Polymorphous low grade adenocarcinoma presenting an uncommon radiographic aspect

Polymorphous Low-Grade Adenocarcinoma: A Proposed Reconstruction Protocol Based on Past Surgical Experience

BACKGROUND

To propose a reconstructive protocol based on surgical management experience of polymorphous low-grade adenocarcinoma (PLGA) and the location of the primary lesion.

METHODS

Data on the surgical management and the reconstructive technique of 14 histologically conformed patients with PLGA, all treated by the same surgeon, were analyzed and evaluated.

RESULTS

Mean follow-up period in our series was 6.2 years. Mean age at diagnosis was 55.5 years and female to male ratio was 2.2:1. The most common presenting sign was a nonpainful lump or mass in an intraoral location. Most patients were managed by wide local excision and reconstruction method varied from primary closure to the use of radial forearm graft. Recurrence appeared in one of the patients in this series, while 2 required further radiation therapy. A protocol for reconstruction of intraoral patients with PLGA is suggested based on our analysis.

CONCLUSION

Surgical management is the gold standard for PLGA treatment. Neck dissection is recommended only in patients with presurgery fine-needle aspiration confirmed lymph node involvement. The reconstruction depends mainly on location and size of the primary lesion.

Polymorphous low-grade adenocarcinoma: a case report

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.

The frequency and distribution pattern of minor salivary gland tumors in a government dental teaching hospital, Chennai, India

OBJECTIVES

Data are not available regarding distribution of minor salivary gland tumors from the specialist pathology setting in India. The purpose of this study was to determine the relative frequency and distribution of minor salivary gland tumors and to compare the data with pertinent studies.

STUDY DESIGN

The records and archival samples of the Department of Oral and Maxillofacial Pathology, Tamil Nadu Government Dental College and Hospital, Chennai, India, served as source material for this retrospective study. All cases with a diagnosis of minor salivary gland tumors recorded between 1971 and August 2008 were retrieved and reviewed.

RESULTS

A total of 185 minor salivary gland tumors were identified with reference to the latest World Health Organization classification, representing a relative frequency of 1.52% over the study period of 37 years (1971-2008) from 12,147 biopsy samples. Malignant tumors (75%) predominated over benign tumors (25%). The age range was 12-82 years with a mean of 46 years. Mucoepidermoid carcinoma was the most frequent tumor (34%), followed by pleomorphic adenoma (22%), adenoid cystic carcinoma (15%), and polymorphous low-grade adenocarcinoma (10%). The overall gender distribution was almost equal. Palate was the most frequent involved site, followed by alveolar mucosa and floor of the mouth.

CONCLUSIONS

The present study shows a higher proportion of malignant tumors and a tendency toward male predilection during the past decades. The overall data are consistent with hospital-based studies from Asia and series from other geographic regions.