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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] [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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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] [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] [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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Poondiyar Sirajuddin SH, Chunnusamy R. Synchronous pleomorphic adenoma in the infratemporal fossa and contralateral submandibular gland and endoscopic removal. BMJ Case Rep 2021; 14:14/5/e237775. [PMID: 34020984 DOI: 10.1136/bcr-2020-237775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The objective of this article is to elucidate on our experience with the first case reported in the literature of a synchronous presentation of pleomorphic adenoma (PA) in infratemporal fossa as well as the contralateral submandibular gland. PA most commonly arises from the major salivary glands but has also been reported to arise from minor salivary glands in unusual sites such as the nasal septum, main stem bronchus, trachea, lacrimal gland, external auditory canal, etc. However, it seldom involves the infratemporal fossa and extremely few cases are reported in the literature and coexistent contralateral synchronous PA is nowhere reported in literature. The infratemporal fossa tumour posed a diagnostic dilemma and therapeutic challenge because of its concealed location which we dealt successfully with endoscopic sublabial trans maxillary approach.
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Affiliation(s)
| | - Rayappa Chunnusamy
- Department of ENT and Head and Neck Surgery, Apollo Specialty Cancer Hospital, Chennai, Tamil Nadu, India
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AlKindi M, Ramalingam S, Hakeem LA, AlSheddi MA. Giant Parotid Pleomorphic Adenoma with Atypical Histological Presentation and Long-Term Recurrence-Free Follow-Up after Surgery: A Case Report and Review of the Literature. Case Rep Dent 2020; 2020:8828775. [PMID: 32953184 PMCID: PMC7481918 DOI: 10.1155/2020/8828775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 08/14/2020] [Accepted: 08/21/2020] [Indexed: 11/17/2022] Open
Abstract
Salivary gland tumors (SGT) comprise 3% of all head and neck tumors, are mostly benign, and arise frequently in the parotid gland. Pleomorphic adenoma (PA) is the commonest SGT, representing 60-70% of all benign parotid tumors. Clinically, parotid PA presents as irregular, lobulated, asymptomatic, slow-growing preauricular mass, involving both superficial and deep lobes, and could grow to gigantic proportions. Histologically, PA has epithelial and mesenchymal elements in chondromyxoid matrix and is managed surgically. Based on a review of 43 cases reported in English literature since 1995, giant parotid PA is reported as large as 35 cm (diameter) and 7.3 kg (resected weight). Although rare, 10 cases of malignant transformation were reported in the review. Surgical management included extracapsular dissection (ECD), superficial parotidectomy, and total parotidectomy for benign tumors, and adjuvant radiation or chemotherapy for malignant tumors. We further present the case of a 36-year-old healthy male with slow-growing and asymptomatic giant parotid PA, of 4-year duration. The patient presented with firm, lobulated preauricular swelling, provisionally diagnosed as PA based on radiographic and cytological findings. The tumor was resected through ECD, and the patient had uneventful postoperative recovery and a 7-year recurrence-free follow-up period. Histological examination revealed epimyoepithelial proliferation punctuated by chondromyxoid areas, with extensive squamous metaplasia and keratin cysts. To the best of knowledge from indexed literature, giant parotid PA is rarely reported in Saudi Arabia. In addition to its rarity, this case is reported for its benign nature despite atypical histological presentation, successful surgical management without complications, and long-term recurrence-free follow-up. Based on this report, clinicians must be aware of atypical histological presentations associated with PA and plan suitable surgical management and follow-up to avoid morbidity. Nevertheless, attempts must be made to diagnose and manage these lesions at an early stage and before they reach gigantic proportions.
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Affiliation(s)
- Mohammed AlKindi
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Sundar Ramalingam
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Lujain Abdulmajeed Hakeem
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Manal A. AlSheddi
- Department of Basic Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
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Cystic Myoepithelioma of Parapharyngeal Space. Indian J Otolaryngol Head Neck Surg 2018; 71:689-692. [PMID: 31742043 DOI: 10.1007/s12070-018-1488-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 08/29/2018] [Indexed: 10/28/2022] Open
Abstract
Myoepitheliomas are rare tumours of salivary glands arising from myoepithelial cells, which are normal constituent of the salivary acini and ducts and are found between the epithelial cells and the basement membrane. The most common site of origin of Myoepitheliomas are the salivary glands and rarely other sites in the head and neck have been described in literature. Myoepithelioma arising from parapharyngeal space provide both a diagnostic and therapeutic challenge. We present such a case and discuss its diagnostic and therapeutic aspects.
