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Gomes ÁNDM, Oliveira KK, Marchi FA, Bettim BB, Germano JN, Gonçalves Filho J, Pinto CAL, Lourenço SV, Coutinho-Camillo CM. TGFβ signaling pathway in salivary gland tumors. Arch Oral Biol 2024; 162:105943. [PMID: 38479278 DOI: 10.1016/j.archoralbio.2024.105943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/05/2024] [Accepted: 03/03/2024] [Indexed: 04/17/2024]
Abstract
OBJECTIVE Pleomorphic adenoma (PA), mucoepidermoid carcinoma (MEC), and adenoid cystic carcinoma (ACC) are the most prevalent salivary gland tumors. Their pathogenesis has been recently associated with complex molecular cascades, including the TGFβ signaling pathway. The aim of this study was to evaluate the expression of genes associated with the TGFβ signaling pathway (TGFB1, ITGB6, SMAD2, SMAD4, FBN1, LTBP1, and c-MYC) to map possible downstream alterations in the TGFβ cascade. DESIGN Thirteen PA, 17 MEC, 13 ACC, and 10 non-neoplastic salivary gland samples were analyzed by real-time RT-PCR. RESULTS Cases of PA presented increased TGFB1, LTPB1, c-MYC, and FBN1 expressions, whereas SMAD2 expression was decreased when compared to non-neoplastic tissue. MEC patients displayed increased expressions of TGFB1, ITGB6, FBN1, and c-MYC and decreased expressions of SMAD2 and SMAD4. ACC cases exhibited elevated expressions of the investigated genes except TGFB1. The present results suggest that decreased expression of SMAD2 and SMAD4 does not impede the transcriptional regulation of c-MYC, especially in PA and MEC. Increased expressions of ITGB6, TGFB1, LTBP1, and FBN1 appear to be related to the regulation of the TGFβ signaling pathway in these tumors. Additionally, we observed a higher expression of SMAD4 in ACC and a raised expression of ITGB6 and lowered expression of SMAD2 in MEC. CONCLUSIONS Our study demonstrated the differential expression of TGFβ cascade members in salivary gland tumors such as SMAD2/SMAD4 and c-MYC as well as the participation of ITGB6, TGFB1, LTBP1, and FBN1, contributing to the understanding of the mechanisms involved in tumor progression.
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Affiliation(s)
- Ágatha Nagli de Mello Gomes
- International Research Center, A.C.Camargo Cancer Center, São Paulo, Brazil; National Institute of Science and Technology in Oncogenomics and Therapeutic Innovation, São Paulo, Brazil
| | | | - Fabio Albuquerque Marchi
- Department of Head and Neck Surgery, University of São Paulo Medical School, São Paulo, Brazil; Center for Translational Research in Oncology, Cancer Institute of the State of São Paulo (ICESP), São Paulo, Brazil
| | | | | | - João Gonçalves Filho
- Department of Head and Neck Surgery and Otorhinolaringology, A.C.Camargo Cancer Center, São Paulo, Brazil
| | | | | | - Cláudia Malheiros Coutinho-Camillo
- International Research Center, A.C.Camargo Cancer Center, São Paulo, Brazil; National Institute of Science and Technology in Oncogenomics and Therapeutic Innovation, São Paulo, Brazil.
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Monestier L, Del Grande J, Haddad R, Santini L, Michel J, Varoquaux A, Fakhry N. Correlation between MRI (DWI and DCE) and cellularity of parotid gland pleomorphic adenomas. Eur Arch Otorhinolaryngol 2024; 281:2655-2665. [PMID: 38498193 DOI: 10.1007/s00405-024-08562-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/14/2024] [Indexed: 03/20/2024]
Abstract
PURPOSE Parotid pleomorphic adenomas present a risk of recurrence, higher when the tumour is a hypocellular subtype. The aim of the study was to determine whether it is possible to characterize this histological subtype with diffusion and perfusion sequences of the preoperative MRI. METHODS This retrospective study included 97 patients operated between 2010 and 2020. Histologic slides review was performed to classify tumours into three histologic subtypes: hypocellular, classical and hypercellular. Univariate and multivariate analyses studied the correlation between histology and diffusion and perfusion MRI parameters obtained with OleaSphere® software. RESULTS The hypocellular subtype had higher apparent diffusion coefficient values than the other two subtypes: 2.13 ± 0.23, 1.83 ± 0.42, and 1.61 ± 0.4 × 10-3 mm2/s for hypocellular, classical and hypercellular subtype respectively (p < 0.0001). Multivariate analysis showed that an ADCmean > 1.88 × 10-3 mm2/s was suggestive of a hypocellular pleomorphic adenoma in 79% of the cases, with a specificity and PPV of 94 and 96% (p < 0.001), respectively. CONCLUSION The histological subtype of a pleomorphic adenoma can be predicted preoperatively with ADC values. A prospective and multicentric study on a larger cohort is needed to confirm our results.
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Affiliation(s)
- Laura Monestier
- Department of Oto-Rhino-Laryngology-Head and Neck Surgery, La Conception University Hospital, AP-HM, Aix-Marseille University, Marseille, France
| | - Jean Del Grande
- Department of Pathology, La Timone University Hospital, AP-HM, Aix-Marseille University, Marseille, France
| | - Ralph Haddad
- Department of Oto-Rhino-Laryngology-Head and Neck Surgery, La Conception University Hospital, AP-HM, Aix-Marseille University, Marseille, France
| | - Laure Santini
- Department of Oto-Rhino-Laryngology-Head and Neck Surgery, La Conception University Hospital, AP-HM, Aix-Marseille University, Marseille, France
| | - Justin Michel
- Department of Oto-Rhino-Laryngology-Head and Neck Surgery, La Conception University Hospital, AP-HM, Aix-Marseille University, Marseille, France
| | - Arthur Varoquaux
- Department of Radiology, La Conception University Hospital, AP-HM, Aix-Marseille University, Marseille, France
| | - Nicolas Fakhry
- Department of Oto-Rhino-Laryngology-Head and Neck Surgery, La Conception University Hospital, AP-HM, Aix-Marseille University, Marseille, France.
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Rajbhar R, Margam S, Fernandes G. Oral cavity salivary gland pleomorphic adenoma: a histomorphological case series. Ann Diagn Pathol 2024; 71:152306. [PMID: 38614034 DOI: 10.1016/j.anndiagpath.2024.152306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 04/02/2024] [Accepted: 04/06/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND Pleomorphic adenoma (PA), the most common benign salivary gland epithelial lesion, has a biphasic epithelial-mesenchymal pattern and great histopathological diversity. METHODS This study's objective was to conduct a retrospective clinicopathological analysis, focusing on the histopathology characteristics of salivary gland PA. RESULTS There were ten cases of pleomorphic adenoma. The mean age was 33.5 years and no gender predilection was observed. All the patients presented with an asymptomatic mass and the duration of presentation was 31.2 ± 19.4 months. The cellular subtype (50 %) of PA was the most common. Capsular infiltration and incomplete capsules occurred in 20 % of cases. All the cases had round (100 %) and myxoid stroma. The cellular subtype was more common in the major salivary glands; showed capsular abnormalities (incomplete capsule, absent capsule, and tumor infiltration); and had more plasmacytoid, angular, spindled non-luminal cells as well as inflammation and cystic degeneration. The classic subtype had more clear and oncocytic cells along with sebaceous and squamous differentiation. The stroma-rich subtype had the shortest duration of complaints (three months) and showed giant cell reaction. CONCLUSIONS These findings confirm previous studies on the clinicopathological features of pleomorphic adenomas and highlight important morphologic characteristics like capsular invasion and squamous metaplasia, which can otherwise indicate malignancy.
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Affiliation(s)
- Rahul Rajbhar
- Department of Pathology, Seth G.S. medical college and K.E.M.H., Parel, Mumbai 400012, Maharashtra, India.
| | - Sangita Margam
- Department of Pathology, Seth G.S. medical college and K.E.M.H., Parel, Mumbai 400012, Maharashtra, India.
| | - Gwendolyn Fernandes
- Department of Pathology, Seth G.S. medical college and K.E.M.H., Parel, Mumbai 400012, Maharashtra, India.
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Yadav V, Bhagat S, Sharma D, Aggarwal A, Goel K. Giant Pleomorphic Adenoma of Infratemporal Fossa: A Rare Case Report. Indian J Otolaryngol Head Neck Surg 2024; 76:2042-2047. [PMID: 38566728 PMCID: PMC10982243 DOI: 10.1007/s12070-023-04394-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 11/18/2023] [Indexed: 04/04/2024] Open
Abstract
Of all the head and neck tumors, salivary gland tumors account to 3%. Pleomorphic adenomas are one of the most common benign tumors arising from major salivary glands, although it could also develop from minor salivary glands situated at accessory sites like nasal cavity, pharynx, parapharyngeal space, lacrimal glands etc. Tumors of infratemporal fossa are quite unusual, mainly because of its hidden location in retromaxillary region. We report an unusual case of 65 years old male presenting with complaint of progressive left cheek swelling for 4 years. FNAC revealed pleomorphic adenoma of minor salivary gland tumor. Intraoperatively a giant lobulated tumor was seen occupying almost whole space of infratemporal fossa, which was removed in-toto via open approach. Patient was kept on regular follow up with no evidence of recurrence reported till date.
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Affiliation(s)
- Vishav Yadav
- Department of Otolaryngology, Head and Neck Surgery, Government Medical College Patiala, Patiala, 147001 India
| | - Sanjeev Bhagat
- Department of Otolaryngology, Head and Neck Surgery, Government Medical College Patiala, Patiala, 147001 India
| | - Dinesh Sharma
- Department of Otolaryngology, Head and Neck Surgery, Government Medical College Patiala, Patiala, 147001 India
| | - Ankita Aggarwal
- Department of Otolaryngology, Head and Neck Surgery, Government Medical College Patiala, Patiala, 147001 India
| | - Khushboo Goel
- Department of Otolaryngology, Head and Neck Surgery, Government Medical College Patiala, Patiala, 147001 India
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Ali HM, Keaton AB, Rourk K, Lohse C, Tasche KK, Price DL, Van Abel KM, Yin LX, Moore EJ. Partial superficial parotidectomy for pleomorphic adenoma of the parotid gland: Early post-operative outcomes. Am J Otolaryngol 2024; 45:104185. [PMID: 38104469 DOI: 10.1016/j.amjoto.2023.104185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 12/07/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION There has been historical controversy regarding the extent of resection in the management of pleomorphic adenomas. This study aims to evaluate the extent of surgery and short-term postoperative outcomes of partial superficial parotidectomy (PSP) for the management of pleomorphic adenomas at a tertiary, high-volume center. METHODS A retrospective chart review of patients who underwent PSP was performed. Variables included demographics, pre-operative facial nerve function, operative techniques, postoperative complications/facial nerve function, and recurrence. RESULTS 151 adults who underwent PSP for pleomorphic adenoma from January 1st, 2000 to December 31st, 2022 were identified. Median age was 55 (IQR 40-66) years with females representing 74 % of the cohort. Median tumor size at presentation was 1.8 (IQR 1.3-2.3) cm. Baseline facial nerve function was excellent for most patients (House-Brackmann I, 99 %). Most patients underwent a superficial inferior parotidectomy (88 %). Modified Blair incision (70 %) was the most common incision. Intraoperatively, the facial nerve was identified in 149 (99 %) patients. The main trunk was identified in 126 (85 %) patients. No patient had tumor spillage. Only two patients required parotid bed reconstruction. The most common complication was ear numbness (60 %). Postoperatively, 114 patients were House-Brackmann grade I at both preoperative and postoperative assessment, 8 went from grade I to II, and 1 went from grade VI to II (Bell's palsy that resolved to grade II following surgery). Median follow-up was 1(IQR 1-5) month. CONCLUSION PSP is efficacious in the management of pleomorphic adenomas with preservation of facial nerve function, and minimal post-operative complications. Future study is needed to assess long term recurrence risk.
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Affiliation(s)
- Hawa M Ali
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN, United States
| | - Aniya B Keaton
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN, United States; University of Tennessee, Knoxville, TN, United States
| | - Katelyn Rourk
- Mayo Clinic Alix School of Medicine, Rochester, MN, United States
| | - Christine Lohse
- Department of Quantitative Health Sciences, Rochester, MN, United States
| | - Kendall K Tasche
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN, United States
| | - Daniel L Price
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN, United States
| | - Kathryn M Van Abel
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN, United States
| | - Linda X Yin
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN, United States
| | - Eric J Moore
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN, United States.
