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Mauceri R, Coppini M, Alecci G, Cordova A, Florena AM, Magro G, Toro C, Campisi G. Polymorphous Adenocarcinoma: A Systematic Review of the Literature and Presentation of Two Cases in a Less-Considered Anatomical Site. Cancers (Basel) 2024; 16:220. [PMID: 38201647 PMCID: PMC10778460 DOI: 10.3390/cancers16010220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 12/28/2023] [Accepted: 12/31/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Polymorphous adenocarcinoma (PAC) is the second-most common malignant tumour of the minor salivary glands. Although PAC predominantly affects the palate, it can also involve the buccal mucosa. This systematic review aims to investigate the literature data about PAC. Furthermore, we report two cases of patients affected by PAC in an infrequently considered anatomical site. METHODS According to PRISMA guidelines, a systematic review search was conducted on PubMed, Scopus, and Web of Science. Observational studies conducted on patients with a histological diagnosis of PAC were selected and analysed. Furthermore, two cases of patients with PAC affecting the buccal mucosa were reported. RESULTS Twenty-nine studies were included, and 143 patients affected by PAC were analysed (62 males, 75 females, and 6 undefined, with a mean age of 57.4 ± 14.5 years). The palate was the most affected site (99/143, 69.2%), followed by the buccal mucosa (12/143, 8.4%). Moreover, we report two cases of patients with PAC affecting the buccal mucosa (one male and one female, with a mean age of 70.5 ± 2.5 years). CONCLUSIONS The present study underscores the importance of considering the buccal mucosa as a possible location of minor salivary gland tumours; although it is a less-considered affliction, it is not uncommon.
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Affiliation(s)
- Rodolfo Mauceri
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90127 Palermo, Italy; (R.M.); (G.C.)
- Unit of Oral Medicine and Dentistry for Fragile Patients, Department of Rehabilitation, Fragility, and Continuity of Care, University Hospital Palermo, 90127 Palermo, Italy
| | - Martina Coppini
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90127 Palermo, Italy; (R.M.); (G.C.)
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 90122 Messina, Italy
| | - Giuseppe Alecci
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo, 90127 Palermo, Italy; (G.A.); (A.M.F.)
| | - Adriana Cordova
- Plastic and Reconstructive Surgery Section, Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90127 Palermo, Italy;
| | - Ada Maria Florena
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo, 90127 Palermo, Italy; (G.A.); (A.M.F.)
| | - Gaetano Magro
- Department of Biomedical and Biotechnological Sciences, Section of Physiology, School of Medicine, University of Catania, 95123 Catania, Italy;
| | - Corrado Toro
- Maxillofacial Surgery Unit, Clinica del Mediterraneo of Ragusa, 97100 Ragusa, Italy;
| | - Giuseppina Campisi
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90127 Palermo, Italy; (R.M.); (G.C.)
- Unit of Oral Medicine and Dentistry for Fragile Patients, Department of Rehabilitation, Fragility, and Continuity of Care, University Hospital Palermo, 90127 Palermo, Italy
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2
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Miserocchi G, Bassi M, De Luca G, Calpona S, De Rosa F, Bongiovanni A, Parisi E, Di Menna G, De Vita A, Liverani C, Spadazzi C, Cocchi C, Vanni S, Capelli L, Magnani M, Meccariello G, Vicini C, Campobassi A, Mercatali L, Ibrahim T. High-grade transformation of a polymorphous adenocarcinoma of the salivary gland: a case report and review of the literature. Front Oncol 2023; 13:1245043. [PMID: 37795450 PMCID: PMC10545860 DOI: 10.3389/fonc.2023.1245043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/23/2023] [Indexed: 10/06/2023] Open
Abstract
Background Polymorphous adenocarcinoma (PAC) represents the second most widespread neoplasm of the minor salivary glands. These tumors rarely develop a histological progression from low-grade to high-grade malignancy, named "high-grade transformation" (HGT). Only nine cases are described in literature. Case description Here, we describe the case of a 76-year-old male patient with a PAC recurrence of the oral floor displaying HGT, and we explore the tumor cytomorphological features, genomic profiling, and the patient's clinical management. The tumor mass was characterized by poorly atypical cellular elements with vesicular nuclei and comedonecrosis foci. The growth pattern was predominantly solid, tubular, and cribriform. The lesion did not show microsatellite instability or targeted molecular alterations. The case was successfully treated with radical surgery followed by radiotherapy. Conclusion We report for the first time the recurrence of a PAC with HGT arising in the oral floor after 20 years from the primary lesion. These preliminary data and the literature analysis enhance the knowledge of this extremely rare disease.