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Gavriel H, Yeheskeli E, Hermann G, Eviatar E. Leiomyosarcoma of the parapharyngeal space: a very rare entity. EAR, NOSE & THROAT JOURNAL 2016; 93:E5-8. [PMID: 25025422 DOI: 10.1177/014556131409300701] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Leiomyosarcoma of the head and neck is very rare, as only about 100 cases have been reported; of these, only 3 cases have been previously reported in the parapharyngeal space. We report the fourth such case, and we review the features of this entity. The patient was an 84-year-old woman who presented to the emergency department for treatment of an 18-month history of right-sided headache, a 6-month history of right-sided hearing loss and nasal obstruction, and a 2-month history of dysphagia. Physical examination revealed a bulge in the right side of the soft palate and the right lateral nasopharyngeal wall and complete obstruction of the right eustachian tube. Indirect laryngoscopy detected a bulge in the right lateral hypopharyngeal wall. Otoscopy revealed otitis media with effusion in the right ear. Imaging demonstrated a space-occupying lesion in the right parapharyngeal space that extended from the base of the skull to the level of the hypopharynx. Biopsy and histology identified the mass as a leiomyosarcoma. Metastasis to the brain was discovered shortly thereafter, and the patient died 10 months later. The unusual presentation of head and neck leiomyosarcoma requires a high index of suspicion and appropriate diagnostic imaging. Surgical excision is the recommended treatment when feasible; chemoradiotherapy does not appear to affect disease progression.
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Affiliation(s)
- Haim Gavriel
- Department of Otolaryngology-Head and Neck Surgery, Assaf Harofeh Medical Center, Zerifin 70300, Israel.
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Pleomorphic adenoma involving soft tissue overlying the anterior border of ramus of the mandible: A rare ectopic presentation. J Oral Biol Craniofac Res 2015; 6:S62-S64. [PMID: 27900254 DOI: 10.1016/j.jobcr.2015.09.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 09/29/2015] [Indexed: 01/31/2023] Open
Abstract
Ectopic pleomorphic adenoma is a rare presentation in sites other than major and minor salivary glands. In literature, cases of pleomorphic adenoma in the soft tissue of the neck, skin of the external auditory canal, subcutaneous layer of nose, and lymph node of mediastinum have been reported. We report a case of ectopic pleomorphic adenoma localized in the soft tissue over the anterior border of the ramus of left side of the mandible.
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Satpathy S, Dam A, Hossain MA, Chatterjee J. Double mandibular osteotomy with segmental mandibular swing approach to parapharyngeal space. Natl J Maxillofac Surg 2015; 5:213-6. [PMID: 25937739 PMCID: PMC4405970 DOI: 10.4103/0975-5950.154840] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Surgical removal of benign tumors of the Parapharyngeal space (PPS) is the treatment of choice. PPS tumors may remain undetected for long periods of time and large tumors in the PPS can extend into the Retropharyngeal Space or into the Infra-Temporal Fossa. Anatomically, the mandible represents a significant obstacle to successful PPS surgery. Except for very small tumors, it is difficult to remove larger tumors from this region without some form of mandibular retraction. The standard mandibular “swing” approach involves splitting of the lower lip and a single parasymphysis osteotomy for retraction of the mandible laterally to expose the PPS. However, the morbidity associated with midline lip split and anesthesia of the hemi-labial region caused by the severing of the mental nerve is an unwanted complication of this approach. In this article, we describe an easier double mandibular osteotomy (Segmental Mandibular Swing Approach) which avoids the morbidity associated with lip splitting or intra-oral mucosal incision but allows excellent exposure of the superior and lateral aspect of PPS for easier removal of large tumors in this region.