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Naik U, Amin SE, Elsayad M, Saluja K. Pleomorphic Adenoma with a Novel Gene Rearrangement-LINC01606::PLAG1. Head Neck Pathol 2024; 18:10. [PMID: 38393488 PMCID: PMC10891012 DOI: 10.1007/s12105-024-01612-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 01/09/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Pleomorphic adenoma is a well-known benign salivary gland neoplasm characterized by the presence of varying proportions of three different components, including bi-layered ducts, myoepithelial cells, and admixed within a chondromyxoid/fibrous stroma. METHOD We report an interesting case of an adult male who presented with bleeding from an extensively degenerated parotid gland mass, concerning for a vascular neoplasm versus primary malignant tumor. Microscopically, majority of the viable tumor exhibited diffuse proliferation of spindle to epithelioid cells, with focal areas depicting cribriform glands, ducts, and scant chondromyxoid stroma. RESULT Next-generation sequencing (NGS) RNA-based fusion panel analysis identified a gene rearrangement involving the pleomorphic adenoma gene 1 (PLAG1), with a novel, cryptogenic fusion partner known as LINC01606; [LINC01606::PLAG1; inv(8;8)(8q12.1;8q12.1)]. CONCLUSION To the best of our knowledge, this is the first documented case of a long non-coding RNA (lnc-RNA) serving as a rearrangement partner with the PLAG1 gene. We reviewed the molecular characteristics of this entity and explored the potential role of LINC01606::PLAG1 in the tumorigenesis of pleomorphic adenoma.
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Affiliation(s)
- Udit Naik
- Department of Pathology and Laboratory Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, TX, 77030, USA
| | - Sara E Amin
- Department of Pathology and Laboratory Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, TX, 77030, USA
| | - Mahmoud Elsayad
- Department of Pathology and Laboratory Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, TX, 77030, USA
| | - Karan Saluja
- Department of Pathology and Laboratory Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, TX, 77030, USA.
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Alsaleh S, Alharbi T. Pleomorphic adenoma of the nasal septum: A case report. Int J Surg Case Rep 2024; 115:109229. [PMID: 38211555 PMCID: PMC10788786 DOI: 10.1016/j.ijscr.2024.109229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 01/01/2024] [Accepted: 01/03/2024] [Indexed: 01/13/2024] Open
Abstract
INTRODUCTION Pleomorphic adenomas are benign salivary gland tumors with epithelial, myxoid, and mucoid components. They rarely occur in the upper respiratory tract where the predominant site is the nasal septum, leading to symptoms of nasal obstruction. Identifying these tumors requires histopathological examination, and they are usually managed surgically. PRESENTATION OF CASE A middle-aged lady presented to the outpatient otorhinolaryngology clinic with symptoms of unilateral nasal obstruction. Nasal endoscopy in the clinic revealed a right-sided anterior nasal septal vascular mass, which was confirmed with a contrast-enhanced CT scan with suspicion of septal hemangioma. Surgical examination and endoscopic removal of the septal mass were carried out under anesthesia, and histopathology of the specimen showed predominant myoepithelial cellularity with scanty stroma, consistent with a diagnosis of pleomorphic adenoma. The patient had an uneventful post-operative stay and follow-up with no recurrence. DISCUSSION Nasal cavity pleomorphic adenomas are important to identify and treat, as they can recur and potentially turn malignant. Endoscopic endonasal surgery is emerging as the treatment of choice for these adenomas, as it is associated with minimal morbidity and cosmetic impact. CONCLUSION We report a rare case of nasal septal pleomorphic adenoma in a middle-aged female, which was successfully treated with endoscopic endonasal surgery.
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Affiliation(s)
- Saad Alsaleh
- Department of Otorhinolaryngology Head & Neck Surgery, College of medicine, King Saud University, Riyadh, Saudi Arabia
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Kumar H, Rizwan QS, Gupta M, Kumar T. Giant Pleomorphic Adenoma of Submandibular Gland. Indian J Otolaryngol Head Neck Surg 2024; 76:1361-1364. [PMID: 38440458 PMCID: PMC10909034 DOI: 10.1007/s12070-023-04349-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 11/07/2023] [Indexed: 03/06/2024] Open
Abstract
Pleomorphic adenoma is a benign tumor of salivary glands which is relatively rare among head & neck neoplasms. Parotid gland is the most common site of occurrence whereas submandibular gland is rarely affected. We present a case of a giant pleomorphic adenoma of submandibular gland.
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Affiliation(s)
| | | | - Mayank Gupta
- Deptt. Of ENT, GSVM Medical College, Kanpur, UP India
| | - Tarun Kumar
- Deptt. Of ENT, GSVM Medical College, Kanpur, UP India
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Roh JL. Extracapsular dissection via single cervical incision for parotid pleomorphic adenoma. Clin Oral Investig 2023; 28:40. [PMID: 38151592 DOI: 10.1007/s00784-023-05420-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 11/21/2023] [Indexed: 12/29/2023]
Abstract
OBJECTIVES Surgical management of parotid pleomorphic adenoma ranges from total parotidectomy to extracapsular dissection (ECD). Minimalistic techniques aim to preserve function and minimize the rate of recurrence. This study assesses functional, aesthetic, and disease control outcomes post-ECD through a sole transverse cervical incision for parotid pleomorphic adenoma. MATERIALS AND METHODS This longitudinal analysis enrolled 36 consecutive patients with pleomorphic adenoma who underwent ECD via a single cervical incision. Complications, satisfaction, salivary function, and tumor recurrence were evaluated. Salivary gland function was assessed using scintigraphy at 6 months post-surgery. RESULTS Tumors occurred in superficial (83%) or deep (17%) parotid inferior parts according to the European Salivary Gland Society level classification. The median tumor size was 2.8 cm (1.8-6.0 cm); the median operation time was 42 min (30-65 min). No tumor spillage or facial nerve injuries occurred. Facial nerve paralysis was only temporary in two (6%) patients, with minimal other complications. Operated parotid gland function matched the unoperated side. No recurrence was found during the median follow-up of 44 months (24-60 months). CONCLUSIONS ECD via a single transverse cervical incision is a safe approach for benign parotid tumors, yielding excellent functional and disease control outcomes. CLINICAL RELEVANCE These findings can provide clinically meaningful minimally invasive recommendations to treat pleomorphic adenoma with minimal complications.
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Affiliation(s)
- Jong-Lyel Roh
- Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Gyeonggi-do, 13496, Republic of Korea.
- Department of Biomedical Science, General Graduate School, CHA University, Seongnam, Republic of Korea.
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Yeom S, Lee DH, Lee JK, Lim SC. Growth rates over time of unoperated parotid benign tumors. Am J Otolaryngol 2023; 45:104183. [PMID: 38211399 DOI: 10.1016/j.amjoto.2023.104183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 12/06/2023] [Indexed: 01/13/2024]
Abstract
INTRODUCTION The treatment of parotid benign tumor is in principle surgery, but observation may be necessary in some cases. The purpose of this study was to investigate the growth rates over time of unoperated parotid benign tumors. METHODS We retrospectively reviewed the medical records of 63 patients with unoperated parotid benign tumors diagnosed at our institution between January 2010 and December 2022. RESULTS Forty-nine of the 63 patients had a Warthin tumor and 13 patients had a pleomorphic adenoma. On average, the unoperated parotid benign tumors grew 0.02 cm in length and 0.4 cm3 in volume per year. Compared to pleomorphic adenomas, Warthin tumors were more predominant in male patients and in those with a smoking history and a longer duration of smoking history; patients with Warthin tumors were also followed up longer (p < 0.05). However, the length and volume growth rates of unoperated Warthin tumors and pleomorphic adenomas did not significantly differ. CONCLUSION Surgery is the standard treatment for parotid benign tumors. However, small benign parotid tumors identified during preoperative examination can be observed through close follow-up, taking into account the patient's medical and general condition.
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Affiliation(s)
- Sujung Yeom
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School & Hwasun Hospital, Hwasun, South Korea
| | - Dong Hoon Lee
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School & Hwasun Hospital, Hwasun, South Korea.
| | - Joon Kyoo Lee
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School & Hwasun Hospital, Hwasun, South Korea
| | - Sang Chul Lim
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School & Hwasun Hospital, Hwasun, South Korea
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Muna AI, Surya MEK, Margaretha M, Kosasih J, Syafriadi M. Pathogenesis Analysis of Salivary Gland Tumors Through the Expression of Programmed Death-Ligand 1 (PD-L1). Indian J Otolaryngol Head Neck Surg 2023; 75:3098-3102. [PMID: 37974781 PMCID: PMC10645909 DOI: 10.1007/s12070-023-03906-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 05/23/2023] [Indexed: 11/19/2023] Open
Abstract
Pleomorphic adenoma (PA) is the most common salivary gland neoplasm, followed by Warthin's tumor (WT). In addition to its high frequency, PA also shows metastasis and transformation towards malignancy as carcinoma ex-pleomorphic adenoma (CXPA). While the histogenesis of WT remains unclear, especially given the presence of lymphoid stroma around the developing tumor and the immunological interaction between them. Immune escape is a carcinogenesis mechanism of tumors to avoid the host immune system by producing PD-L1. This study was conducted to determine whether there is an immune escape through the expression of PD-L1 in salivary gland tumors. The tissue sections of PA, CXPA, and WT were stained with Hematoxylin Eosin and immunostained with a rabbit monoclonal recombinant anti-PD-L1 antibody. We observed immunopositive PD-L1 on the cell membrane with or without cytoplasm staining. PA and CXPA expressed PD-L1, accompanied by an anomaly expression of CXPA in several spots at the salivary gland at the surgical border. Therefore, PD-L1 is one of the PA pathways to transform into CXPA through immune escape. WT expressed PD-L1 in the cytoplasm and lymphoid stroma but not on the cell membrane. It is interpreted as positive constitutive, which may have the function of increasing tumor cell growth, while overexpressed PD-L1 in lymphoid stroma is thought to be associated with a poor prognosis of the tumor and is suspected to transform into malignancy, such as B-cell Lymphoma.
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Affiliation(s)
- Aisyah Izzatul Muna
- Departement of Biomedical Sciences, Faculty of Dentistry, University of Jember, Kalimantan I/37 Tegal Boto Campus, Sumbersari District, Jember Regency, East Java 68121 Indonesia
| | - Maria Evata Krismawati Surya
- Departement of Biomedical Sciences, Faculty of Dentistry, University of Jember, Kalimantan I/37 Tegal Boto Campus, Sumbersari District, Jember Regency, East Java 68121 Indonesia
| | - Meiske Margaretha
- Departement of Pathology, dr. Soebandi General Hospital, Jember Regency, East Java Indonesia
| | - Jane Kosasih
- Departement of Pathology, dr. Soebandi General Hospital, Jember Regency, East Java Indonesia
| | - Mei Syafriadi
- Departement of Biomedical Sciences, Faculty of Dentistry, University of Jember, Kalimantan I/37 Tegal Boto Campus, Sumbersari District, Jember Regency, East Java 68121 Indonesia
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Chidambaram KS, Muraleedharan M, Keshri A, Mayilvaganan S, Hameed N, Aqib M, Kumar A, Manogaran RS, Kumar R. The Outcomes and Surgical Nuances of Minimally Invasive Parotid Surgery for Pleomorphic Adenoma. Indian J Otolaryngol Head Neck Surg 2023; 75:3256-3262. [PMID: 37974711 PMCID: PMC10645680 DOI: 10.1007/s12070-023-03947-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 06/08/2023] [Indexed: 11/19/2023] Open
Abstract
Benign parotid tumors follow an indolent course and present as slow-growing painless swelling in the pre-and-infra-auricular areas. The treatment of choice is surgery. Though the gold standard technique is Superficial Parotidectomy, Extracapsular Dissection (ECD) is an alternative option with the same outcome and decreased complications. This study discusses our experience with extracapsular dissection and the surgical nuances for better results. A retrospective study of histologically confirmed cases of pleomorphic adenoma of the parotid gland, who underwent Extracapsular dissection between September 2019 and March 2023, was done. The demographic details, clinical characteristics, and outcomes were evaluated. There were 33 patients, including 16 females and 17 males, with a mean age of 32.75 years. All cases presented as slow-growing painless swelling for a mean duration of 5 years. Most of the tumors (94%) were of size between 2 and 4 cm, with few tumors more than 4 cm. All underwent extracapsular dissection with complete excision. There was only one complication (seroma) and no incidence of facial palsy in our experience with ECD. The goal of a benign parotid surgery is the complete removal of the tumor with minimum complications, which could be achieved with ECD, which has good tumor clearance and lesser rates of complications with good cosmesis. Thus, this minimally invasive parotid surgery could be a worthwhile option in properly selected cases.
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Affiliation(s)
| | | | - Amit Keshri
- Neurotology Unit, Department of Neurosurgery, SGPGIMS, Lucknow, UP India
| | | | - Nazrin Hameed
- Neurotology Unit, Department of Neurosurgery, SGPGIMS, Lucknow, UP India
| | - Mohd Aqib
- Neurotology Unit, Department of Neurosurgery, SGPGIMS, Lucknow, UP India
| | - Arushi Kumar
- Department of ENT, Nalanda Medical College, and Hospital, Patna, Bihar India
| | | | - Raj Kumar
- Department of Neurosurgery, SGPGIMS, Lucknow, UP India
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Wu Y, Liu L, Lu H, Liu S, Yang W, Xu W. Clinicopathological characteristics of pleomorphic adenoma from the labial gland: A 20-year experience with 173 cases in one single institution. J Stomatol Oral Maxillofac Surg 2023; 124:101539. [PMID: 37329958 DOI: 10.1016/j.jormas.2023.101539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/07/2023] [Accepted: 06/13/2023] [Indexed: 06/19/2023]
Abstract
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.