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Affiliation(s)
- Giacomo Miserocchi
- Preclinic and Osteoncology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Massimo Bassi
- Maxillofacial Surgery Unit, “Bufalini Hospital”, Azienda Unità Sanitaria Locale (AUSL) Romagna, Cesena, Italy
| | - Giovanni De Luca
- Pathology Unit, “Bufalini” Hospital, Azienda Unità Sanitaria Locale (AUSL) Romagna, Cesena, Italy
| | - Sebastiano Calpona
- Preclinic and Osteoncology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Francesco De Rosa
- Immunotherapy, Cell Therapy and Biobank, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Alberto Bongiovanni
- Preclinic and Osteoncology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Elisabetta Parisi
- Radiotherapy Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Italy
| | - Giandomenico Di Menna
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Alessandro De Vita
- Preclinic and Osteoncology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Chiara Liverani
- Preclinic and Osteoncology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Chiara Spadazzi
- Preclinic and Osteoncology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Claudia Cocchi
- Preclinic and Osteoncology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Silvia Vanni
- Preclinic and Osteoncology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Laura Capelli
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Massimo Magnani
- Department of Head-Neck Surgery Azienda Unità Sanitaria Locale (AUSL) Romagna, Ear Nose Throat (ENT) Unit, Bufalini Hospital, Cesena, Italy
| | - Giuseppe Meccariello
- Otolaryngology and Head-Neck Surgery Unit, Department of Head-Neck Surgeries, Morgagni Pierantoni Hospital, Azienda USL della Romagna, Forlì, Italy
| | - Claudio Vicini
- Otolaryngology and Head-Neck Surgery Unit, Department of Head-Neck Surgeries, Morgagni Pierantoni Hospital, Azienda USL della Romagna, Forlì, Italy
| | - Angelo Campobassi
- Maxillofacial Surgery Unit, “Bufalini Hospital”, Azienda Unità Sanitaria Locale (AUSL) Romagna, Cesena, Italy
| | - Laura Mercatali
- Preclinic and Osteoncology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Toni Ibrahim
- Preclinic and Osteoncology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
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3
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Nonaka T, Takei H. Immunohistochemical Profile of Polymorphous Adenocarcinoma of Minor Salivary Gland: A Systematic Review and Meta-Analysis. Head Neck Pathol 2022; 16:980-990. [PMID: 35507302 PMCID: PMC9729680 DOI: 10.1007/s12105-022-01453-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 03/21/2022] [Indexed: 12/16/2022]
Abstract
Polymorphous adenocarcinoma (PAC) is a rare variant of minor salivary gland tumors. Because of its architectural diversity, histological diagnosis of PAC can be difficult especially for small biopsies, and immunohistochemistry is of great help in differentiating it from its histologic mimics. The aim of this study is to conduct a systematic literature review to identify reliable immunohistochemical markers for PAC. We conducted an electronic literature search of the MEDLINE, ScienceDirect, SpringerLink, and Wiley Online Library databases, covering the literature published in the period between 1988 and 2021. The eligibility criteria included case reports and retrospective studies of PAC cases with details of immunohistochemical markers. Following the search and selection process, 32 studies with 409 cases were included in this systematic review. Overall, > 90% positivity was observed for pan-cytokeratin (CK) (97.3%), CK7 (96.8%), CK7/8 (97.4%), E-cadherin (90.0%), Vimentin (92.5%), S100 (97.0%), p63 (91.7%), and SOX10 (100%), while little to no positivity was observed for CK20 (0.0%), p40 (0.0%), and GFAP (5.0%). The average MIB-1 labeling index was 3.78%. The results of this systematic review indicate that CK7+/CK20-, p63+/p40-, S100+, Vimentin+, and GFAP- immunophenotype have diagnostic value for PAC. In addition, the use of S100, MSA, p40, and c-Kit provide additional layers of information helpful to differentiate PAC from adenoid cystic carcinoma, one of challenging differential diagnoses.
