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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. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 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] [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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Umemori K, Ono K, Kanemoto H, Obata K, Kawai H, Nakamura T, Nakano K, Ibaragi S, Nagatsuka H, Sasaki A. Lip pleomorphic adenomas: case series and literature review. Gland Surg 2022; 11:1730-1740. [PMID: 36353586 PMCID: PMC9638788 DOI: 10.21037/gs-22-308] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 09/04/2022] [Indexed: 06/04/2024]
Abstract
BACKGROUND Pleomorphic adenoma (PA) is the most frequent benign salivary gland tumor, but a lip PA is rare. Although this tumor may be definitively diagnosed by imaging or a tissue biopsy if it is reasonably large, PAs on the lip are relatively small, and they present findings that are similar to those of other lip lesions, which can make a preoperative diagnosis difficult. METHODS We analyzed all PAs in the oral region and lesions on the lips treated in our department over the past 20 years, and we discuss them together with the relevant literature. RESULTS We found that 11.8% (n=6) of the PAs occurred on a lip (upper lip: 9.8%, lower lip: 2.0%), and ~1% of all mass lesions of the lips were PAs. The average size of the lip PAs was 1.5±0.7 cm (range, 0.7-2.2 cm). For preoperative diagnostic assistance, ultrasonography (US) (n=4), magnetic resonance (MR) (n=3), or no imaging (n=2) was used. An excisional biopsy was performed in all cases, and to date, no recurrence or malignant transformation has been observed. CONCLUSIONS Lip PA is relatively rare. Because almost all of these lesions are small, a preoperative diagnosis is more difficult compared to palatal lesions. This tumor is also prone to long-term neglect and has the potential for recurrence and malignant transformation. It is thus necessary to perform an excision that includes the capsule and surrounding tissues, and careful postoperative follow-up should be continued.
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Affiliation(s)
- Koki Umemori
- Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kisho Ono
- Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hideka Kanemoto
- Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kyoichi Obata
- Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hotaka Kawai
- Department of Oral Pathology and Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Tomoya Nakamura
- Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Keisuke Nakano
- Department of Oral Pathology and Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Soichiro Ibaragi
- Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hitoshi Nagatsuka
- Department of Oral Pathology and Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Akira Sasaki
- Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Pleomorphic Adenoma Presenting as an Atypical Nasal Mass in a 26-Year-Old Female. Case Rep Surg 2020; 2020:3726397. [PMID: 32908772 PMCID: PMC7474362 DOI: 10.1155/2020/3726397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 08/12/2020] [Accepted: 08/17/2020] [Indexed: 11/17/2022] Open
Abstract
Pleomorphic adenoma (PA) is a salivary gland tumor that may rarely occur in the nasal cavity. It can be a clinical diagnostic dilemma in many instances due to many possible differential diagnoses. We report the case of a 26-year-old female who presented with a 3-year history of a right nasal growth associated with ipsilateral nasal blockage, nasal pain, and rhinorrhea. Radiological image showed a mild enhancing lesion in the right nasal cavity. The patient underwent a lateral rhinotomy with wide excision of the mass. Histopathological exam was consistent with PA. Nasal PA is a rare entity and should be suspected as a diagnosis for intranasal tumors.
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Kazikdas KC, Yalcinozan ET, Dirik MA. Pleomorphic adenoma of the upper lip. Natl J Maxillofac Surg 2020; 11:110-112. [PMID: 33041587 PMCID: PMC7518476 DOI: 10.4103/njms.njms_55_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 06/19/2018] [Accepted: 02/18/2019] [Indexed: 11/23/2022] Open
Abstract
We present a rare case of pleomorphic adenoma in the upper lip region, with erosion of the maxillary bone and distortion of the facial appearance. A 20-year-old man presented with a painless mass on his upper lip, which had gradually increased in size over a period of 2 years. Computed tomography demonstrated a 30 mm × 28 mm enhancing mass in the upper lip region with no invasion to the surrounding tissues. Erosion of the maxillary bone posterior to this lesion was noted. The lesion was excised completely with a wedge of mucosa overlying the tumoral mass, accompanied with abdominal fat grafting to prevent labial asymmetry. Histological examination confirmed the diagnosis of a minor salivary gland pleomorphic adenoma in the upper lip. The pathology, clinical manifestations, and treatment of intraoral pleomorphic adenomas are reviewed.