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Affiliation(s)
- Yifan Wu
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; College of Stomatology, Shanghai Jiao Tong University, Shanghai, PR China; National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, PR China; Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, PR China; Shanghai Center of Head and Neck Oncology Clinical and Translational Science, Shanghai, PR China
| | - Limin Liu
- Department of Oral pathology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China
| | - Hao Lu
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; College of Stomatology, Shanghai Jiao Tong University, Shanghai, PR China; National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, PR China; Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, PR China; Shanghai Center of Head and Neck Oncology Clinical and Translational Science, Shanghai, PR China
| | - Shengwen Liu
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; College of Stomatology, Shanghai Jiao Tong University, Shanghai, PR China; National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, PR China; Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, PR China; Shanghai Center of Head and Neck Oncology Clinical and Translational Science, Shanghai, PR China
| | - Wenjun Yang
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; College of Stomatology, Shanghai Jiao Tong University, Shanghai, PR China; National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, PR China; Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, PR China; Shanghai Center of Head and Neck Oncology Clinical and Translational Science, Shanghai, PR China
| | - Wanlin Xu
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; College of Stomatology, Shanghai Jiao Tong University, Shanghai, PR China; National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, PR China; Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, PR China; Shanghai Center of Head and Neck Oncology Clinical and Translational Science, Shanghai, PR China.
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AlWatban Z, AlAnsari H, AlAseeri D, AlJawder A, Janahi W. Pleomorphic Adenoma of the Oral Cavity: Systematic Review. Indian J Otolaryngol Head Neck Surg 2023; 75:3288-3304. [PMID: 37974882 PMCID: PMC10646098 DOI: 10.1007/s12070-023-03927-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 05/31/2023] [Indexed: 11/19/2023] Open
Abstract
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.
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Affiliation(s)
- Zaki AlWatban
- Ministry of Health, Riyadh, Kingdom of Saudi Arabia
- Otorhinolaryngology, Head and Neck Surgery Department, King Hamad University Hospital, Muharraq, Bahrain
| | - Hasan AlAnsari
- Otorhinolaryngology, Head and Neck Surgery Department, King Hamad University Hospital, Muharraq, Bahrain
- Pediatric Otorhinolaryngology, Sheffield Children’s Hospital, Sheffield, UK
| | - Danya AlAseeri
- Otorhinolaryngology, Head and Neck Surgery Department, King Hamad University Hospital, Muharraq, Bahrain
| | - Aysha AlJawder
- Pathology, Blood Bank and Laboratory Department, King Hamad University Hospital, Muharraq, Bahrain
| | - Waleed Janahi
- Otorhinolaryngology, Head and Neck Surgery Department, King Hamad University Hospital, Muharraq, Bahrain
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Akram MU, Hasham N, Atique H, Raza A. Pleomorphic adenomia of lower lip: A case report. Pak J Med Sci 2023; 39:1887-1890. [PMID: 37936725 PMCID: PMC10626064 DOI: 10.12669/pjms.39.6.7191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 07/27/2023] [Accepted: 08/06/2023] [Indexed: 11/09/2023] Open
Abstract
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.
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Affiliation(s)
- Muhammad Usman Akram
- Muhammad Usman Akram, FCPS, MRCSed, MRCS Assistant Professor Akbar Niazi Teaching Hospital and (IMDC), Islamabad, Pakistan
| | - Nausheen Hasham
- Nausheen Hasham, MBBS Akbar Niazi Teaching Hospital and (IMDC), Islamabad, Pakistan
| | - Hafsa Atique
- Hafsa Atique, MBBS, Medical Student Akbar Niazi Teaching Hospital and (IMDC), Islamabad, Pakistan
| | - Ahmad Raza
- Ahmad Raza, FCPS, MRCS Professor Akbar Niazi Teaching Hospital and (IMDC), Islamabad, Pakistan
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Su HZ, Yang JJ, Li ZY, Hong LC, Lin WJ, Chen C, Guo J, Fang ZY, Xue ES. A nomogram incorporating clinical, conventional ultrasound and shear wave elastography findings for distinguishing pleomorphic adenoma from Warthin's tumor of the major salivary glands. Dentomaxillofac Radiol 2023; 52:20230051. [PMID: 37395620 PMCID: PMC10552128 DOI: 10.1259/dmfr.20230051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 04/28/2023] [Accepted: 05/05/2023] [Indexed: 07/04/2023] Open
Abstract
OBJECTIVE Pre-operative differentiation between pleomorphic adenoma (PA) and Warthin's tumor (WT) of the major salivary glands is crucial for treatment decisions. The purpose of this study was to develop and validate a nomogram incorporating clinical, conventional ultrasound (CUS) and shear wave elastography (SWE) features to differentiate PA from WT. METHODS A total of 113 patients with histological diagnosis of PA or WT of the major salivary glands treated at Fujian Medical University Union Hospital were enrolled in training cohort (n = 75; PA = 41, WT = 34) and validation cohort (n = 38; PA = 22, WT = 16). The least absolute shrinkage and selection operator (LASSO) regression algorithm was used for screening the most optimal clinical, CUS, and SWE features. Different models, including the nomogram model, clinic-CUS (Clin+CUS) and SWE model, were built using logistic regression. The performance levels of the models were evaluated and validated on the training and validation cohorts, and then compared among the three models. RESULTS The nomogram incorporating the clinical, CUS and SWE features showed favorable predictive value for differentiating PA from WT, with the area under the curves (AUCs) of 0.947 and 0.903 for the training cohort and validation cohort, respectively. Decision curve analysis showed that the nomogram model outperformed the Clin+CUS model and SWE model in terms of clinical usefulness. CONCLUSIONS The nomogram had good performance in distinguishing major salivary PA from WT and held potential for optimizing the clinical decision-making process.
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Affiliation(s)
| | - Jia-Jia Yang
- Department of Ultrasound, Fujian Medical University Union Hospital, Fuzhou, China
| | - Zhi-Yong Li
- Department of Ultrasound, Fujian Medical University Union Hospital, Fuzhou, China
| | - Long-Cheng Hong
- Department of Ultrasound, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Wen-Jin Lin
- Department of Ultrasound, Fujian Medical University Union Hospital, Fuzhou, China
| | - Cong Chen
- Department of Ultrasound, Fujian Medical University Union Hospital, Fuzhou, China
| | - Jie Guo
- Department of Ultrasound, Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Zhen-Yan Fang
- Department of Ultrasound, Fujian Medical University Union Hospital, Fuzhou, China
| | - En-Sheng Xue
- Department of Ultrasound, Fujian Medical University Union Hospital, Fuzhou, China
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Jalaeefar A, Saffar H, Shirkhoda M, Garajei A, Sharifi A. Reconstruction with facial artery musculo-mucosal flap (FAMM.F) after resection of upper lip pleomorphic adenoma: Case report. Int J Surg Case Rep 2023; 111:108822. [PMID: 37741079 PMCID: PMC10520520 DOI: 10.1016/j.ijscr.2023.108822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 09/05/2023] [Accepted: 09/09/2023] [Indexed: 09/25/2023] Open
Abstract
INTRODUCTION Although pleomorphic adenoma (PA) is the most common neoplasm of both minor and major salivary glands, its presence in the buccal surface of upper lip is rare. PRESENTATION OF CASE A 70-year-old male presented with a chief complaint of recent rapid growth of a mass in the buccal aspect of the upper lip. A well-circumscribed mass measuring 3 × 2 cm with intact overlying mucosa without regional lymphadenopathy was evident. Core needle biopsy report was suggestive of PA. Complete excision of the tumor was performed. The defect was large and primary closure was not possible. Reconstruction with FAMM flap was planned. After 4 weeks, the flap was covered with epithelia and created a satisfactory result. DISCUSSION The definite diagnosis of PA is based on histopathological examination. The following features help to differentiate PA from other tumors; tubuloalveolar and gland-like structures, islands of cuboidal or polygonal cells in a chondroid, hyalinized, fibroadipose or mucinous hypocellular stroma which are stained positively for periodic acid-Schiff and Alcian. Despite these characteristics, differentiation of PA from dermal mixed tumor may be challenging especially when the specimen is from the upper lip. The main advantages of FAMM.F are being thin and pliable flap, having wide arc of rotation; being suitable for reconstruction of mucosal defects; resistance against postoperative radiotherapy and easy harvesting. CONCLUSION The FAMM flap is a reliable reconstruction technique for medium-sized intraoral defects with limited morbidity to the donor site. It provides functional reconstruction of the oral cavity with a low risk of post-operative complications.
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Affiliation(s)
- Amirmohsen Jalaeefar
- Department of General Surgery, Subdivision of Surgical Oncology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hana Saffar
- Department of Anatomical and Clinical Pathology, Cancer Institute, Imam Khomeni Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Shirkhoda
- Department of General Surgery, Subdivision of Surgical Oncology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ata Garajei
- Department of Oran and Maxillofacial Surgery, School of Dentistry, Iran; Department of Head and Neck Surgical Oncology and Reconstructive Surgery, Cancer Institute, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirsina Sharifi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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18
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Gobishangar S, Raviraj S, Vinojan S, Dias SJT, Theepan JMM, Dinoshiga K. Surgical management of a giant parotid gland pleomorphic adenoma in Northern Sri Lanka: A case report. Int J Surg Case Rep 2023; 111:108865. [PMID: 37778136 PMCID: PMC10562165 DOI: 10.1016/j.ijscr.2023.108865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/03/2023] Open
Abstract
INTRODUCTION Pleomorphic adenoma is the most common benign tumour of the parotid gland. It is commonly observed in middle-aged women. Usually, pleomorphic adenomas are asymptomatic with a slow-progressing tendency. There is a substantial risk of malignant transformation if left untreated. Imaging modalities and fine needle aspiration cytology are highly valuable preoperative diagnostic tools and aid in selecting therapeutic interventions. Surgical technique is chosen based on clinical grounds. PRESENTATION OF CASE A 48-year-old woman presented with a painless extensive mass in the left-sided face. A provisional diagnosis of the benign parotid tumour was made based on clinical evaluation. Imaging studies and cytological assessment suggested pleomorphic adenoma of the left parotid gland, and left-sided total parotidectomy with facial nerve dissection was performed. DISCUSSION Pleomorphic adenoma involving the deep lobe of the parotid gland is rare. It typically grows slowly. If left untreated, it can present as a giant mass, as in our case. The extensive tumour mass can also involve adjacent structures, including facial nerve. Therefore, surgical dissection must be involved facial nerve and adjacent muscles. CONCLUSION Surgical dissection of giant pleomorphic adenoma is challenging and often leads to significant deformities postoperatively. Early intervention will improve surgical outcomes and quality of life.
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Affiliation(s)
- S Gobishangar
- Department of Surgery, Faculty of Medicine, University of Jaffna, Sri Lanka; University Surgical Unit, Teaching Hospital, Jaffna, Sri Lanka.
| | - S Raviraj
- Department of Surgery, Faculty of Medicine, University of Jaffna, Sri Lanka; University Surgical Unit, Teaching Hospital, Jaffna, Sri Lanka
| | - S Vinojan
- Department of Surgery, Faculty of Medicine, University of Jaffna, Sri Lanka; University Surgical Unit, Teaching Hospital, Jaffna, Sri Lanka
| | - S J T Dias
- University Surgical Unit, Teaching Hospital, Jaffna, Sri Lanka
| | - J M M Theepan
- Department of Pathology, Teaching Hospital, Jaffna, Sri Lanka
| | - K Dinoshiga
- Department of Surgery, Faculty of Medicine, University of Jaffna, Sri Lanka
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Ding A, Lv H, Cao J, Wang X, Xiong P. Ultrasonography characteristics of cystic components in primary salivary gland tumors. BMC Cancer 2023; 23:833. [PMID: 37670285 PMCID: PMC10481467 DOI: 10.1186/s12885-023-11331-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 08/23/2023] [Indexed: 09/07/2023] Open
Abstract
OBJECTIVES The present study aimed to characterize the ultrasonography (US) features of cystic components in salivary gland tumors (SGTs). MATERIALS AND METHODS A total of 207 patients (218 lesions) with pathologically confirmed primary SGTs were analyzed. Preoperative US revealed the presence of cystic components in lesions. Lesion size, shape, margin, and US findings of the cystic components, including number, distribution, margin, occupying rate, and internal characteristics, were evaluated. RESULTS Similarities were observed between the US performance of benign SGTs (B-SGTs) and malignant SGTs (M-SGTs) with cystic components. Differences in sex and age of patients, number, distribution, and internal characteristics of cystic components were statistically significant. For SGTs with cystic components, the proportions of M-SGTs to ill-defined margins (P = 0.002), eccentric distribution (P = 0.019), and none of the internal characteristics (P = 0.019) were significantly higher than those of B-SGTs. Younger age (P = 0.001), eccentric distribution (P = 0.034) and ill-defined margin (P < 0.001) were risk factors for diagnosing M-SGTs. Cystic component features needed to be combined with lesion indicators (border and shape) to improve diagnostic sensitivity. CONCLUSIONS US features of the B-SGTs and M-SGTs were significantly different. Cystic component is of interest in the US-related differential diagnosis of B-SGT and M-SGT. CLINICAL RELEVANCE Cystic components are potentially valuable in the differential diagnosis of B-SGTs and M-SGTs on US.