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Affiliation(s)
- Taichiro Nonaka
- Department of Cellular Biology and Anatomy, Louisiana State University Health Sciences Center, Shreveport, LA, 71103, USA.
| | - Hidehiro Takei
- Department of Pathology and Translational Pathobiology, Louisiana State University Health Sciences Center, Shreveport, LA, 71103, USA
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4
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Mandal A, Mahato P, Das C, Mukhopadhyay M. Polymorphous adenocarcinoma of the parotid – An uncommon site of occurrence. INTERNATIONAL JOURNAL OF ADVANCED MEDICAL AND HEALTH RESEARCH 2022. [DOI: 10.4103/ijamr.ijamr_207_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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5
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Mimica X, Katabi N, McGill MR, Hay A, Zanoni DK, Shah JP, Wong RJ, Cohen MA, Patel SG, Ganly I. Polymorphous adenocarcinoma of salivary glands. Oral Oncol 2019; 95:52-58. [PMID: 31345394 DOI: 10.1016/j.oraloncology.2019.06.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 05/29/2019] [Accepted: 06/02/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Polymorphous adenocarcinoma of salivary gland (PAC) is rare. Despite being described as a low risk histology, some patients develop regional and distant metastasis. More aggressive behavior has been attributed to a PAC subcategory called cribriform adenocarcinoma of minor salivary glands (CAMSG). We examined oncological outcomes of PAC. PATIENTS AND METHODS Fifty-seven patients with PAC were identified from an institutional database of 884 patients surgically treated for salivary gland malignancies from 1985 to 2015. Detailed histopathological analysis was performed. Survival outcomes were calculated using the Kaplan-Meier method. Factors predictive of recurrence were identified using the Cox proportional hazard method. RESULTS Fifty-four (95%) had tumors of minor salivary gland origin; the most frequent location was the oral cavity in 41 (76%), specifically the hard palate in 32 (55%). Forty-six patients (81%) were clinical T1-T2; 3 (5%) had a clinically positive neck. Thirty-two patients (56%) were classified as PAC and 14 (25%) as CAMSG. Forty-four patients (77%) had surgery alone; 13 (23%) had surgery and postoperative radiotherapy. The 5- and 10-year overall survival and disease-specific survival were 88% and 79% and 98% and 94%, respectively (median follow up 84 [1-159] months); 5- and 10-year recurrence-free survival were 93% and 88%, respectively. Univariate analysis showed male sex, III/IV stage, and CASMG variant had increased incidence of recurrence but were not statistically significant. CONCLUSION PAC of the salivary glands is an indolent disease with good survival outcomes. Recurrence is uncommon and tends to occur late. Long-term follow-up is indicated in patients with this disease.
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Affiliation(s)
- Ximena Mimica
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
| | - Nora Katabi
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
| | - Marlena R McGill
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
| | - Ashley Hay
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
| | - Daniella Karassawa Zanoni
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
| | - Jatin P Shah
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Department of Oncology and Reconstructive Surgery, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.
| | - Richard J Wong
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
| | - Marc A Cohen
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
| | - Snehal G Patel
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
| | - Ian Ganly
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
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6
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Andreasen S, Kiss K, Mikkelsen LH, Channir HI, Plaschke CC, Melchior LC, Eriksen JG, Wessel I. An update on head and neck cancer: new entities and their histopathology, molecular background, treatment, and outcome. APMIS 2019; 127:240-264. [PMID: 30811708 DOI: 10.1111/apm.12901] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 10/08/2018] [Indexed: 12/12/2022]
Abstract
The head and neck region harbor numerous specialized tissues of all lineages giving rise to a plethora of different malignancies. In recent years, new types and subtypes of cancer has been described here due to the recognition of their histological and molecular characteristics. Some have been formally accepted in the most recent classifications from the World Health Organization (WHO) and American Joint Committee on Cancer (AJCC) as distinct diseases due to characteristics in clinical presentation, outcome, and treatment. In particular, this applies to malignancies of the salivary gland, sinonasal tract, and oropharynx. In this overview, we present the most recent developments in the classification, histopathological characteristics, and molecular features of head and neck cancer. The clinical and radiological characteristics, outcome, and treatment options including perspectives for targeted therapies, are discussed.
