might rarely develop at uncommon intraoral sites with atypical presentations, thus complicating its early diagnosis. Surgical resection is the major therapeutic strategy for this rare entity and has a favorable prognosis.

Trend Analysis of Head and Neck Neoplasms between 2012-2018 in Patients Residing in Al-Madinah, Saudi Arabia: A Retrospective Study

Objectives  This study sought to present a view of head and neck neoplasms (HNN) prevalence with specific focus on sociodemographic determinants in Al-Madinah Province, Saudi Arabia.

Materials and Methods  This was a hospital-based retrospective study based on retrieval of histopathological data for a period of 6 years between 2012 and 2018. Data was collected from the archives of the Oral and Maxillofacial Pathology Laboratory at King Fahad Hospital (the only referral center for biopsy services) in Al-Madinah City.

Statistical Analysis  An independent t -test and/or nonparametric (Mann–Whitney U test, chi-squared test) tests were used to determine the differences between groups. Statistical significance was set at the p -value < 0.05.

Results  Out of 96 patients, a total of 58 patients had valid biopsy data with preoperative diagnosis. Over three quarters of the cases ( n = 44) were benign with only 24% were malignant. Males were more likely to be diagnosed with a benign tumor than females (54.5 vs. 45.6%, respectively), and malignancy was also more common in males (64.3 vs. 24.1). A significant difference was found in relation to mean age of older patients who were more likely to be diagnosed with malignant tumors ( p = 0.001).

Conclusions  The findings suggest that most of biopsied HNN cases are benign neoplasms. Age is a significant risk factor for head and neck malignancy in this region. Delays in diagnosis of HNN need to be explored.