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Affiliation(s)
- AngAng Ding
- Department of Ultrasound, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Huan Lv
- Department of Ultrasound, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Jinye Cao
- Department of Ultrasound, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Xin Wang
- Department of Vascular Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
| | - Ping Xiong
- Department of Ultrasound, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
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Kumar P, Gupta A, Aggarwal N, Vijay S, Kumar P. Incidence and Possible Predictive Factors of Facial Nerve Paralysis after Superficial Parotidectomy for Benign Tumours: Our Experience. Indian J Otolaryngol Head Neck Surg 2023; 75:2000-2005. [PMID: 37636740 PMCID: PMC10447721 DOI: 10.1007/s12070-023-03690-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 03/06/2023] [Indexed: 08/29/2023] Open
Abstract
Salivary gland tumors represent 3-10% of all head and neck neoplasms. Most of the tumours are benign with parotid gland being most commonly affected. Surgical intervention in the form of parotidectomy forms the mainstay of treatment. Among the various postoperative complications that may occur after parotidectomy, facial nerve weakness is the most dreaded one for both the surgeon as well as the patient. In the literature, the incidence of transient facial weakness after parotid surgery ranges from 10 to 68%, and long-term dysfunction ranges from 0 to 19%. Apart from injury mechanisms such as nerve division, stretch, thermal injuries, ischemia, several other risk factors such as tumour size, disease duration etc. have also been identified for post parotidectomy facial nerve dysfunction which vary considerably from study to study. Thus, facial nerve injury despite being a common and dreaded complication is also a preventable one. We in our institute conducted a retrospective study from January 2018 to December 2021 to evaluate the incidence of facial nerve weakness and possible predictive factors among 60 patients who underwent superficial parotidectomy for benign tumours and found that when it comes to benign tumours surgical technique rather than tumour factors are more important in preventing nerve injury. Undertaking this study was important in order to emphasize the importance of extensive preoperative planning and better surgical practices among budding head and neck surgeons in our country.
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Affiliation(s)
- Pankaj Kumar
- Dept. of E.N.T, Head and Neck surgery, Dr Baba Saheb Ambedkar Medical College and Hospital, Delhi, India
| | - Ajay Gupta
- Dept. of E.N.T, Head and Neck surgery, Dr Baba Saheb Ambedkar Medical College and Hospital, Delhi, India
| | - Nitish Aggarwal
- Dept. of E.N.T, Head and Neck surgery, Dr Baba Saheb Ambedkar Medical College and Hospital, Delhi, India
- Dept. of E.N.T, Head and Neck surgery, Dr Baba Saheb Ambedkar Medical College and Hospital, Room no. 2279, Bhagawan Mahavir Marg, Sector 6 Rd, Rohini, Delhi, 110085 India
| | - Saurabh Vijay
- Dept. of E.N.T, Head and Neck surgery, Dr Baba Saheb Ambedkar Medical College and Hospital, Delhi, India
| | - Pallika Kumar
- Dept. of E.N.T, Head and Neck surgery, Dr. Ram Manohar Lohia Hospital and Atal Bihari Vajpayee Institute of Medical Sciences, Delhi, India
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Fakhril-din Z, Kiss K, Lund EL, Jørgensen JS, Heegaard S. Adenocarcinoma in situ (ductal type) ex pleomorphic adenoma of the lacrimal gland. Am J Ophthalmol Case Rep 2023; 31:101855. [PMID: 37229514 PMCID: PMC10203733 DOI: 10.1016/j.ajoc.2023.101855] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 03/27/2023] [Accepted: 05/01/2023] [Indexed: 05/27/2023] Open
Abstract
Purpose To present the clinical and histopathological characteristics of a rare case of ductal carcinoma in situ ex pleomorphic adenoma in the lacrimal gland. Observations A 73-years-old Caucasian female presented with complaints of double vision and pain in the left eye region. Clinical examination revealed ptosis and exophthalmos of the left eye as well as diplopia on downward gaze. Magnetic resonance imaging of the left orbit demonstrated a 17 × 22 mm homogeneous tumor in the left lacrimal fossa. The tumor was excised in toto. Histopathological examination revealed a pleomorphic adenoma with ductal structures with benign looking epithelial cells, surrounded by myoepithelial cells. Tumor areas with cribriform architecture consisting of ductal structures with abnormal luminal epithelial cells and intact myoepithelial cell layer were also present. The surgical margins were clear. All luminal and myoepithelial cells were positive for cytokeratin 7, the luminal cells in the cribriform areas were positive for human epidermal growth factor 2 and androgen receptor. The myoepithelial cells were positive for cytokeratin 5, calponin and focally for glial fibrillar acid protein. The findings were diagnostic for ductal carcinoma in situ ex pleomorphic adenoma. Next generation sequencing Oncomine Comprehensive Assay mutation analysis found mutations in the BRCA2 (p.K3326*), BAP1 (p.S395*), and TP53 (p.E285K) genes in the ductal carcinoma in situ and BRCA2 (p.C9976A) in the pleomorphic adenoma part. Conclusion and importance To our knowledge, this tumor is only the second described ductal carcinoma in situ ex pleomorphic adenoma of the lacrimal gland.
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Affiliation(s)
- Zainab Fakhril-din
- Department of Pathology, Rigshospitalet, University of Copenhagen, Denmark
- Department of Ophthalmology, Rigshospitalet, University of Copenhagen, Denmark
| | - Katalin Kiss
- Department of Pathology, Rigshospitalet, University of Copenhagen, Denmark
| | - Eva Løbner Lund
- Department of Pathology, Rigshospitalet, University of Copenhagen, Denmark
| | | | - Steffen Heegaard
- Department of Pathology, Rigshospitalet, University of Copenhagen, Denmark
- Department of Ophthalmology, Rigshospitalet, University of Copenhagen, Denmark
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22
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Gambhir A, Deo JK. Palatal Swellings: A Proposed Classification and a Case Report of Pleomorphic Adenoma of Minor Salivary Gland of the Palate. J Maxillofac Oral Surg 2023; 22:538-542. [PMID: 37534360 PMCID: PMC10390423 DOI: 10.1007/s12663-022-01808-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 10/04/2022] [Indexed: 11/28/2022] Open
Abstract
Palatal swellings are a commonly encountered diagnostic entity. They can be infectious, neoplastic, odontogenic, vascular, congenital or secondary manifestation of a systemic disease. While individual palatal lesions are well documented in the literature, there is lack of a comprehensive classification of such entities. Proper classification helps in prompt and accurate diagnosis, facilitating proper management. This article proposes a comprehensive classification of palatal swellings based on their location, clinical findings and aetiology, and describes a case report of pleomorphic adenoma of the minor salivary gland of the palate.
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Affiliation(s)
- Amarjeet Gambhir
- Department of Oral and Maxillofacial Surgery, Lady Hardinge Medical College and SSK Hospital, Connaught Place, New Delhi, 110001 India
| | - Jaspreet Kaur Deo
- Department of Oral and Maxillofacial Surgery, Lady Hardinge Medical College and SSK Hospital, Connaught Place, New Delhi, 110001 India
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23
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Kokubun K, Chujo T, Yamamoto K, Akashi Y, Nakajima K, Takano M, Katakura A, Matsuzaka K. Intraoral Minor Salivary Gland Tumors: A Retrospective, Clinicopathologic, Single-Center Study of 432 Cases in Japan and a Comparison with Epidemiological Data. Head Neck Pathol 2023; 17:739-750. [PMID: 37076754 PMCID: PMC10513980 DOI: 10.1007/s12105-023-01551-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 03/30/2023] [Indexed: 04/21/2023]
Abstract
BACKGROUND Intraoral minor salivary gland tumors are relatively rare lesions with histological subtypes not commonly found in major salivary glands. This study aimed to retrospectively evaluate the clinicopathologic features of intraoral minor salivary gland tumors from the Tokyo Dental College Hospital, Japan, and compare them with findings from other epidemiological studies. METHODS We conducted a retrospective clinicopathologic evaluation of 432 cases of intraoral minor salivary gland tumors [161 male (37.3%) and 271 female (62.7%) patients; mean age: 52.5 and 48.6 years for males and females, respectively; age at diagnosis: 7-87 (mean: 50.1) years] from the Tokyo Dental College Hospital between 1975 and 2022, including 283 benign tumors (65.5%) and 149 malignant tumors (34.5%). RESULTS The most common benign tumor was pleomorphic adenoma (n = 239), whereas mucoepidermoid carcinoma was the most common malignant tumor (n = 74). The mean age of patients with benign and malignant tumors was 48.4 and 53.2 years, respectively, with patients with malignant tumors being significantly older (P = 0.0042). The mean age of patients with malignant tumors was significantly higher in males (56.7 years) than in females (50.9 years) (P = 0.0376), although the mean age of patients with benign tumors did not differ by sex. Tumors were commonly located in the palate [250 cases (57.9%)]. Benign tumors were more frequent in the palate, upper lip, and buccal mucosa, whereas malignant tumors were more frequent in the palate, floor of the mouth, buccal mucosa, and retromolar area. CONCLUSIONS Understanding the features of intraoral minor salivary gland tumors is useful for diagnosis. Our study provides important epidemiological data (patient differences in age at occurrence, sex, and site of origin) that will inform clinicians and researchers.
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Affiliation(s)
- Katsutoshi Kokubun
- Department of Pathology, Tokyo Dental College, 2-9-18 Kandamisaki-Cho, Chiyoda-Ku, Tokyo, 101-0061, Japan.
| | - Takatoshi Chujo
- Department of Pathology, Tokyo Dental College, 2-9-18 Kandamisaki-Cho, Chiyoda-Ku, Tokyo, 101-0061, Japan
| | - Kei Yamamoto
- Department of Pathology, Tokyo Dental College, 2-9-18 Kandamisaki-Cho, Chiyoda-Ku, Tokyo, 101-0061, Japan
| | - Yoshihiko Akashi
- Department of Pathology, Tokyo Dental College, 2-9-18 Kandamisaki-Cho, Chiyoda-Ku, Tokyo, 101-0061, Japan
| | - Kei Nakajima
- Department of Pathology, Tokyo Dental College, 2-9-18 Kandamisaki-Cho, Chiyoda-Ku, Tokyo, 101-0061, Japan
| | - Masayuki Takano
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College, Tokyo, Japan
| | - Akira Katakura
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Tokyo, Japan
| | - Kenichi Matsuzaka
- Department of Pathology, Tokyo Dental College, 2-9-18 Kandamisaki-Cho, Chiyoda-Ku, Tokyo, 101-0061, Japan
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Zheng X, Huang C, Yu B, Liu S, Li T, Guan Y, Ding J. Differentiation of neurogenic tumours and pleomorphic adenomas in the parapharyngeal space based on texture analysis of T2WI. BMC Oral Health 2023; 23:548. [PMID: 37559074 PMCID: PMC10413588 DOI: 10.1186/s12903-023-03283-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 08/03/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND The purpose of this study was to identify neurogenic tumours and pleomorphic adenomas of the parapharyngeal space based on the texture characteristics of MRI-T2WI. METHODS MR findings and pathological reports of 25 patients with benign tumours in the parapharyngeal space were reviewed retrospectively (13 cases with pleomorphic adenomas and 12 cases with neurogenic tumours). Using PyRadiomics, the texture of the region of interest in T2WI sketched by radiologists was analysed. By using independent sample t-tests and Mann‒Whitney U tests, the selected texture features of 36 Gray Level Co-Occurrence Matrix (GLCM) and Gray Level Dependence Matrix (GLDM) were tested. A set of parameters of texture features showed statistically significant differences between the two groups, which were selected, and the diagnostic efficiency was evaluated via the operating characteristic curve of the subjects. RESULTS The differences in the three parameters - small dependence low level emphasis (SDLGLE), low level emphasis (LGLE) and difference variance (DV) of characteristics - between the two groups were statistically significant (P < 0.05). No significant difference was found in the other indices. ROC curves were drawn for the three parameters, with AUCs of 0.833, 0.795, and 0.744, respectively. CONCLUSIONS There is a difference in the texture characteristic parameters based on magnetic resonance T2WI images between neurogenic tumours and pleomorphic adenomas in the parapharyngeal space. For the differential diagnosis of these two kinds of tumours, texture analysis of significant importance is an objective and quantitative analytical tool.
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Affiliation(s)
- Xuewei Zheng
- Department of Radiology, China-Japan Union Hospital of Jilin University, No. 829 of Xinmin Street, Chaoyang District, Changchun, 130021, China
| | - Chencui Huang
- Department of Research Collaboration, R&D Center, Beijing Deepwise and League of PHD Technology Co. Ltd., Beijing, 100080, China
| | - Baoting Yu
- Department of Radiology, China-Japan Union Hospital of Jilin University, No. 829 of Xinmin Street, Chaoyang District, Changchun, 130021, China
| | - Shuo Liu
- Department of Radiology, China-Japan Union Hospital of Jilin University, No. 829 of Xinmin Street, Chaoyang District, Changchun, 130021, China
| | - Tong Li
- Department of Radiology, China-Japan Union Hospital of Jilin University, No. 829 of Xinmin Street, Chaoyang District, Changchun, 130021, China
| | - Yuyao Guan
- Department of Radiology, China-Japan Union Hospital of Jilin University, No. 829 of Xinmin Street, Chaoyang District, Changchun, 130021, China
| | - Jun Ding
- Department of Radiology, China-Japan Union Hospital of Jilin University, No. 829 of Xinmin Street, Chaoyang District, Changchun, 130021, China.