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Affiliation(s)
- Simon Andreasen
- Department of Otorhinolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark.,Department of Pathology, Rigshospitalet, Copenhagen, Denmark
| | - Katalin Kiss
- Department of Pathology, Rigshospitalet, Copenhagen, Denmark
| | - Lauge Hjorth Mikkelsen
- Department of Pathology, Rigshospitalet, Copenhagen, Denmark.,Department of Ophthalmology, Rigshospitalet, Copenhagen, Denmark
| | - Hani Ibrahim Channir
- Department of Otorhinolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark
| | | | | | - Jesper Grau Eriksen
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Irene Wessel
- Department of Otorhinolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark
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7
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Palatal Polymorphous Adenocarcinoma with High-Grade Transformation: A Case Report and Literature Review. Head Neck Pathol 2018; 13:131-139. [PMID: 29594833 PMCID: PMC6513909 DOI: 10.1007/s12105-018-0916-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 03/26/2018] [Indexed: 01/05/2023]
Abstract
Polymorphous adenocarcinoma (PAC) is the second most common intraoral malignant neoplasm of the minor salivary glands. However, it is very rare for PAC to show high-grade transformation (HGT) and to our knowledge, the English literature only seven reported cases. HGT tends to be observed when PAC recurs, and it is extremely rare to be seen at initial presentation. Here we report a 43-year-old Japanese male patient with PAC of the right palate showing HGT at initial presentation. Histopathologically, the tumor was characterized by a prominent solid and papillary-cystic growth pattern, with nuclear atypia and necrosis in area of HGT. The immunohistochemical staining pattern was consistent with PAC, as the tumor cells showed diffuse positivity for cytokeratin, vimentin and S-100, and focal positivity for bcl-2, ɑ-SMA and EMA. The tumor cells in HGT areas were markedly positive for AR and Ki-67 (about 40%/HPF), and also focally positive for cyclin D1 and p53, whereas HER2/neu, ER, PgR, p63, D2-40, GCDFP-15, and mitochondria were negative. Here we present a very rare case of palatal PAC with HGT at initial presentation.
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8
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Andreasen S, Melchior LC, Kiss K, Bishop JA, Høgdall E, Grauslund M, Wessel I, Homøe P, Agander TK. The PRKD1 E710D hotspot mutation is highly specific in separating polymorphous adenocarcinoma of the palate from adenoid cystic carcinoma and pleomorphic adenoma on FNA. Cancer Cytopathol 2017; 126:275-281. [DOI: 10.1002/cncy.21959] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 11/17/2017] [Accepted: 12/06/2017] [Indexed: 01/13/2023]
Affiliation(s)
- Simon Andreasen
- Department of Otorhinolaryngology and Maxillofacial Surgery; Zealand University Hospital; Koge Denmark
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology; Copenhagen University Hospital Rigshospitalet; Copenhagen Denmark
| | | | - Katalin Kiss
- Department of Pathology; Copenhagen University Hospital; Copenhagen Denmark
| | - Justin Avery Bishop
- Department of Pathology; University of Texas Southwestern Medical Center; Dallas Texas
| | - Estrid Høgdall
- Department of Pathology; Herlev Hospital, University of Copenhagen; Herlev Denmark
| | - Morten Grauslund
- Department of Pathology; Copenhagen University Hospital; Copenhagen Denmark
| | - Irene Wessel
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology; Copenhagen University Hospital Rigshospitalet; Copenhagen Denmark
| | - Preben Homøe
- Department of Otorhinolaryngology and Maxillofacial Surgery; Zealand University Hospital; Koge Denmark
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9
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Sharma P, Wadhwan V, Kumar KVA, Venkatesh A, Thapa T. Indolent palatal swelling: Catch 22. Natl J Maxillofac Surg 2017; 7:221-224. [PMID: 28356700 PMCID: PMC5357931 DOI: 10.4103/0975-5950.201352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
We present an interesting but intriguing case of an indolent palatal swelling. The lesion was asymptomatic causing little discomfort to the patient and thus was an incidental clinical finding. Provisional diagnosis was a benign, minor salivary gland tumor. Clinical differential diagnoses included benign lymphoepithelial lesion or mucus extravasation phenomenon. Nevertheless, we also considered malignancies such as mucoepidermoid carcinoma, lymphoma, and neoplasm of the maxillary sinus. However, the histopathology revealed a rare clinicopathologic entity prompting immediate treatment of the lesion.
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Affiliation(s)
- Preeti Sharma
- Department of Oral Pathology and Microbiology, Subharti Dental College, Meerut, Uttar Pradesh, India
| | - Vijay Wadhwan
- Department of Oral Pathology and Microbiology, Subharti Dental College, Meerut, Uttar Pradesh, India
| | - K V Arun Kumar
- Department of Oral Surgery, Subharti Dental College, Meerut, Uttar Pradesh, India
| | - Arvind Venkatesh
- Department of Oral Pathology, Subharti Dental College, Meerut, Uttar Pradesh, India
| | - Timsy Thapa
- Department of Oral Surgery, Subharti Dental College, Meerut, Uttar Pradesh, India
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10
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Chatura KR. Polymorphous low grade adenocarcinoma. J Oral Maxillofac Pathol 2015; 19:77-82. [PMID: 26097312 PMCID: PMC4451674 DOI: 10.4103/0973-029x.157206] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Accepted: 04/15/2015] [Indexed: 11/05/2022] Open
Abstract
Polymorphous low-grade adenocarcinoma (PLGA), is a rare, salivary gland intraoral tumor with complexities in diagnosis and this review highlights the difficulties.