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Affiliation(s)
- Shouvanik Satpathy
- Department of ENT and Head Neck Oncology, Chittaranjan National Cancer Institute, Kolkata, West Bengal, India
| | - Aniruddha Dam
- Department of ENT and Head Neck Oncology, Chittaranjan National Cancer Institute, Kolkata, West Bengal, India
| | - Mollah Arafat Hossain
- Department of ENT and Head Neck Oncology, Chittaranjan National Cancer Institute, Kolkata, West Bengal, India
| | - Jayanta Chatterjee
- Department of ENT and Head Neck Oncology, Chittaranjan National Cancer Institute, Kolkata, West Bengal, India
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Datarkar AN, Deshpande A. Giant Parapharyngeal Space Pleomorphic Adenoma of the Deep Lobe of Parotid Presenting as Obstructive Sleep Apnoea: A Case Report & Review of the Diagnostic and Therapeutic Approaches. J Maxillofac Oral Surg 2014. [PMID: 26225040 DOI: 10.1007/s12663-014-0690-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Salivary gland tumours constitute about less than 4 % of all head and neck tumours. Pleomorphic adenoma, also called benign mixed tumour, is the most common tumour of the salivary glands. About 80-90 % of these tumours occur in the major salivary gland mainly parotid gland and 10 % of them occur in the minor salivary glands. AIMS AND METHODS Aim of this case report is to discuss the unique case of giant parotid pleomorphic adenomas arising in the deep lobe involving the parapharyngeal space and difficulty in respiration at sleep during nights repoted at this institute. The patient was undergoing treatment for obstructive sleep apnea syndrome when she reported at this institute for disturbed sleep. Diagnosis was based on computed tomography scan and magnetic resonance imaging and cytology by means of fine needle aspiration biopsy. CONCLUSION An exhaustive pre-operative diagnostic algorithm is mandatory before approaching such lesions involving parapharyngeal space. Fine needle aspiration biopsy is, in our opinion, mandatory to avoid histological surprises. The surgical approach varies according to the location of the tumour and should provide excellent visibility with wide surgical exposure to secure local neurovascular structures.
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Affiliation(s)
- Abhay N Datarkar
- Department of Craniofacial Surgery, Meditrina Institute of Medical Sciences, Nagpur, India
| | - Ajay Deshpande
- Department of Craniofacial Surgery, Meditrina Institute of Medical Sciences, Nagpur, India
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Abstract
Parapharyngeal space tumors are rare, accounting for 0.5% of head and neck neoplasms. Most of them are benign and originate in the salivary glands, especially the pleomorphic adenoma. We presented a 47-year-old man with parotid tail pleomorphic adenoma extending to the parapharyngeal space. The patient applied to our clinic with the complaints of a painless mass on his neck and in his mouth for 3 months. After fine needle aspiration biopsy, the mass was diagnosed as pleomorphic adenoma. The patient was hospitalized and operated in our clinic. As we see in literature review, parapharyngeal space tumors are rare, and most of them are pleomorphic adenomas arising from the deep lobe of the parotid gland and extend into the PPS.
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12
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Parapharyngeal space tumors without mandibulotomy: our experience. Eur Arch Otorhinolaryngol 2011; 269:265-73. [DOI: 10.1007/s00405-011-1594-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2010] [Accepted: 03/08/2011] [Indexed: 10/18/2022]
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Hakeem AH, Hazarika B, Pradhan SA, Kannan R. Primary pleomorphic adenoma of minor salivary gland in the parapharyngeal space. World J Surg Oncol 2009; 7:85. [PMID: 19909506 PMCID: PMC2781005 DOI: 10.1186/1477-7819-7-85] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2008] [Accepted: 11/12/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND World literature suggests parapharyngeal space lesions account for only 0.5% head and neck tumours and the majority of the minor salivary gland tumours are malignant. The parapharyngeal space is very rare site for this tumour. CASE PRESENTATION Two cases of primary pleomorphic adenomas arising de novo from minor salivary glands in the para pharyngeal space are reported. Review of literature, clinical features, pathology, radiological findings and treatment of these tumours are discussed. CONCLUSION Pleomorphic adenoma arising de novo in the parapharyngeal space is of rare occurrence. High index of suspicion and an adequate clearance of the tumour with a cuff of surrounding dispensable normal tissues is the key to successful treatment of such tumours.
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Affiliation(s)
- Arsheed H Hakeem
- Department of Surgical Oncology, Prince Aly Khan Hospital, Aga Hall, Nsbit Road, Mazagaon, Mumbai, India.