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Jovančević L, Fejsa Levakov A, Jovančević B. INTRANASAL PLEOMORPHIC ADENOMA ARISING FROM THE LATERAL NASAL WALL. Acta Clin Croat 2023; 62:387-390. [PMID: 38549593 PMCID: PMC10969644 DOI: 10.20471/acc.2023.62.02.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 07/11/2022] [Indexed: 04/02/2024] Open
Abstract
Pleomorphic adenoma is very rare in the sinonasal region, with the most common localization on the nasal septum, followed by lateral nasal wall. In the case presented, a 72-year-old woman was complaining of the right sided nasal obstruction without any other symptoms. The symptom started a year before and increased progressively. Anterior rhinoscopy revealed a mucosa-covered, smooth-surfaced, soft, polypoid, pale, grayish-pink in color mass in the right nasal cavity, approximately 2x2 cm in size. Nasal endoscopy showed the mass to have a broad base on the lateral nasal wall. Computerized tomography scan showed a homogeneous, solid soft tissue mass, 25x18x12 mm in size, which was attached to the lateral nasal wall, behind the nasal vestibule, just in front of the inferior turbinate. Endonasal endoscopic complete tumor excision was performed, during which some spillage of the tumor occurred. Histology diagnosis was pleomorphic adenoma of minor salivary glands. The patient was followed up on regular basis and had no tumor recurrence in the 6th postoperative year. Intranasal pleomorphic adenoma arising from the lateral nasal wall in front of the inferior turbinate is extremely rare, so the presented case is probably the first ever published.
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Affiliation(s)
- Ljiljana Jovančević
- University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
- University Clinical Center of Vojvodina, Department of Otorhinolaryngology and Head and Neck Surgery, Novi Sad, Serbia
| | - Aleksandra Fejsa Levakov
- University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
- University Clinical Center of Vojvodina, Department of Pathology and Histology, Novi Sad, Serbia
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Inomata M, Kuroki S, Oguri N, Sato Y, Kawano F, Maeda R. Pleomorphic adenoma of the trachea: A case report. Int J Surg Case Rep 2023; 109:108499. [PMID: 37459695 PMCID: PMC10439302 DOI: 10.1016/j.ijscr.2023.108499] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 08/17/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Although pleomorphic adenoma is the most common type of parotid gland tumor, its occurrence in the trachea is rare. Here, we describe a successfully resected pleomorphic adenoma of the trachea in a woman with severe respiratory failure that had been preoperatively misdiagnosed as asthma. CASE PRESENTATION A 69-year-old woman presented to the emergency department with symptoms of worsening dyspnea and subsequent loss of consciousness. She had a history of progressively worsening wheezing and stridor over the course of 2-years and had been diagnosed with asthma. Arterial blood gas sample analysis indicated type II respiratory failure. A chest computed tomographic scan revealed a tumor in the trachea, which was almost completely obstructing the lower tracheal lumen. The tumor was located just above the carina. To alleviate airway constriction and achieve complete resection, carinal resection with reconstruction was performed. The postoperative diagnosis was pleomorphic adenoma of the trachea. CLINICAL DISCUSSION Pleomorphic adenoma is a rare tracheal tumor that may present with obstructive airway symptoms that mimic asthma. CONCLUSION Tracheal tumors should be considered in patients with chronic respiratory symptoms that do not improve with medication.
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Affiliation(s)
- Mayu Inomata
- Department of Thoracic and Breast Surgery, Faculty of Medicine, University of Miyazaki Hospital, Miyazaki, Japan
| | - Shoei Kuroki
- Department of Thoracic and Breast Surgery, Faculty of Medicine, University of Miyazaki Hospital, Miyazaki, Japan
| | - Nobuyuki Oguri
- Department of Diagnostic Pathology, Faculty of Medicine, University of Miyazaki Hospital, Miyazaki, Japan
| | - Yuichiro Sato
- Department of Diagnostic Pathology, Faculty of Medicine, University of Miyazaki Hospital, Miyazaki, Japan
| | - Fumiya Kawano
- Department of Thoracic and Breast Surgery, Faculty of Medicine, University of Miyazaki Hospital, Miyazaki, Japan
| | - Ryo Maeda
- Department of Thoracic and Breast Surgery, Faculty of Medicine, University of Miyazaki Hospital, Miyazaki, Japan.
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Hammami B, Achour I, Yousfi G, Walha O, Mnejja M, Chaabouni MA, Charfeddine I. A juvenile pleomorphic adenoma of the palate. SAGE Open Med Case Rep 2023; 11:2050313X231180374. [PMID: 37325167 PMCID: PMC10262646 DOI: 10.1177/2050313x231180374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 05/19/2023] [Indexed: 06/17/2023] Open
Abstract
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.
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Affiliation(s)
- Bouthaina Hammami
- Department of Otolaryngology – Head and Neck Surgery, Habib Bourguiba Hospital, Sfax, Tunisia
- University of Sfax, Sfax, Tunisia
| | - Imen Achour
- Department of Otolaryngology – Head and Neck Surgery, Habib Bourguiba Hospital, Sfax, Tunisia
- University of Sfax, Sfax, Tunisia
| | - Ghada Yousfi
- Department of Otolaryngology – Head and Neck Surgery, Habib Bourguiba Hospital, Sfax, Tunisia
- University of Sfax, Sfax, Tunisia
| | - Omar Walha
- Department of Otolaryngology – Head and Neck Surgery, Habib Bourguiba Hospital, Sfax, Tunisia
- University of Sfax, Sfax, Tunisia
| | - Malek Mnejja
- Department of Otolaryngology – Head and Neck Surgery, Habib Bourguiba Hospital, Sfax, Tunisia
- University of Sfax, Sfax, Tunisia
| | - Mohamed Amin Chaabouni
- Department of Otolaryngology – Head and Neck Surgery, Habib Bourguiba Hospital, Sfax, Tunisia
- University of Sfax, Sfax, Tunisia
| | - Ilhem Charfeddine
- Department of Otolaryngology – Head and Neck Surgery, Habib Bourguiba Hospital, Sfax, Tunisia
- University of Sfax, Sfax, Tunisia
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Galib R, Ahmed A, Ahmed M, Sharma SC. Mucoepidermoid Carcinoma of the Parotid Gland Mimicking Pleomorphic Adenoma on Cytology: A Case Report. Indian J Otolaryngol Head Neck Surg 2023; 75:1201-1203. [PMID: 37275053 PMCID: PMC10235372 DOI: 10.1007/s12070-022-03441-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 12/22/2022] [Indexed: 01/13/2023] Open
Abstract
Salivary gland tumors most commonly involve the parotid gland. Among all the tumors, 80% are benign and of all the benign tumors 80% originate from the parotid gland. The pleomorphic adenoma is the most common benign tumor whereas the mucoepidermoid carcinoma is the most prevalent malignant tumor. Mucoepidermoid carcinoma is a diagnostic challenge on FNAC with a high false negative rate. A 17-year-old female presented with slow-growing painless swelling below the right ear for two years. The history and clinical examination appeared to be benign parotid swelling. The further investigation proceeded and fine needle aspiration cytology was performed. A case of the parotid lump which has shown the pleomorphic adenoma of the parotid gland on cytology. Surgical resection was done and a post-operative specimen of the parotid gland showed mucoepidermoid carcinoma on histopathology. FNAC is not always reliable in the case of mucoepidermoid carcinoma of the parotid gland, especially in the low-grade type. The confirmatory diagnosis can be made only after the histopathological examination.
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Affiliation(s)
- Rubina Galib
- Department of Otorhinolaryngology, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh 202002 India
| | - Aftab Ahmed
- Department of Otorhinolaryngology, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh 202002 India
| | - Murad Ahmed
- Department of Pathology, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh 202002 India
| | - S. C. Sharma
- Department of Otorhinolaryngology, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh 202002 India
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29
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Daniels A, Levitan D, Chernichenko N. The Rare Presentation of Multiple Chondroid Syringomas in One Patient: A Case Report. Indian J Otolaryngol Head Neck Surg 2023; 75:1250-1252. [PMID: 37275003 PMCID: PMC10234902 DOI: 10.1007/s12070-023-03537-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 01/21/2023] [Indexed: 02/07/2023] Open
Abstract
Chondroid syringomas are rare, benign tumors originating from sweat glands occurring as singular lesions of the head and neck. This case report presents a patient in whom multiple chondroid syringoma lesions were found. Thus illuminating the possibility for such occurrences in the future of which physicians should be aware.
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Affiliation(s)
- Adam Daniels
- SUNY Downstate Health Sciences University College of Medicine, Brooklyn, NY USA
- Department of Otolaryngology, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY 11203 USA
| | - Daniel Levitan
- Department of Pathology, SUNY Downstate Health Sciences University, Brooklyn, NY USA
| | - Natalya Chernichenko
- Department of Otolaryngology, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY 11203 USA
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30
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Baskaradass R, Upreti G. Pleomorphic Adenoma of Submandibular Gland in a Pediatric Case. Indian J Otolaryngol Head Neck Surg 2023; 75:1133-1136. [PMID: 37275028 PMCID: PMC10235277 DOI: 10.1007/s12070-022-03391-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 12/07/2022] [Indexed: 12/30/2022] Open
Abstract
Neoplasms of the salivary glands are relatively uncommon, with varied histologic subtypes. Only 5% of these occur in the pediatric age group. The submandibular gland tumors account for just 11.5% of pediatric salivary gland tumors. Few studies have reported the occurrence of pleomorphic adenoma arising in submandibular gland in a child. We describe a case of pleomorphic adenoma affecting submandibular gland in a girl aged eleven years and provide a brief review of current literature. Thorough diagnostic evaluation is required, considering the diverse differential diagnoses of pediatric submandibular masses. Although benign, recurrence and malignant transformation are pertinent concerns in pleomorphic adenoma, especially in a child, considering long life expectancy.
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Affiliation(s)
- Rajeswari Baskaradass
- Department of Otorhinolaryngology, Pandit Deendayal Upadhyay Medical College, 360001 Rajkot, Gujarat India
| | - Garima Upreti
- Department of Otorhinolaryngology, Pandit Deendayal Upadhyay Medical College, 360001 Rajkot, Gujarat India
- Department of Otorhinolaryngology, All India Institute of Medical Sciences, 360006 Rajkot, Gujarat India
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31
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Li S, Su X, Ning Y, Zhang S, Shao H, Wan X, Tan Q, Yang X, Peng J, Gong Q, Yue Q. CT based intratumor and peritumoral radiomics for differentiating complete from incomplete capsular characteristics of parotid pleomorphic adenoma: a two-center study. Discov Oncol 2023; 14:76. [PMID: 37217656 DOI: 10.1007/s12672-023-00665-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 04/20/2023] [Indexed: 05/24/2023] Open
Abstract
OBJECTIVE Capsular characteristics of pleomorphic adenoma (PA) has various forms. Patients without complete capsule has a higher risk of recurrence than patients with complete capsule. We aimed to develop and validate CT-based intratumoral and peritumoral radiomics models to make a differential diagnosis between parotid PA with and without complete capsule. METHODS Data of 260 patients (166 patients with PA from institution 1 (training set) and 94 patients (test set) from institution 2) were retrospectively analyzed. Three Volume of interest (VOIs) were defined in the CT images of each patient: tumor volume of interest (VOItumor), VOIperitumor, and VOIintra-plus peritumor. Radiomics features were extracted from each VOI and used to train nine different machine learning algorithms. Model performance was evaluated using receiver operating characteristic (ROC) curves and the area under the curve (AUC). RESULTS The results showed that the radiomics models based on features from VOIintra-plus peritumor achieved higher AUCs compared to models based on features from VOItumor. The best performing model was Linear discriminant analysis, which achieved an AUC of 0.86 in the tenfold cross-validation and 0.869 in the test set. The model was based on 15 features, including shape-based features and texture features. CONCLUSIONS We demonstrated the feasibility of combining artificial intelligence with CT-based peritumoral radiomics features can be used to accurately predict capsular characteristics of parotid PA. This may assist in clinical decision-making by preoperative identification of capsular characteristics of parotid PA.
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Affiliation(s)
- Shuang Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Xiaorui Su
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Youquan Ning
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Simin Zhang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Hanbing Shao
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Xinyue Wan
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Qiaoyue Tan
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
- Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital of Sichuan University, Chengdu, China
| | - Xibiao Yang
- Department of Radiology, West China Hospital of Sichuan University, #37 GuoXue Xiang, Chengdu, 610041, Sichuan, China
| | - Juan Peng
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China.
- Department of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen, Fujian, China.
| | - Qiang Yue
- Department of Radiology, West China Hospital of Sichuan University, #37 GuoXue Xiang, Chengdu, 610041, Sichuan, China.