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Affiliation(s)
- K R Chatura
- Department of Pathology, Jagadguru Jayadeva Murugarajendra Medical College, Davangere, Karnataka, India
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11
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Patel TD, Vazquez A, Marchiano E, Park RC, Baredes S, Eloy JA. Polymorphous low-grade adenocarcinoma of the head and neck: A population-based study of 460 cases. Laryngoscope 2015; 125:1644-9. [DOI: 10.1002/lary.25266] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2015] [Indexed: 11/11/2022]
Affiliation(s)
- Tapan D. Patel
- Department of Otolaryngology-Head and Neck Surgery; Neurological Institute of New Jersey
| | - Alejandro Vazquez
- Department of Otolaryngology-Head and Neck Surgery; Neurological Institute of New Jersey
| | - Emily Marchiano
- Department of Otolaryngology-Head and Neck Surgery; Neurological Institute of New Jersey
| | - Richard Chan Park
- Department of Otolaryngology-Head and Neck Surgery; Neurological Institute of New Jersey
| | - Soly Baredes
- Department of Otolaryngology-Head and Neck Surgery; Neurological Institute of New Jersey
- Center for Skull Base and Pituitary Surgery; Neurological Institute of New Jersey
| | - Jean Anderson Eloy
- Department of Otolaryngology-Head and Neck Surgery; Neurological Institute of New Jersey
- Center for Skull Base and Pituitary Surgery; Neurological Institute of New Jersey
- Department of Neurological Surgery; Rutgers New Jersey Medical School; Newark New Jersey U.S.A
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12
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Sathyanarayanan R, Suresh V, Therese Thomas BA. Polymorphous Low-Grade Adenocarcinoma of the Palate: A Rare Case Report. IRANIAN JOURNAL OF CANCER PREVENTION 2015; 9:e3447. [PMID: 27366306 PMCID: PMC4926308 DOI: 10.17795/ijcp-3447] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 08/20/2015] [Accepted: 11/05/2015] [Indexed: 11/25/2022]
Abstract
Introduction Polymorphous low-grade adenocarcinoma (PLGA) has been known as a comparatively less aggressive malignant tumor that predominantly occurs in the minor salivary glands. It has presented as a painless, slow growing tumor in the oral cavity. It has been reported to occur rarely in the palate and the prognosis of this lesion is far better than adenocarcinoma as the regional metastasis would be very minimal. A clear difference between the biologic behaviors of adenocarcinoma and PLGA has been reported in literature. Case Presentation A 63-year-old female reported at our institute with a swelling in relation to her upper left back region of her jaw for three months, gradual in onset and associated with pain. After clinical and radiological examination, the differential diagnosis were consolidated abscess or minor salivary gland tumor. An incisional biopsy was done and the lesion was diagnosed as PLGA. The lesion was treated by wide excision and reconstruction with immediate obturator. The post-operative follow up showed no evidence of recurrence and the healing was satisfactory. Conclusions The site of predilection of PLGA is more in favor of palate (49 - 77.8%) followed by either upper lip or buccal mucosa (7.4 - 13.4%). There are sporadic reports of metastasis sometimes even transformation to a high grade adenocarcinoma, sometimes ending in mortality. Cervical lymph node metastasis is rare with reported incidence of 5 - 15% and is more commonly seen in recurrent tumor than the initial diseases. Extra palatal PLGAs present with significant papillary growth or arising from ventral surface of tongue frequently metastasize to cervical lymph nodes. Distant metastasis is very rare with an incidence of 7.5% and the site involved is the lung which is attributed to the inadequate control of the disease.