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Affiliation(s)
- Kadir Cagdas Kazikdas
- Department of Otorhinolaryngology, Faculty of Medicine, Near East University, Nicosia, Cyprus
| | - Eda Tuna Yalcinozan
- Department of Otorhinolaryngology, Faculty of Medicine, Near East University, Nicosia, Cyprus
| | - Mehmet Alp Dirik
- Department of Radiology, Faculty of Medicine, Near East University, Nicosia, Cyprus
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Abstract
Pleomorphic adenoma constitutes 50% of salivary gland tumors affecting mostly the parotid gland extraorally, and the palate intraorally. While the upper lip is a common site, it is unusual to encounter this tumor in the lower lip. A 26-year-old man complained of a persistent lump affecting the lower lip. The lesion was excised and was shown on histopathological examination to be a pleomorphic adenoma with squamous metaplasia. At the 18-month review appointment, there was complete healing and no recurrence. Pleomorphic adenoma in the lower lip should be considered among the differential diagnosis of lower labial swellings, especially in young patients. There needs to be reconsideration of the epidemiological and histological characteristics.
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Affiliation(s)
- Ibrahim Nourwali
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Taibah University, Al Madinah Al Munawara, Saudi Arabia
| | - Najla Dar-Odeh
- Department of Oral Basic and Clinical Sciences, College of Dentistry, Taibah University, Al Madinah Al Munawara, Saudi Arabia
- Department of Oral Surgery, Oral Medicine and Periodontics, School of Dentistry, University of Jordan, Amman, Jordan
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Ahmedi JR, Ahmedi E, Perjuci F, Ademi R, Gashi A, Agani Z, Kurshumliu F, Reçica B. Pleomorphic Adenoma of Minor Salivary Glands in Child. Med Arch 2018; 71:360-363. [PMID: 29284907 PMCID: PMC5723176 DOI: 10.5455/medarh.2017.71.360-363] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Introduction: Tumors of salivary glands are very rare in children overall, and rarely in minor salivary glands. Among them pleoomorphic adenoma (PA) is the most common benign tumor of salivary glands in children and it acounts 60% of all salivary neoplasms, frequently found in major salivary glands (85 %) and rarely in minor salivary glands (10-15%). PA appears as painless oval mass, elastic consistency and smooth surface. It characterized by slow evolution of growing. The diagnosis can be confirmed only by histopathological features, after total excision of the lesion. Case report: This case report present the uncommon case of the formation well circumscribed in upper lip region, nearby the frenulum labii oris superior in 10 years old school girl. After clinical intraoral examination of the formation approximately 2cm in size the surgical treatment has been done and histopathologic analysis resulted as PA. Conclusion: Long term follow-up examination is necessary due to possible recurence or malignancy alteration.
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Affiliation(s)
| | - Enis Ahmedi
- School of Dentistry, Faculty of Medicine, Prishtina, Kosovo
| | | | - Resmije Ademi
- School of Dentistry, Faculty of Medicine, Prishtina, Kosovo
| | - Ali Gashi
- School of Dentistry, Faculty of Medicine, Prishtina, Kosovo
| | - Zana Agani
- School of Dentistry, Faculty of Medicine, Prishtina, Kosovo
| | | | - Bylbyl Reçica
- School of Dentistry, Faculty of Medicine, Prishtina, Kosovo
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Tzermpos F, Chatzichalepli C, Cocos A, Kleftogiannis M, Zarakas M, Chrysomali E. Atypical Presentation of an Upper Lip Pleomorphic Adenoma: Case Report. Acta Stomatol Croat 2014; 48:48-53. [PMID: 27688351 PMCID: PMC4872811 DOI: 10.15644/asc48/1/6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Accepted: 02/03/2014] [Indexed: 10/31/2022] Open
Abstract
The pleomorphic adenoma (PA) or mixed tumor is the most common neoplasm of the salivary glands, usually presenting with a non-specific clinical manifestation and a diverse histopathological pattern. The region of the lips is the second most common site for minor gland neoplasms. The aim of this paper is to report the case of a 39 year old caucasian woman presenting with a swelling on the right side of the upper lip combined with a history of trauma in the region of the upper right central incisor, eight years ago. The swelling was attributed to the periapical lesion of the upper right central incisor that was observed on the orthopantomography. Intraoperatively the surgeon came upon a nodule of firm consistency in the mucolabial fold. The histopathologic diagnosis of this lesion was benign mixed tumor of salivary gland. This report discusses the deviation in frequency of mixed salivary gland tumor between upper and lower lip, the clinical differential diagnosis, the histopathological pattern and the appropriate treatment.