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14
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Nitassi S, Oujilal M, Boulaich M, Essakalli L, Kzadri M. [Giant pleomorphic adenoma of the parotid gland]. REVUE DE STOMATOLOGIE ET DE CHIRURGIE MAXILLO-FACIALE 2009; 110:350-2. [PMID: 19833364 DOI: 10.1016/j.stomax.2009.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2008] [Revised: 03/24/2009] [Accepted: 06/15/2009] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Slow evolution pleomorphic parotid adenoma may be diagnosed late. These giant tumors have a functional, esthetic, and social impact. They raise prognostic issues because of the risk of degeneration. We present a case of a giant pleomorphic adenoma involving the parotid glands and try to explain the reasons for the diagnostic delay and describe therapeutic specificities. CASE REPORT A 54 year-old male patient consulted for swelling of the parotid region slowly evolving over the last 10 years. This lesion had been unsuccessfully treated by conventional methods. A painless 20cm long plurinodular mass was located in the right lateral cervical region. Its consistence was heterogeneous. The CT scan revealed a heterogeneous tumor with hyperdense and hypodense areas without any associate lesions. A total conservative parotidectomy was performed; the anatomopathological examination confirmed the diagnosis of a pleomorphic adenoma, weighing 1.2kg for a diameter of 19cm, without malignant degeneration. The postoperative evolution was uneventful. DISCUSSION The recommended treatment for giant parotid adenoma is total conservative parotidectomy. Besides its functional and esthetic impact, the giant parotid adenoma is at high risk of malignant degeneration. Documentation on the nature of the lesion, its evolutive potential, and an early surgical management could limit its incidence.
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Affiliation(s)
- S Nitassi
- Service ORL et chirurgie cervico-faciale, hôpital des spécialités, CHU Rabat-Salé, Rabat, Maroc.
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Jeyanthi K, Karthikeyan R, Sherlin HJ, Anuja N, Ramani P, Priya P, Chandrasekar T, Khan N, Narayanan V. Pleomorphic adenoma in the infra-temporal space: the first case report. Head Neck Pathol 2007; 1:173-7. [PMID: 20614271 PMCID: PMC2807513 DOI: 10.1007/s12105-007-0036-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2007] [Accepted: 09/26/2007] [Indexed: 11/30/2022]
Abstract
The infratemporal fossa is a deep retromaxillary space corresponding to the inferior aspect of the middle cranial fossa. Tumours in the infratemporal fossa are very rare; therefore experience in their diagnosis and therapeutic management is very limited. Tumors that are reported commonly in the infratemporal region are nasopharyngeal carcinomas, juvenile angiofibromas and adenoid cystic carcinomas. To the best of our knowledge, this is the first report in the English language literature of a pleomorphic adenoma presenting in the infratemporal space and probably arising from an ectopic minor salivary gland, along with a brief description of the surgical technique.
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Affiliation(s)
- K. Jeyanthi
- Department of Oral and Maxillofacial Pathology, College of Dental Surgery, Saveetha University, 162, P.H. Road, Velappanchavadi, Chennai, 600077 Tamilnadu India
| | - Ramalingam Karthikeyan
- Department of Oral and Maxillofacial Pathology, College of Dental Surgery, Saveetha University, 162, P.H. Road, Velappanchavadi, Chennai, 600077 Tamilnadu India
| | - Herald J. Sherlin
- Department of Oral and Maxillofacial Pathology, College of Dental Surgery, Saveetha University, 162, P.H. Road, Velappanchavadi, Chennai, 600077 Tamilnadu India
| | - N. Anuja
- Department of Oral and Maxillofacial Pathology, College of Dental Surgery, Saveetha University, 162, P.H. Road, Velappanchavadi, Chennai, 600077 Tamilnadu India
| | - Pratibha Ramani
- Department of Oral and Maxillofacial Pathology, College of Dental Surgery, Saveetha University, 162, P.H. Road, Velappanchavadi, Chennai, 600077 Tamilnadu India
| | - Premkumar Priya
- Department of Oral and Maxillofacial Pathology, College of Dental Surgery, Saveetha University, 162, P.H. Road, Velappanchavadi, Chennai, 600077 Tamilnadu India
| | - T. Chandrasekar
- Department of Oral and Maxillofacial Pathology, College of Dental Surgery, Saveetha University, 162, P.H. Road, Velappanchavadi, Chennai, 600077 Tamilnadu India
| | - Naushad Khan
- Department of Oral and Maxillofacial Surgery, College of Dental Surgery, Saveetha University, 162, P.H. Road, Velappanchavadi, Chennai, 600077 Tamilnadu India
| | - Vinod Narayanan