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Affiliation(s)
- Ramanujam Sathyanarayanan
- Department of Oral and Maxillofacial Surgery, Indira Gandhi Institute of Dental Sciences, Puducherry, India
| | - Venkatachalam Suresh
- Department of Oral and Maxillofacial Surgery, Indira Gandhi Institute of Dental Sciences, Puducherry, India
| | - Beena Agnes Therese Thomas
- Department of Oral and Maxillofacial Surgery, Indira Gandhi Institute of Dental Sciences, Puducherry, India
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13
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El-Nagdy S, Salama NM, Mourad MI. Immunohistochemical clue for the histological overlap of salivary adenoid cystic carcinoma and polymorphous low-grade adenocarcinoma. Interv Med Appl Sci 2013; 5:131-9. [PMID: 24265903 DOI: 10.1556/imas.5.2013.3.6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 07/20/2013] [Accepted: 07/22/2013] [Indexed: 11/19/2022] Open
Abstract
It remains difficult to distinguish adenoid cystic carcinoma (ACC) from polymorphous low-grade adenocarcinoma (PLGA). Although these neoplasms exhibit nearly similar histologic patterns, their biologic behavior is significantly different. This study was carried out in an attempt to overcome the histological overlap between these tumors using immunohistochemical method for c-kit and galectin-3 proteins on twenty cases of salivary gland tumors including twelve ACC and eight PLGA. Results revealed positive cytoplasmic reactivity for c-kit in 100% of ACC cases and only in 25% of PLGA. On the other hand, galectin-3 expression was observed in 100% of both ACC and PLGA cases. Moreover, solid variant of ACC showed overexpression of both proteins than cribriform and tubular subtypes. Significant positive correlation between the two studied proteins in ACC and PLGA was also observed (p < 0.05). Upon these results, over expression of c-kit and galectin-3 in ACC cases supports the concept of solid variant as a high-grade tumor. Moreover, c-kit may be used as a helpful marker to distinguish ACC from PLGA in cases where the diagnosis can be challenging.
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Affiliation(s)
- Sherif El-Nagdy
- Oral Pathology Department, Faculty of Dentistry, Mansoura University Mansoura Egypt
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14
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Nagao T, Sato E, Inoue R, Oshiro H, H. Takahashi R, Nagai T, Yoshida M, Suzuki F, Obikane H, Yamashina M, Matsubayashi J. Immunohistochemical analysis of salivary gland tumors: application for surgical pathology practice. Acta Histochem Cytochem 2012; 45:269-82. [PMID: 23209336 PMCID: PMC3496863 DOI: 10.1267/ahc.12019] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Accepted: 07/04/2012] [Indexed: 01/05/2023] Open
Abstract
Salivary gland tumors are relatively uncommon and there exists a considerable diagnostic difficulty owing to their diverse histological features in individual lesions and the presence of a number of types and variants, in addition to overlapping histological patterns similar to those observed in different tumor entities. The classification is complex, but is closely relevant to the prognostic and therapeutic aspects. Although hematoxylin-eosin staining is still the gold standard method used for the diagnosis, immunohistochemistry (IHC) can enhance the accuracy and be a helpful tool when in cases to investigate the subjects that cannot be assessed by histological examination, such as the cell nature and differentiation status, cell proliferation, and tumor protein expression. This review depicts on the practical diagnostic utility of IHC in salivary gland tumor pathology under the following issues: assessment of cell differentiation, focusing on neoplastic myoepithelial cells; discrimination of histologically mimic tumor groups; diagnosis of specific tumor types, e.g., pleomorphic adenoma, adenoid cystic carcinoma, and salivary duct carcinoma; and evaluation of malignancy and prognostic factors. IHC plays a limited, even though important, role in the diagnosis of salivary gland tumors, but is often useful to support the histological assessment. However, unfortunately few tumor type-specific markers are still currently available. For these reasons, IHC should be considered a method that can be used to assist the final diagnosis, and its results themselves do not directly indicate a definitive diagnosis.
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Affiliation(s)
- Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Anatomic Pathology, Tokyo Medical University
| | - Eiichi Sato
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Anatomic Pathology, Tokyo Medical University
| | - Rie Inoue
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Anatomic Pathology, Tokyo Medical University
| | - Hisashi Oshiro
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Anatomic Pathology, Tokyo Medical University
| | - Reisuke H. Takahashi
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Anatomic Pathology, Tokyo Medical University
| | - Takeshi Nagai
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Anatomic Pathology, Tokyo Medical University
| | - Maki Yoshida
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Anatomic Pathology, Tokyo Medical University
| | - Fumie Suzuki
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Anatomic Pathology, Tokyo Medical University
| | - Hiyo Obikane
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Anatomic Pathology, Tokyo Medical University
| | - Mitsumasa Yamashina
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Anatomic Pathology, Tokyo Medical University
| | - Jun Matsubayashi
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Anatomic Pathology, Tokyo Medical University
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15
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Potluri A, Prasad J, Levine S, Bastaki J. Polymorphous low-grade adenocarcinoma: a case report. Dentomaxillofac Radiol 2011; 42:14804843. [PMID: 22184472 DOI: 10.1259/dmfr/14804843] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
We present a case of de novo polymorphous low-grade adenocarcinoma (PLGA) arising in a minor salivary gland with a relatively large radiographic extent compared with that of most of the PLGAs reported. This paper describes the radiographic extent of the lesion and the findings of CT imaging.