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Birigi M, Mweya CN. Surgical tumour excision of pleomorphic adenoma of submandibular salivary gland: A case report and literature review. Int J Surg Case Rep 2023; 106:108236. [PMID: 37105025 PMCID: PMC10164913 DOI: 10.1016/j.ijscr.2023.108236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/13/2023] [Accepted: 04/15/2023] [Indexed: 04/29/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Pleomorphic adenoma is a benign tumour commonly found in salivary glands and surgical excision is the preferred treatment. CASE PRESENTATION This case report describes a 37-year-old male patient who was psychologically affected, socially stigmatised and economically jeopardised, underwent successful surgical excision of a pleomorphic adenoma in the submandibular gland. The procedure involved making a lower submandibular incision through the skin, followed by blunt dissection to approach the tumour, where the whole gland was involved and excised. Haemostasis was achieved through compression, transfixing, and under-running sutures. The patient recovered well without any complications and was discharged with a good outlook. CLINICAL DISCUSSION Proper diagnosis and using proper surgical techniques is essential to ensure favourable outcomes. Early diagnosis and prompt management of pleomorphic adenoma are crucial to prevent complications and improve the patient's quality of life. CONCLUSION Surgical tumour excision is a safe and effective treatment for pleomorphic adenoma in the submandibular gland. Successful surgery has significant changes in the quality of life of the patient.
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Affiliation(s)
- Msafiri Birigi
- Dental Department, Mbeya Zonal Referral Hospital, P.O. Box 419, Mbeya, Tanzania; Mbeya College of Health and Allied Sciences, University of Dar es Salaam, P.O. Box 608, Mbeya, Tanzania
| | - Clement N Mweya
- Mbeya College of Health and Allied Sciences, University of Dar es Salaam, P.O. Box 608, Mbeya, Tanzania; Mbeya Medical Research Centre, National Institute for Medical Research, P.O. Box 2410, Mbeya, Tanzania.
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Marlapudi SK, Bishnoi T, Sahu PK, kumar P. Common Tumor in an uncommon location: Pleomorphic Adenoma of nasal cavity - a case Report. Indian J Otolaryngol Head Neck Surg 2023; 75:947-950. [PMID: 37206835 PMCID: PMC10188731 DOI: 10.1007/s12070-022-03446-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 12/25/2022] [Indexed: 02/06/2023] Open
Abstract
Pleomorphic adenoma (PA) is the most common benign salivary gland tumor of which parotid gland involvement is the most common. PA may arise from minor salivary glands as well, however, PA is very rare in the sinonasal and nasopharyngeal areas. It usually affects middle aged females. They are frequently misdiagnosed due to high cellularity and myxoid stroma, leading to delay in diagnosis & further appropriate management. Here we present a case report of a female who presented with gradually progressive nasal obstruction, on examination found to have a nasal mass in right nasal cavity. Imaging was done and the nasal mass was excised. Histopathological report revealed a PA. Common tumor in an uncommon location: Pleomorphic adenoma of the nasal cavity - a case report.
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Affiliation(s)
| | - Tapasya Bishnoi
- Department of ENT-HNS, Command Hospital Airforce, Bangalore, India
| | - PK Sahu
- Department of ENT-HNS, Command Hospital Airforce, Bangalore, India
| | - Praveen kumar
- Department of ENT-HNS, Command Hospital Airforce, Bangalore, India
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Assar S, Assar S, Mardanifard HA, Jaafari-Ashkavandi Z. Salivary Gland Tumors in Iran: A Systematic Review of 2870 Cases Based on the New WHO Classification. Iran J Pathol 2023; 18:1-11. [PMID: 37383154 PMCID: PMC10293605 DOI: 10.30699/ijp.2023.559121.2942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 11/06/2022] [Indexed: 06/30/2023]
Abstract
Background & Objective There is no consensus on the prevalence of salivary gland tumors (SGTs) in Iran. Thus, we systematically reviewed the literature about the prevalence of SGTs in Iran and applied the last world health organization (WHO) classification. Methods The systematic literature search was performed in EMBASE, Scopus, PubMed MEDLINE, Google Scholar, Scientific Information Database (SID), and Magiran; we searched for "salivary gland," "tumor," "prevalence," and "Iran" until 1 March 2021. The studies included were written in the English and Farsi languages. The weighted mean prevalence of SGTs was calculated as prevalence (%) * (N/the sum of all N). We used the unpaired Two-sample T-test to compare the weighted means. Results A total of 17 studies, including 2870 patients, were selected for the data synthesis. The weighted mean prevalence of benign and malignant tumors was 66% (95% CI: 59-73) and 34% (95% CI: 27-41), respectively. The patients' mean age was reported in 10 out of the 17 studies. The weighted mean age of the patients was 40 (95% CI: 37-42) and 49 (95% CI: 43-55) years for benign and malignant tumors, respectively (P=0.01). Pleomorphic adenoma (PA), followed by Warthin's tumor (WT), was the most prevalent benign tumor. Moreover, the most common malignant tumors were mucoepidermoid carcinoma (MEC) and adenoid cystic carcinoma (AdCC). Conclusion More than one-third of SGTs in Iran were malignant, which is higher than the reports from Middle Eastern countries. Information about risk factors and the burden of SGTs in Iran is insufficient. Thus, further well-designed longitudinal studies are warranted.
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Affiliation(s)
- Sahar Assar
- School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sepideh Assar
- School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Zohreh Jaafari-Ashkavandi
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Tondi-Resta I, Hobday SB, Gubbiotti MA, Jalaly JB, Rassekh CH, Montone KT, Baloch ZW. Carcinoma Ex Pleomorphic Adenomas: An Institutional Experience and Literature Review. Am J Clin Pathol 2023; 159:502-515. [PMID: 36921078 DOI: 10.1093/ajcp/aqac181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 12/13/2022] [Indexed: 03/17/2023] Open
Abstract
OBJECTIVES To provide an institutional experience with cases diagnosed as carcinoma ex pleomorphic adenoma (CXPA), including the cytologic and histologic findings and clinical follow-up, followed by a comparison to the experience documented in the literature. METHODS We identified cases of CXPA diagnosed at our institution from 2011 to 2021 and reviewed the cytologic and histologic diagnoses, as well as the treatment and clinical outcomes. Additionally, a literature review of the English literature was performed on CXPAs from 2011 to 2021. RESULTS Forty-one cases of CXPA were identified, with the majority subclassified as adenocarcinoma, not otherwise specified. Five tumors underwent cytogenetic studies and five underwent molecular studies. To date, 36 patients are alive, 8 of whom experienced locoregional recurrence or distant metastasis. CONCLUSIONS Our institutional experience was comparable to that reported in the literature. Further studies are required to inquire about the role of molecular profiles of CXPAs in clinical risk assessment.
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Affiliation(s)
| | - Sara B Hobday
- Otorhinolaryngology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | | | | | - Christopher H Rassekh
- Otorhinolaryngology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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Gür H, İsmi O, Vayısoğlu Y, Görür K, Ünal M, Güven O, Özcan C. Results of 301 Parotidectomies: A Twenty-Year Experience of One Single Institution. Indian J Otolaryngol Head Neck Surg 2023; 75:208-217. [PMID: 37007887 PMCID: PMC10050268 DOI: 10.1007/s12070-022-03157-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 09/05/2022] [Indexed: 10/14/2022] Open
Abstract
To evaluate demographic, clinical, surgical and histopathological results and complications of 301 parotidectomies performed in southern part of Turkey. The results of 297 patients undergoing 301 parotidectomies between 2000 and 2019 were retrospectively reviewed. Four patients underwent bilateral parotidectomy. Age, gender, side and size of lesion, postoperative facial nerve function (FNF) for benign tumors and types of surgery were evaluated. There were 172 male and 125 female patients. The mean age was 52.53 ± 16.67 years (range 11-90 years). Patients with malignant tumor had higher mean age than the patients with benign diseases (p < 0.001) and the mean age of Warthin tumor (WT) patients was significantly higher than pleomorphic adenoma (PA) (p < 0.001). There was a significant male dominancy in WTs than the PAs (p < 0.001). The mean size of the malignant tumors was significantly higher than the benign tumors (p = 0.012). The mean of cigarette smoking value (pack/year) was higher in WTs than the PAs (p < 0.001). WT incidence was slightly higher than PA in between years 2010 and 2019 (p = 0.272) compared to between years 2000 and 2009. Fine needle aspiration biopsy had a sensitivity of 96% and specificity of 78% for the benign tumors. Tumor location (p < 0.001) and tumor size (p = 0.034) had negative effect on the postoperative FNF. The incidence of WT had a significant rise in the last decade. Deep lobe tumors and increased tumor size had effect postoperative FNF. Experience of surgeon is more important than nerve monitoring to prevent facial paralysis. Partial superficial parotidectomy was available methods for small benign tumors in tail of the parotid gland.
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Affiliation(s)
- Harun Gür
- Department of Otorhinolaryngology, University of Mersin School of Medicine, Çiftlikköy Kampüsü, Çiftlikköy/Yenişehir, Mersin, Turkey
| | - Onur İsmi
- Department of Otorhinolaryngology, University of Mersin School of Medicine, Çiftlikköy Kampüsü, Çiftlikköy/Yenişehir, Mersin, Turkey
| | - Yusuf Vayısoğlu
- Department of Otorhinolaryngology, University of Mersin School of Medicine, Çiftlikköy Kampüsü, Çiftlikköy/Yenişehir, Mersin, Turkey
| | - Kemal Görür
- Department of Otorhinolaryngology, University of Mersin School of Medicine, Çiftlikköy Kampüsü, Çiftlikköy/Yenişehir, Mersin, Turkey
| | - Murat Ünal
- Department of Otorhinolaryngology, University of Mersin School of Medicine, Çiftlikköy Kampüsü, Çiftlikköy/Yenişehir, Mersin, Turkey
| | - Onurhan Güven
- Department of Otorhinolaryngology, University of Mersin School of Medicine, Çiftlikköy Kampüsü, Çiftlikköy/Yenişehir, Mersin, Turkey
| | - Cengiz Özcan
- Department of Otorhinolaryngology, University of Mersin School of Medicine, Çiftlikköy Kampüsü, Çiftlikköy/Yenişehir, Mersin, Turkey
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Ng JKM, Li JJX, Lai BSW, Tsang JY, Chan AWS, Cheung CMT, Ip ECC, Tse GM. WT1 as a myoepithelial marker: a comparative study of breast, cutaneous, and salivary gland lesions. Hum Pathol 2023; 135:76-83. [PMID: 36739952 DOI: 10.1016/j.humpath.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 01/05/2023] [Accepted: 01/18/2023] [Indexed: 02/05/2023]
Abstract
WT1 immunostain is expressed in various benign and malignant neoplasms, as well as normal myoepithelial cells. WT1 shows differential expression in non-neoplastic, benign, and malignant neoplastic myoepithelial cells of the salivary gland. In this study, WT1 immunostain and other myoepithelial markers were compared to investigate the value of WT1 as a myoepithelial marker, and to delineate the expression profile of WT1 in nonsalivary gland myoepithelial cells. WT1, p63, and calponin immunostains were performed on normal and lesional tissues from the breast (adenosis, sclerosing adenosis, lactating adenoma, nipple adenoma, tubular adenoma, adenomyoepithelioma, and adenoid cystic carcinoma [ACC]), skin (cutaneous mixed tumor, hidradenoma, spiradenoma, and ACC), and salivary gland (pleomorphic adenoma and ACC). The stained slides were digitized and orientated with H&E images and assessed simultaneously using QuPath. A total of 129, 58, and 56 breast, cutaneous, and salivary gland lesions, respectively, were included. There was poor agreement between WT1-p63 and WT1-calponin (κ < 0.1) in all organs, with absence of WT1 expression in normal salivary gland myoepithelium and most ACCs. There were no significant differences in WT1 expression in myoepithelial cells in normal breast tissue and benign breast neoplasms. Compared to pleomorphic adenomas, cutaneous mixed tumors showed lower WT1 expression (P < .001). WT1 is a less sensitive myoepithelial marker than calponin and p63. However, its unique pattern of expression in salivary gland primary for pleomorphic adenomas/cutaneous mixed tumor can favor a diagnosis of benign salivary gland tumors, particularly in small biopsy specimens.
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Affiliation(s)
- Joanna K M Ng
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Joshua J X Li
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Billy S W Lai
- Department of Pathology, North District Hospital, Hong Kong
| | - Julia Y Tsang
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Agnes W S Chan
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Christina M T Cheung
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Edric C C Ip
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Gary M Tse
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
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Yanes-Diaz J, Riestra-Ayora J, Rodriguez-Rivero A, Yebra-Gonzalez L, Chaure-Cordero M, Vaduva C, Monedero-Rodrigo G, Martin-Sanz E. Trend changes in the incidence of benign parotid tumours in the last 30 years in a Spanish population. Eur Arch Otorhinolaryngol 2023; 280:855-60. [PMID: 36094561 DOI: 10.1007/s00405-022-07644-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/02/2022] [Indexed: 01/21/2023]
Abstract
PURPOSE To study the demographics and clinical characteristics of benign parotid tumours, focusing on the evolution of the incidence of Warthin tumour (WT) in recent years. METHODS A retrospective observational study is designed of patients diagnosed with a benign parotid tumour in a single tertiary hospital centre, from 1994 to 2021. The evaluation of the relationship between the different variables, and the changes in tumour incidence, is carried out using an analysis of standardized residuals. RESULTS The study evaluated 279 patients, and the total of benign parotid tumours was 291. The most frequent type of tumour was pleomorphic adenoma (PA) (52.7%), followed by WT (37.6%). WT was more frequent in men (79%), and PA in women (55.8%). Smoking history is significantly high in patients with WT (83%), as well as mid-age, compared to PA. CONCLUSIONS It seems to be an increase in the proportion of WT compared to PA in recent years. These changes can be concerning tobacco use and older patients at diagnosis in our series.