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Affiliation(s)
- Fotios Tzermpos
- National and Kapodistrian University of Athens, School Of Dentistry
| | | | - Alina Cocos
- National and Kapodistrian University of Athens, School Of Dentistry
| | | | - Marissa Zarakas
- National and Kapodistrian University of Athens, School Of Dentistry
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Sengul I, Sengul D. Pleomorphic adenoma of the lower lip: A review. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2012; 3:536-9. [PMID: 22363073 PMCID: PMC3271414 DOI: 10.4297/najms.2011.3536] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The lower lip is a very rare emerging site for pleomorphic adenoma. The present review is to accentuate the definition, frequency, clinical and histopathological features, differential diagnosis, prognosis, and treatment choices of pleomorphic adenoma. We reviewed the English-language literature addressing pleomorphic adenoma of the lower lip. The tumors of minor salivary glands are not frequent among whole salivary glands tumors. Pleomorphic adenoma is the most common neoplasm among the minor salivary glands. A wide excision is recommended if there is no cosmetic care and no risk of damage to the functional structures of head and neck. Malignancy of the minor salivary glands are not rare. In addition, malignant transformation of pleomorphic adenoma involved in the benign tumors of minor salivary glands are possible. Thus, awareness of the possibility of existence of a pleomorphic adenoma or a malignant tumor within a mass located on the lower lip has a mentionable importance.
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Affiliation(s)
- Ilker Sengul
- Department of General Surgery, Giresun University, Faculty of Medicine, 28100 Giresun, Turkey
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Simultaneous palatal pleomorphic adenoma and mandibular keratocystic odontogenic tumor in a pediatric patient. J Craniofac Surg 2012; 22:2347-50. [PMID: 22134274 DOI: 10.1097/scs.0b013e318231e480] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Neoplasms of the salivary gland account for 3% of all head and neck tumors; most of these occur in the parotid gland and are benign; 80% of them are pleomorphic adenomas. Benign neoplasms of the salivary gland are rare in children compared with adults. Keratocystic odontogenic tumor (KCOT) is considered the second most frequent neoplasm of all odontogenic tumors after the ameloblastoma. In the present report, we introduce the unusual presentation of a child with a simultaneous pleomorphic adenoma of the right hard palate and a KCOT of the left mandibular angle. DISCUSSION The case is significant for 2 reasons; according to the literature, there are few reports of pleomorphic adenoma arising from a minor salivary gland of the palate in a patient younger than 18 years. This is to our knowledge the first recorded instance of simultaneous palatal pleomorphic adenoma and mandibular KCOT occurring in a child.
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Abstract
Although tumors of minor salivary glands are rare, the pleomorphic adenoma is the most common pathology among the benign neoplasm and can be found with high prevalence in the junction between hard palate and soft palate. The treatment of choice for most of maxillary tumors is surgical through either a total or partial maxillectomy. However, surgical defects caused by such type of treatment lead to both clinical and psychologic disorders for the patient. The immediate oral rehabilitation using interim palate obturator after maxillectomy provides optimization on the healing process, recovers the stomatognathic functions after surgery, and avoids psychosocial sequelae for the patients. This clinical report aimed to present the rehabilitation with immediate palate obturator of a patient who underwent a partial maxillectomy due to a hard palate pleomorphic adenoma of minor salivary glands. We report the clinical importance of the prosthetic rehabilitation and the improvements on both quality of life and stomatognathic functions of this patient. It can be concluded that the immediate rehabilitation of the patient after partial maxillectomy by using an interim palate obturator was a great option and provided clinical benefits in the immediate postoperative period, improving the patient’s quality of life, allowing the patient’s reinsertion into society, and reducing the surgical treatment sequelae.
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Clauser L, Mandrioli S, Dallera V, Sarti E, Galiè M, Cavazzini L. Pleomorphic Adenoma of the Palate. J Craniofac Surg 2004; 15:1026-9. [PMID: 15547398 DOI: 10.1097/00001665-200411000-00029] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Pleomorphic adenoma, is the most common tumor (50%) of the major and minor salivary glands. Seventy percent of the tumors of the minor salivary glands are pleomorphic adenomas, and the most common intraoral site is the palate, followed by the upper lip and buccal mucosa. Pleomorphic adenoma appears as a painless firm mass and, in most cases, does not cause ulceration of the overlying mucosa. Generally it is mobile, except when it occurs in the hard palate. Intraoral mixed tumors, especially those noted within the palate, lack a well-defined capsule. Lesions of the palate frequently involve periosteum or bone. Approximately 25% of benign mixed tumors undergo malignant transformation. Treatment for the pleomorphic adenoma is radical surgery. Inadequate resection leads to local recurrence. The authors report a palate pleomorphic adenoma in a 67-year-old female patient.
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Affiliation(s)
- Luigi Clauser
- Unit of Cranio-Maxillofacial Surgery, St. Anna Hospital and the University of Ferrara, Ferrara, Italy.
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