- Department of Oral and Maxillofacial Surgery, College of Dental Surgery, Saveetha University, 162, P.H. Road, Velappanchavadi, Chennai, 600077 Tamilnadu India
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Maier H, Frühwald S, Tisch M, Danz B, Lorenz KJ. [Epidemiology, diagnosis, and treatment of giant pleomorphic adenomas of the parotid gland]. HNO 2006; 55:812-8. [PMID: 17149634 DOI: 10.1007/s00106-006-1471-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Pleomorphic adenomas of the parotid gland can be slowly growing over the course of many years and may reach an enormous and disfiguring size associated with significant morbidity of the patients. To our knowledge, over the last 80 years 20 cases of giant pleomorphic adenomas (weight 1.2-26.5 kg) have been reported. These tumors occurred predominantly in women (90%). The mean period from initial clinical manifestation until definitive surgical treatment was 20.7 years. The mean age of the patients at the time of surgery was 58.9 years. Malignant transformation occurred in 15.8% of cases. It is likely that the reasons for delayed treatment are the patient's fear of surgery on the one hand, and insufficient medical advise on the other. We report on a 77 year old female who had a 40-year history of a growing parotid tumor that weighed 3.9 kg after resection. The implications of this case for diagnosis and treatment of giant pleomorphic adenomas, and a review of the world literature on these unusual parotid tumors, are presented.
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Affiliation(s)
- H Maier
- Abt. HNO-Heilkunde/Kopf- und Halschirurgie, Bundeswehrkrankenhaus Ulm.
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17
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Ruiz-Laza L, Infante-Cossio P, Garcia-Perla A, Hernandez-Guisado JM, Gutierrez-Perez JL. Giant pleomorphic adenoma in the parapharyngeal space: report of 2 cases. J Oral Maxillofac Surg 2006; 64:519-23. [PMID: 16487817 DOI: 10.1016/j.joms.2005.11.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Luis Ruiz-Laza
- Department of Oral and Maxillofacial Surgery, Virgen del Rocio University Hospital, Seville, Spain
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Hernández Sandemetrio R, Armengot Carceller M, Alba García JR, Taleb C, Jiménez Roig JP, Frías Moya-Angeler S, Basterra Alegría J. Adenoma pleomorfo gigante de lóbulo profundo de la parótida: a propósito de un caso. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2006; 57:56-8. [PMID: 16503035 DOI: 10.1016/s0001-6519(06)78664-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Parapharyngeal space tumors are rare. Salivary neoplasms being the most frequent ones. The important volume they can reach, their silent character, and the complex anatomic relationships of this area makes their surgical resection difficult. This report describes a case of a pleomorphic adenoma in the deep lobe of the parotid gland presented like a parapharyngeal mass, and its diagnosis and treatment.
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Affiliation(s)
- R Hernández Sandemetrio
- Servicio de Otorrinolaringología, Hospital General Universitario, Facultad de Medicina, Valencia.
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Ladeinde AL, Adeyemo WL, Bamgbose BO, Ogunlewe MO, Ajayi FO. Concurrent pleomorphic adenoma in parapharyngeal space and submandibular gland. World J Surg Oncol 2004; 2:6. [PMID: 15035666 PMCID: PMC419374 DOI: 10.1186/1477-7819-2-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2003] [Accepted: 03/18/2004] [Indexed: 11/30/2022] Open
Abstract
Background Pleomorphic adenoma in the parapharyngeal space either occurs de novo or as an extension from the deep lobe of the parotid gland. Case presentation A rare synchronous occurrence of pleomorphic adenoma in the parapharyngeal space and submandibular gland of a 48-year-old Nigerian male is reported. Conclusion Pleomorphic adenoma concurrent in the parapharyngeal space and submandibular gland is very rare. A complete surgical excision of both tumors is the treatment of choice.
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Affiliation(s)
- A L Ladeinde
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, P.M. B. 12003, Lagos, Nigeria
| | - W L Adeyemo
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, P.M. B. 12003, Lagos, Nigeria
| | - B O Bamgbose
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, P.M. B. 12003, Lagos, Nigeria
| | - M O Ogunlewe
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, P.M. B. 12003, Lagos, Nigeria
| | - F O Ajayi
- Department of Oral Pathology and Biology, College of Medicine, University of Lagos P.M. B. 12003, Lagos, Nigeria
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