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Vanroose R, Scheerlinck J, Coopman R, Nout E. Clinical outcomes and cost-effectiveness of superficial parotidectomy versus extracapsular dissection of the parotid gland: a single-centre retrospective study of 161 patients. Int J Oral Maxillofac Surg 2023; 52:191-198. [PMID: 35624006 DOI: 10.1016/j.ijom.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/30/2022] [Accepted: 05/05/2022] [Indexed: 01/11/2023]
Abstract
Improvements in preoperative diagnostics and intraoperative techniques have made the surgical excision of benign parotid gland tumours less invasive. Extracapsular dissection (ECD) has become more popular in comparison to superficial parotidectomy (SP), the gold standard. Although clinical outcomes have been reported, reports on cost-effectiveness are limited. The aim of this retrospective study was to analyse the surgical outcomes and cost-effectiveness of ECD versus SP in benign parotid tumour surgery. A retrospective cohort of 161 patients treated between 2012 and 2020 was collected. Data concerning demographics, clinical outcomes, and cost-efficiency were recorded. Analysis of the 161 unilateral parotidectomy cases (59 SP, 102 ECD) showed a significantly longer operation time, anaesthesia time, and length of stay for SP patients (all P < 0.001). Regarding postoperative complications, transient facial nerve weakness (P < 0.001) and haematoma formation (P = 0.016) were more prevalent in the SP patients. The frequency of positive margins was lower for SP (P = 0.037). No case of recurrence was identified with either technique. ECD showed excellent clinical outcomes as well as a reduction in complications when compared to SP. ECD is a viable alternative for superficial benign parotid gland tumours after thorough preoperative clinical, pathological, and radiological examination. The reduction in operation, anaesthesia, and hospitalization times with ECD is likely to result in a gain in cost-effectiveness.
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Affiliation(s)
- R Vanroose
- Department of Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; Department of Oral and Maxillofacial Surgery, Sint-Elisabeth Hospital, Tilburg, the Netherlands.
| | - J Scheerlinck
- Department of Oral and Maxillofacial Surgery, Sint-Elisabeth Hospital, Tilburg, the Netherlands
| | - R Coopman
- Department of Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; Department of Plastic, Reconstructive and Aesthetic Surgery, Ghent University Hospital, Ghent, Belgium
| | - E Nout
- Department of Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; Department of Oral and Maxillofacial Surgery, Sint-Elisabeth Hospital, Tilburg, the Netherlands
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Sandhu S, Handa S. Pathology Mimicking Orofacial Pain. Dent Clin North Am 2023; 67:117-127. [PMID: 36404072 DOI: 10.1016/j.cden.2022.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A case of a 64-year-old woman is reported, who developed new-onset pain over a preexisting area of right mandibular fullness. Clinical examination, MRI, and fine-needle aspiration cytology confirmed the diagnosis of a benign parotid gland tumor-pleomorphic adenoma, which was treated by total parotidectomy with complete removal of the tumor. When evaluating a patient with orofacial pain, oral health care providers should be cognizant of all potential differential diagnoses, especially in the setting of red flags such as persistent or enlarging facial swelling/fullness.
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Affiliation(s)
- Shaiba Sandhu
- Division of Orofacial Pain, Oral and Maxillofacial Surgery, Department of Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA; Harvard School of Dental Medicine, Boston, MA, USA.
| | - Shruti Handa
- Division of Orofacial Pain, Oral and Maxillofacial Surgery, Department of Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA; Harvard School of Dental Medicine, Boston, MA, USA
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Wani AA, Khan R, Rehman A, Kirmani MH. Conservative Lateral Approach for Pleomorphic Adenomas of Parotid Gland Involving the Parapharyngeal Space-A Case Series. Indian J Otolaryngol Head Neck Surg 2022; 74:5800-5805. [PMID: 36742674 PMCID: PMC9895714 DOI: 10.1007/s12070-021-02409-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 01/18/2021] [Indexed: 02/07/2023] Open
Abstract
The aim of this paper is to present and discuss the symptoms, clinical signs, diagnostic methods and a conservative surgical approach to large parotid pleomorphic adenomas arising from deep lobe and extending to the parapharyngeal space. In this case series we are describing four such cases which presented with painless swelling of different sizes in the parotid region along with intraoral swelling. Detailed diagnostic workup which included computed tomography scan, fine needle aspiration biopsy and magnetic resonance imaging was undretaken for confirming the diagnosis. Complete excision of the tumour via transcervical and transparotid approach without mandibulotomy and after securing local neurovascular structures was performed in all cases. This conservative lateral approach reduces the likelihood of complications. All the four patients were discharged without any complications and a proper follow up was done.
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Affiliation(s)
- Asef Ahmad Wani
- ENT Department SKIMS Medical College and Hospital, Srinagar, Kashmir India
| | - Raphella Khan
- ENT Department SKIMS Medical College and Hospital, Srinagar, Kashmir India
| | - Ayaz Rehman
- ENT Department SKIMS Medical College and Hospital, Srinagar, Kashmir India
| | - Masood H. Kirmani
- ENT Department SKIMS Medical College and Hospital, Srinagar, Kashmir India
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Ingole P, Rajguru J, Chhajed R, Jadhav R, Karmarkar J, Shenoi R. Management of a Giant Para-Pharyngeal Space Pleomorphic Adenoma of Deep Lobe of Parotid Gland Without Mandibular Swing Approach in a 17-Year Old Patient: Rare Case Report. Indian J Otolaryngol Head Neck Surg 2022; 74:5794-5799. [PMID: 36742502 PMCID: PMC9895588 DOI: 10.1007/s12070-021-02385-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 01/11/2021] [Indexed: 02/07/2023] Open
Abstract
Pleomorphic adenomas comprise of 0.5% of all head and neck tumors. Pleomorphic adenoma affects patients from 4th to 6th decades. 10-12% of Pleomorphic adenomas arise from deep lobe of parotid gland that grow medially and involve the parapharyngeal space. Investigations play a role of paramount importance in treatment of para-pharyngeal tumors. CT scanning aids in evaluating the bone structures and possible calcification of the tumors. MRI provides precise tumor margins and the relationship of the tumor with its adjacent vital structures. The most common approaches to access these masses are the trans-oral, trans-mandibular, transcervical and trans-parotid trans-cervical approaches. Complete surgical excision of the lesion is the treatment of choice for such PPS tumors. The choice of surgical approach should enable the surgeon to maximize exposure for complete resection of the tumor while minimize functional and cosmetic morbidity. The various mandibulotomies are median mandibulotomy, para-symphyseal osteotomy, horizontal osteotomy, inverted 'L' osteotomy and double mandibular osteotomy. We report a rare case of giant pleomorphic adenoma arising from the deep lobe of parotid gland of the parapharyngeal space in a young patient. The excision was done in to without the mandibular swing approach making it one of the rare case reports.
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Affiliation(s)
- Pranav Ingole
- Department of Oral and Maxillofacial Surgery, VSPM Dental College and Research Centre, Nagpur, Maharashtra India
| | - Jignesh Rajguru
- Department of Oral and Maxillofacial Surgery, VSPM Dental College and Research Centre, Nagpur, Maharashtra India
| | - Rajcee Chhajed
- Department of Radiodiagnosis, NKP Salve Institute of Medical Sciences, Nagpur, India
| | - Rasika Jadhav
- Consultant Pathologist, Suretech Hospital, Nagpur, India
| | - Jui Karmarkar
- Department of Oral and Maxillofacial Surgery, VSPM Dental College and Research Centre, Nagpur, Maharashtra India
| | - Ramakrishna Shenoi
- Department of Oral and Maxillofacial Surgery, VSPM Dental College and Research Centre, Nagpur, Maharashtra India
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Dhanasekar K, Kapadia H, Neilaj S, Abdeslem M, Dhanasekar G. Melon-sized Parotid Pleomorphic Adenoma-A Case Report. Indian J Otolaryngol Head Neck Surg 2022; 74:5391-5394. [PMID: 36742829 PMCID: PMC9895520 DOI: 10.1007/s12070-021-02660-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 05/19/2021] [Indexed: 02/07/2023] Open
Abstract
This case report describes a 55 year-old gentleman who had been living with an extremely large (1.2 kg) pleomorphic adenoma for 24 years-despite its significant size, weight and appearance. A modified surgical incision and approach were required to remove the tumour, to avoid damaging the facial nerve and its branches.
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Affiliation(s)
- Keerthan Dhanasekar
- University of Sheffield Medical School, Beech Hill Rd, Broomhall, Sheffield, S10 2RX UK
| | - Heena Kapadia
- Scunthorpe General Hospital, Northern Lincolnshire and Goole NHS Foundation Trust, Cliff Gardens, Scunthorpe, North Lincolnshire, DN15 7BH UK
| | - Steven Neilaj
- Scunthorpe General Hospital, Northern Lincolnshire and Goole NHS Foundation Trust, Cliff Gardens, Scunthorpe, North Lincolnshire, DN15 7BH UK
| | - Meriam Abdeslem
- Scunthorpe General Hospital, Northern Lincolnshire and Goole NHS Foundation Trust, Cliff Gardens, Scunthorpe, North Lincolnshire, DN15 7BH UK
| | - Ganapathy Dhanasekar
- Scunthorpe General Hospital, Northern Lincolnshire and Goole NHS Foundation Trust, Cliff Gardens, Scunthorpe, North Lincolnshire, DN15 7BH UK
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Malli MNA, Shoukat AM. External Auditory Canal Pleomorphic Adenoma: A Rare Case Presentation. Indian J Otolaryngol Head Neck Surg 2022; 74:4106-4109. [PMID: 36742482 PMCID: PMC9895616 DOI: 10.1007/s12070-021-02862-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 09/13/2021] [Indexed: 02/07/2023] Open
Abstract
Pleomorphic adenoma originating from the external auditory canal is extremely rare, benign tumor. Ceruminal glands are modified sweat glands of the skin, present in the external auditory canal that may give rise to (a) benign tumors such as ceruminous adenoma, pleomorphic adenoma, and syringocystadenoma papilliferum, or (b) malignant tumors such as ceruminous adenocarcinoma, adenoid cystic carcinoma, and mucoepidermoid carcinoma. We report a case where a 25-year-old woman presented with right aural swelling and otalgia since 1 year. A canal-filling aural mass was noted on clinical examination. Computed tomography imaging showed no intracranial extension or any association with the adjacent parotid gland. Subsequent excision biopsy and histologic examination revealed features suggestive of pleomorphic adenoma. Similar to the pleomorphic adenoma of salivary glands, recurrence or malignant degeneration with cellular atypia and metastasis can occur on rare occasions. Care must be taken to distinguish this from adenoid cystic carcinomas, ceruminous adenocarcinomas, and mucoepidermoid carcinomas.
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Affiliation(s)
| | - Asma Mohd Shoukat
- Department of Otolaryngology and Head & Neck Surgery, Navodaya Medical College, Raichur, Karnataka India
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Fonseca D, Arya SS, Kodandapani S, Chandini A, Kurapati S, Rao C, Gadepalli T, Ali Z. Metastasising Pleomorphic Adenoma: A Rare Entity. Indian J Otolaryngol Head Neck Surg 2022; 74:6321-6323. [PMID: 36742660 PMCID: PMC9895652 DOI: 10.1007/s12070-021-03065-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 12/27/2021] [Indexed: 02/07/2023] Open
Abstract
Pleomorphic adenoma (PA) is the most common benign salivary gland neoplasm. Metastasising PA (MPA) is a rare subtype which is histologically and molecularly indistinguishable from the tumor in the primary location that often occurs after multiple recurrences.We herein report a case of 29 year female who underwent right parotidectomy for PA 15 years ago which was followed by history of recurrences and now presenting with MPA involving ipsilateral lymph nodes.