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Affiliation(s)
- A Potluri
- University of Pittsburgh School of Dental Medicine, Pittsburgh, PA 15261, USA
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16
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Li LJ, Li Y, Wen YM, Liu H, Zhao HW. Addendum to “Clinical analysis of salivary gland tumor cases in West China in past 50 years” [Oral Oncol. 44 (2) (2008) 187–192]. Oral Oncol 2011. [DOI: 10.1016/j.oraloncology.2011.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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17
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18
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Harmouch A, Maher M, Sefiani S. Adénocarcinome polymorphe de bas grade des glandes salivaires: à propos de neuf cas. ONCOLOGIE 2010. [DOI: 10.1007/s10269-010-1969-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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19
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Geha H, François A, Boland F, Drikes S, Peron J. Polymorphous low-grade adenocarcinoma: a review regarding an unusual presentation as infected odontogenic cyst. J Plast Reconstr Aesthet Surg 2008; 62:742-6. [PMID: 19109086 DOI: 10.1016/j.bjps.2008.11.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2008] [Revised: 11/03/2008] [Accepted: 11/08/2008] [Indexed: 10/21/2022]
Abstract
The World Health Organisation (WHO) classified polymorphous low-grade adenocarcinoma (PLGA) in 1990 as a low-grade malignancy; ICD-O 8525/3 being the assigned international code. It has been frequently described as occurring in hard- or soft-palate accessory salivary glands: some cases being described in the tongue and in major salivary glands. We present an extensive literature review about PLGA and the most common diagnostic pitfalls. We also report the first case where it was seen surrounding an impacted maxillary tooth and discuss it in regard to our review.
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Affiliation(s)
- H Geha
- Service de Chirurgie Maxillo-faciale et Stomatologie, CHU Rouen, France.
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20
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Hunter JB, Smith RV, Brandwein-Gensler M. Low-grade papillary adenocarcinoma of the palate: the significance of distinguishing it from polymorphous low-grade adenocarcinoma. Head Neck Pathol 2008; 2:316-23. [PMID: 20614302 PMCID: PMC2807587 DOI: 10.1007/s12105-008-0082-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2008] [Accepted: 08/11/2008] [Indexed: 11/28/2022]
Abstract
Low-grade papillary adenocarcinoma (LGPA) represents a relatively rare histological variant of polymorphous low-grade adenocarcinoma (PLGA). There has been a debate as to whether LGPA is associated with greater aggressive potential compared to PLGA; this is further obfuscated by the fact that diagnostic criteria for LGPA have not been well-defined. We believe that this is the first report of a patient with LGPA who developed metastases to the femur and scalp. We review the published evidence for classifying LGPA as distinct from PLGA. The weight of published data does support the idea that LGPA is oncologically distinct from LGPA. However, as uniform diagnostic criteria are lacking, we suggest a cut-off value of 10% or greater papillary formation as being necessary to separate LGPA from PLGA.
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Affiliation(s)
- Jacob B. Hunter
- Departments of Otorhinolaryngology-Head Neck Surgery, Pathology, Albert Einstein College of Medicine (JH), Montefiore Medical Center, Bronx, New York USA
| | - Richard V. Smith
- Departments of Otorhinolaryngology-Head Neck Surgery, Pathology, Albert Einstein College of Medicine (JH), Montefiore Medical Center, Bronx, New York USA
| | - Margaret Brandwein-Gensler
- Departments of Otorhinolaryngology-Head Neck Surgery, Pathology, Albert Einstein College of Medicine (JH), Montefiore Medical Center, Bronx, New York USA
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21
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Uemaetomari I, Tabuchi K, Tobita T, Tsuji S, Wada T, Kamma H, Hara A. The Importance of Postoperative Radiotherapy against Polymorphous Low-Grade Adenocarcinoma of the Parotid Gland: Case Report and Review of the Literature. TOHOKU J EXP MED 2007; 211:297-302. [PMID: 17347556 DOI: 10.1620/tjem.211.297] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Polymorphous low-grade adenocarcinoma (PLGA) of the salivary gland is a disease entity that is a recently described form of adenocarcinoma. PLGA most commonly arises in the minor salivary glands. We report two cases of PLGA of the parotid gland. Case 1: A 52-year-old female visited the University of Tsukuba Hospital with a painless mass in the left parotid region. A superficial parotidectomy and postoperative radiotherapy were performed. The patient has been free from disease for 50 months. Case 2: A 55-year-old female initially noticed a painless slowly growing mass in the left parotid region. The tumor was removed with a superficial parotidectomy. The local recurrence was found 6 years after the initial surgery. The recurrent tumor was removed, and radiotherapy was administered thereafter. The patient has been free from the disease for 33 months since the last treatment. The treatment for the primary lesion is crucial for the prognosis since metastasis to the regional lymph node or to distant region is unusual in PLGA. Although surgical extirpation is the recommended modality for treatment of PLGA, wide resection with a safety margin is often difficult in the parotid gland because of the presence of the facial nerve. Our two cases were successfully treated with surgery and postoperative radiotherapy. Although our literature search revealed 32 previously reported cases of PLGA of the parotid gland, only five of the 32 cases were treated postoperative radiotherapy. We highlight the importance of postoperative radiotherapy for PLGA of the parotid gland.