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Affiliation(s)
- Daphne Fonseca
- Present Address: Department of Pathology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana State 500034 India
| | - Sahithi Shilpa Arya
- Present Address: Department of Pathology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana State 500034 India
| | - Suseela Kodandapani
- Present Address: Department of Pathology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana State 500034 India
| | - Anita Chandini
- Present Address: Department of Pathology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana State 500034 India
| | - Samatha Kurapati
- Present Address: PDCC-Oncopathology, Department of Laboratory Medicine, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana State 500034 India
| | - Chandrasekhara Rao
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana State 500034 India
| | - Tejonath Gadepalli
- Department of Nuclear Medicine, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana State 500034 India
| | - Zakir Ali
- Department of Nuclear Medicine, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana State 500034 India
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Ghaloo SK, Qayyum MU, Shaikh OS, Faisal M, Keerio AA, Hussain RT. Carcinoma ex- pleomorphic adenoma of mandible: A case report and review of literature. Int J Surg Case Rep 2022; 100:107729. [PMID: 36274292 PMCID: PMC9596728 DOI: 10.1016/j.ijscr.2022.107729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 09/22/2022] [Accepted: 10/04/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction and importance The most common benign neoplasm of major and minor salivary glands is pleomorphic adenoma (PA). Around 80 % of all parotid neoplasms are pleomorphic adenomas, while 44–68 % and 38–43 % tumors were pleomorphic adenomas of submandibular and minor salivary gland tumors. PA has been reported in a variety of anatomic locations including true intraosseous mandibular tumor, external ear canal, TMJ region, lacrimal gland, epiglottis, larynx and nasopharynx, breast, lung, esophagus, sinonasal and skull base and trachea. Pleomorphic adenoma has a tendency to transform into a number of malignancies; carcinoma ex-pleomorphic adenoma, carcinosarcoma or metastasizing pleomorphic adenoma. Pleomorphic adenomas most commonly transform into carcinoma ex-pleomorphic adenoma (CEPA). Case presentation A 30-year-old male presented with the primary complaint of a long-standing swelling at his right mandibular region for past 18 months. On intra oral examination, there was a non-healing alveolar socket of right lower 3rd molar tooth while rest of the dentition and mucosal surfaces were normal. On extra oral examination, mouth opening was adequate with intact lower border of the mandible and no palpable lymph nodes in the neck. Initial biopsy of lesion showed pleomorphic adenoma, but later the lesion came out to be carcinoma ex-pleomorphic adenoma, for which he underwent segmental mandibulectomy and free fibular flap. Clinical discussion The prevalence of CEPA transformation from pleomorphic adenoma is 1.5 % within the first 5 years of diagnosis, going up to 10 % after 15 years. The true rate of malignant transformation in recurrent pleomorphic adenoma is reported to be 3.3 %. We report a case of an intra-osseous carcinoma ex pleomorphic adenoma (CEPA) of the mandible. It is thought that ectopic entrapment of salivary tissue or developmentally included embryonic remnants of submandibular glands within recesses or lacunae of the mandibular bone could explain the intraosseous origin of a salivary gland tumor in the mandible. Since carcinoma ex pleomorphic adenoma (CEPA) arises from primary or recurrent pleomorphic adenoma, therefore it poses a diagnostic challenge for histopathologists. The radiographic picture of primary tumor/recurrence can mimic odontogenic cyst/tumor; therefore, a sinister disease process should always be kept in mind. In the post operative period, regular follow up is required to treat any recurrence. The recurrence rate for such disease has not been documented. Conclusion Intra osseous CEPA is a very rare tumor. Intra bony tumors which rapidly increase in size have signs and symptoms of nerve involvement and cause bony destruction should have a high suspicion of index of malignancy. Therefore, biopsy must be correlated with clinical and radiological features. Regular follow up is necessary to detect any recurrence promptly. Carcinoma expleomorphic adenoma is a salivary gland tumor that can rarely occur in unique sites like mandible. Pleomorphic adenoma can co-exist with carcinoma expleomorphic adenoma which may give different biopsy results. Clinical and radiological correlation with tissue diagnosis is important.
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Affiliation(s)
- Shayan Khalid Ghaloo
- Shaukat Khanum Memorial Cancer Hospital, Lahore, Pakistan,Corresponding author at: Ruby Beach Apartments, Clifton Block 1, Karachi, Pakistan.
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Phulware RH, Dutta R, Subramanian P, Singh S, Das P. Rare Floret Like Tyrosine Crystals in Pleomorphic Adenomas of Parotid Gland. Indian J Otolaryngol Head Neck Surg 2022; 74:1797-1799. [PMID: 36452597 PMCID: PMC9702217 DOI: 10.1007/s12070-020-01807-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 01/22/2020] [Indexed: 10/25/2022] Open
Abstract
The pleomorphic adenoma arising in the parotid gland is a benign neoplasm that is aptly named because of its histomorphological diversity. The stromal component can contain chondromyxoid material, amyloid, and elastic fibers, along with a few rare reports of crystalline structures present in this tumor. Especially, the crystalline components are rarely encountered or appreciated in routine pathology reporting. Here, we report a case of pleomorphic adenoma of the parotid gland, in which tyrosine-rich crystalloids were identified in abundance and were confirmed with special stains and electron microscopy. Though their exact source is not yet known, crystallization of the stromal or myoepithelial cell secretion has been hypothesized. This comprehensive report is to make the histopathologists aware of this rare morphological observation in pleomorphic adenomas so that more cases are identified and followed-up to reveal the impact of their presence in a subset of pleomorphic adenomas.
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Affiliation(s)
- Ravi Hari Phulware
- Departments of Pathology, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, 110029 India
| | - Rimlee Dutta
- Departments of Pathology, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, 110029 India
| | - Priyadarshini Subramanian
- Departments of Pathology, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, 110029 India
| | - Suchita Singh
- Departments of Otolaryngology (ENT), All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, 110029 India
| | - Prasenjit Das
- Departments of Pathology, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, 110029 India
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Aswani E, Sherlin HJ, Jayaraj G, Don KR, Santhanam A. Comparison of Diagnostic Reliability of p63 and Smooth Muscle Actin in Salivary Gland Neoplasms. Indian J Otolaryngol Head Neck Surg 2022; 74:2520-2526. [PMID: 36452668 PMCID: PMC9702114 DOI: 10.1007/s12070-020-02237-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 10/16/2020] [Indexed: 10/23/2022] Open
Abstract
Salivary gland neoplasms pose considerable diagnostic difficulty owing to their diverse histological features in individual lesions and the presence of a number of types and variants & similar histological features with other tumor entities. Myoepithelial and basal cells play a significant role in the pathogenesis of salivary gland neoplasm. p63 and smooth muscle actin are more reliable markers for identifying these cells and not studied much comparing their reliability in the diagnosis of salivary gland neoplasms. Hence, the aim of this study is to evaluate and compare the diagnostic reliability of immunohistochemical markers such as p63 and smooth muscle actin (SMA) in the diagnosis of various benign and malignant salivary gland neoplasms. The study comprises of 18 samples categorized into two groups: Group I comprised 9 cases, of which 4 cases were Pleomorphic adenoma, 2 cases were Myoepithelioma, 2 cases of Basal cell adenoma and 1 case was Warthin's tumor; and Group II consisted of 9cases, of which 3 was Mucoepidermoid carcinoma, 1 cases were Myoepithelial carcinoma and 5 cases were Adenoid cystic carcinoma. The selected cases were subjected to immunohistochemistry (IHC) procedure to assess the expression pattern of p63 and smooth muscle actin. The obtained data was analysed statistically by using Mann-Whitney test. In SMA, strong positivity for epithelial and connective tissue components of benign salivary neoplasm is about 22.2%respectively. In malignant salivary neoplasm, SMA was strongly positive for the epithelial and connective tissue component of about 77.7% and 88.8% cases respectively. The difference in the connective tissue components was found to be statistically significant (U = 24, P = 0.032). P63 was strongly positive for the epithelial and connective tissue component of benign salivary neoplasm of about 33.3% and 11.1% cases respectively.In malignant salivary neoplasm, p63 was strongly positive for the epithelial component of about 66.6% cases and connective tissue is completely negative. Alpha-SMA can be utilized as reliable IHC markers for salivary gland neoplasms due to its diagnostic importance in tumors with myoepithelial origin indicative of the histogenesis of salivary gland tumors and even p63 can be used as specific markers for differentiation of malignant salivary gland tumors.
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Affiliation(s)
- E. Aswani
- Department of Oral Pathology, Saveetha Dental College and Hospitals, Saveetha Institute Of Medical and Technical Sciences, Saveetha University, Chennai, 600077 India
| | - Herald J. Sherlin
- Department of Oral Pathology, Saveetha Dental College and Hospitals, Saveetha Institute Of Medical and Technical Sciences, Saveetha University, Chennai, 600077 India
| | - Gifrina Jayaraj
- Department of Oral Pathology, Saveetha Dental College and Hospitals, Saveetha Institute Of Medical and Technical Sciences, Saveetha University, Chennai, 600077 India
| | - K. R. Don
- Department of Oral Pathology, Saveetha Dental College and Hospitals, Saveetha Institute Of Medical and Technical Sciences, Saveetha University, Chennai, 600077 India
| | - Archana Santhanam
- Department of Oral Pathology, Saveetha Dental College and Hospitals, Saveetha Institute Of Medical and Technical Sciences, Saveetha University, Chennai, 600077 India
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Singh A, Phulware RH, Ahuja A, Gupta A, Kaushal M. Pleomorphic Adenoma with Extensive Squamous and Adipocytic Metaplasia Mimicking as Low Grade Mucoepidermoid Carcinoma on FNAC. Indian J Otolaryngol Head Neck Surg 2022; 74:2132-2135. [PMID: 36452717 PMCID: PMC9702417 DOI: 10.1007/s12070-020-02039-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 08/04/2020] [Indexed: 11/30/2022] Open
Abstract
Pleomorphic adenoma (PA) is the most common salivary gland tumor, accounting for 54-76% of all salivary gland neoplasms. Extensive squamous metaplasia in PA can be mistaken for malignancy, including low grade mucoepidermoid carcinoma and squamous cell carcinoma. Here, we present an unusual case of PA with extensive squamous metaplasia and keratin cyst formations in a minor salivary gland, and discuss its microscopic features, including the immunohistochemical characteristics, and differential diagnosis of this uncommon presentation.
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Affiliation(s)
- Anu Singh
- Department of Pathology, ABVIMS, PGIMER, RML Hospital, New Delhi, India
| | | | - Arvind Ahuja
- Department of Pathology, ABVIMS, PGIMER, RML Hospital, New Delhi, India
| | - Ankur Gupta
- Department of Otorhinolaryngology, ABVIMS, PGIMER, RML Hospital, New Delhi, India
| | - Manju Kaushal
- Department of Cytopathology, ABVIMS, PGIMER, RML Hospital, New Delhi, India
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Arrojo ML, Oliveira KK, Bettim BB, Kowalski LP, Carraro DM, Meira ITJE, Torrezan GT, Lourenço SV, Coutinho-Camillo CM. Tight junction gene expression in salivary gland tumors. Pathol Res Pract 2022; 238:154113. [PMID: 36099718 DOI: 10.1016/j.prp.2022.154113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/29/2022] [Accepted: 08/31/2022] [Indexed: 11/18/2022]
Abstract
Salivary gland neoplasms comprise a heterogeneous group of lesions with multiple histological subtypes, each with distinct growth patterns, resulting in a spectrum of tumor-specific prognoses; pleomorphic adenoma (PA) and mucoepidermoid carcinoma (MEC) are the most common representatives of these neoplasms. Many studies have associated specific profiles of membrane and adhesion molecules in salivary gland tissues; these profiles appear to be relevant in tumor biology as well as be interpreted as fingerprints for tumor classification, diagnostic prognostic and therapeutic targets. One of these membrane molecule complexes are the tight junctions, composed by various proteins, in which claudins are protagonists. The aim of this study was to evaluate the expressions of genes that encode tight junction proteins (CLDN-1, -3, -4, -5, -7, and -11, occludin [OCLN], zonula occludens [TJP1, TJP2, and TJP3] and junctional adhesion molecule A [F11R]) in MEC and PA using real time RT-PCR. We observed high expression of CLDN-1 and -7 and low expression of CLDN-3, -11 and TJP2 in MEC compared to PA. PA samples demonstrated high OCLN expression when compared to MEC. CRTC1::MAML2 fusion was detected in 12 of 20 (60.0%) MEC samples and was associated with CLDN7 expression, while the absence of fusion was associated with high histological grade. Increased CLDN5 expression was associated with submandibular gland tumors. This study demonstrated differential expressions of genes encoding tight junction constituent proteins and their associations with tumor characteristics, suggesting their potential future role as diagnostic and prognostic markers.
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Affiliation(s)
- Maria Luiza Arrojo
- International Research Center, A.C.Camargo Cancer Center, São Paulo, Brazil
| | | | | | - Luiz Paulo Kowalski
- Department of Head and Neck Surgery and Otorhinolaryngology, A.C.Camargo Cancer Center, São Paulo, Brazil
| | - Dirce Maria Carraro
- Clinical and Functional Genomics Group, International Research Center A.C.Camargo Cancer Center, São Paulo, Brazil
| | - Isabella Tanus Job E Meira
- Clinical and Functional Genomics Group, International Research Center A.C.Camargo Cancer Center, São Paulo, Brazil
| | - Giovana Tardin Torrezan
- Clinical and Functional Genomics Group, International Research Center A.C.Camargo Cancer Center, São Paulo, Brazil
| | - Silvia Vanessa Lourenço
- Department of General Pathology, Dental School, University of São Paulo, São Paulo, SP, Brazil
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