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Affiliation(s)
- Isao Uemaetomari
- Department of Otolaryngology, Institute of Clinical Medicine, University of Tsukuba, Japan
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22
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Asioli S, Marucci G, Ficarra G, Stephens M, Foschini MP, Ellis IO, Eusebi V. Polymorphous adenocarcinoma of the breast. Report of three cases. Virchows Arch 2005; 448:29-34. [PMID: 16220292 DOI: 10.1007/s00428-005-0084-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2005] [Accepted: 08/28/2005] [Indexed: 10/25/2022]
Abstract
We report three cases of polymorphous adenocarcinoma (PLA) of the breast in 37-, 55- and 74-year-old women, respectively. The patients have no evidence of previous malignancy. The tumours consist of monotonous cells showing a wide spectrum of growth patterns: solid nests, trabeculae, tubules, cribriform structures, strands and fascicles reminiscent of polymorphous low-grade adenocarcinoma of salivary glands. To our knowledge, PLA has never been reported in the breast; therefore, this tumour should be added to the list of neoplastic lesions of the breasts that have the same features as those of the salivary glands.
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Affiliation(s)
- Sofia Asioli
- Section of Pathology, Department of Oncology, University of Bologna, Bellaria Hospital, Bologna, Italy
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23
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González-García R, Rodríguez-Campo FJ, Muñoz-Guerra MF, Nam-Cha SH, Sastre-Pérez J, Naval-Gías L. Polymorphous low-grade adenocarcinoma of the palate. Auris Nasus Larynx 2005; 32:275-80. [PMID: 15963668 DOI: 10.1016/j.anl.2005.03.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2005] [Revised: 02/14/2005] [Accepted: 03/25/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Polymorphous low-grade adenocarcinoma (PLGA) is a rare tumor that mostly affects minor salivary glands. The purpose of this study is to report six new cases followed-up during a long period. We also review the literature concerning clinical, histological and immunohistochemical features, as well as the proper management. METHODS Malignant tumors of the salivary glands diagnosed in our department from 1990 to 1999 were reviewed. A total of 66 cases were registered. Six of these cases were diagnosed as PLGA. All cases satisfied the histopathological criteria for this entity, and at least 3 years follow-up was available. RESULTS In the six cases the primary location was the mucosa of the palate. Hard palate was affected in 83.3% of the cases. There were no cases of extraoral PLGA in our series. Tumors were ulcerated in a 16.6% of the cases, and exofitic in the other 86.4%. Histologically, it was observed a tumoral proliferation of round clusters of uniform cells with round-to-oval clear nuclei and small nucleoli. All the cases underwent surgical management with local excision with surgical margins, five of them with bone extirpation associated. No recurrence was observed in four cases, whereas the remaining two cases showed recurrence in the follow-up. In one of the patients, lococervical recurrence appeared 12 months after the surgery, and this patient died after a few months. The remaining patients have been followed-up for 11, 7, 4 and 3 years postoperatively, with no evidence of recurrence. CONCLUSION Our results for a long follow-up period support the idea for a low grade of malignancy and good prognosis of this tumor, but the appearance of recurrences many years after the surgery must induce us to be very careful and systematic with the follow-up.
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Affiliation(s)
- Raúl González-García
- Department of Oral and Maxillofacial Surgery, University Hospital La Princesa, Autónoma University, c/ Diego de León, 62, 28006 Madrid, Spain.
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