Pleomorphic adenoma of the upper lip in a child

Degeneration of a Huge Pleomorphic Adenoma in the Nasal Cavity Extended to the Hard Palate: A Case Report and Review of the Literature

The pleomorphic adenoma is a benign tumor. The patient was 55 years old, with no particular pathological history. For 18 months, she had a progressive and permanent right nasal obstruction associated with intermittent epistaxis, rhinorrhea and chronic unilateral tearing. The nasofibroscopy showed a smooth reddish bleeding tumor of the right nasal cavity, reaching the lower part of the middle cornet. Oropharynx examination revealed on the right side a sessile and bulging tumor of the palate with respect of the mucosa, the tumor goes through the choanae into the oropharynx. The CT scan showed a large aggressive lesion process centered on the right nasal cavity with bone lysis of the posterolateral wall of the maxillary sinus and invasion of the infratemporal fossa. MRI showed a maxillary right naso-sinusal tumor process infiltrating the ethmoidal cells, the right infratemporal fossa with endobuccal extension and filling the nasopharyngeal lumen. The patient was operated through the right external para-latero-nasal, associated to an endonasal abord. Anatomo-pathological with immune-histochemical study was performed to ensure complete removal of the tumor and it showed a high grade cystic adenoid carcinoma.

Rare upper lip pleomorphic adenoma presents as cutaneous skin lesion: Case report

Introduction

Pleomorphic adenoma of the minor salivary gland is not uncommon. Although malignant lesion is the most common in the minor salivary glands, benign lesion has been also reported. Many ectopic sites for minor salivary gland including the lip have been reported mainly intra-orally. But external cutaneous lesion is not that common, which will confuse the diagnosis.

Case presentation

This is a case report of a small 1.5 × 1 cm lesion in the left side of the upper lip in a healthy male. The lesion is fixed to the skin and was confused as dermal sebaceous cyst, which was excised with 2 mm safe margin under local anesthesia in an academic setting and closed primarily. Wound healed completely with no local complication and no evidence of recurrence in 1 year.

Discussion

Minor salivary glands are numerous in numbers specially in the oral cavity mainly in the hard and soft palate. Ectopic site in the head and neck area is well documented including the upper lip. But cutaneous presentation in the skin of the upper lip is not very common and can be easily missed especially if the specimen is not sent to permanent pathology. Pleomorphic adenoma has a unified histopathological feature that can be diagnosed by expert histopathologist.

Conclusion

Even for benign looking skin lesions excision with safe margin and histopathology should be the standard of care. By executing this we ensure a serious malignancy will not be missed, were additional surgical or non-surgical management might be considered necessary.

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Pleomorphic adenoma is the most common salivary gland benign tumor.

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Ectopic site is well known in the literature.

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Cutaneous presentation of pleomorphic adenoma is extremely rare.

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Histopathology examination for any excised lesion is extremely crucial even when benign looking.

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Occasionally further surgical or non surgical treatment might be necessary.

Comprehensive characterization of pleomorphic adenoma at intraoral unusual sites

OBJECTIVE

The present study aimed to comprehensively characterize the epidemiologic characteristics, clinicopathologic characteristics, clinical treatments, and prognoses of pleomorphic adenoma (PA) identified at unusual intraoral sites.

STUDY DESIGN

Patients diagnosed with PA in oral and maxillofacial regions at our institution in the past 16 years (2005-2020) were screened from the inpatient disease registry. All data concerning patients with PA found at unusual intraoral sites (defined as intraoral locations except sublingual gland and palate) were retrieved. Previously published cases with adequate clinicopathologic data were collected from PubMed and Embase. Eligible cases were further reviewed and included for statistical analyses.

RESULTS

Among 1039 cases of PA diagnosed at our institution, 52 lesions were found at unusual intraoral sites. A literature review identified another 63 eligible cases from 32 articles. The upper lip was the most common sites for these lesions (n = 57), followed by buccal mucosa (n = 34), tongue (n = 8), lower lip (n = 8), and retromolar area (n = 2). Recurrence and malignant transformation after surgical resection were extremely rare for these lesions.

CONCLUSIONS

PA might rarely develop at uncommon intraoral sites with atypical presentations, thus complicating its early diagnosis. Surgical resection is the major therapeutic strategy for this rare entity and has a favorable prognosis.

Pleomorphic adenoma of the upper lip: A rare case report

Pleomorphic adenoma (PA), also called mixed tumor, is the most common benign tumor of the salivary glands that mostly occurs in the parotid or submandibular glands but may also occur in the minor salivary glands that are distributed throughout the oral cavity. The common sites of PA of the minor salivary glands are the palates followed by lips and cheeks. Surgical removal with adequate margins is the principal treatment. We present a case of PA (arising from the minor salivary gland of the upper lip) - a rare site in a 65-year-old female who presented with a swelling upper lip of 2-year duration. Fine-needle aspiration cytology of the swelling revealed PA which was confirmed by histopathological examination after complete excision of the swelling.

Pleomorphic Adenoma in the Lower Lip: A Case Report and a Review

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.

Histopathological Findings of Intraoral Pleomorphic Adenomas: A Retrospective Study of a Case Series

The aim of this study was to describe the clinicopathological features of 21 cases of intraoral pleomorphic adenoma (PA), with emphasis on histopathological findings. Between 2000 and 2016, all patients diagnosed as intraoral PA were retrieved and histopathological slides stained with hematoxylin and eosin reviewed to confirm the diagnosis. All tumors were classified histologically according to Seifert et al (1980). The clinical and histopathological variables were analyzed using the Fisher's exact test, considering a significance level of 5% (P < .05). Plasmacytoid (85.7%), spindle (38.1%), and epithelioid (9.5%) myoepithelial cells were observed. Oncocytic (47.6%) and mucous (19%) cells were also found. The stroma was predominantly fibrous (95.2%), followed by myxoid (66.7%), hyaline (61.9%), and chondromyxoid (33.3%). Squamous (57.1%), adipose (47.6%), sebaceous (14.3%), and bone (14.3%) differentiations were found. Additionally, a group of tumors presented pleomorphism (23.8%), mitoses (14.3%), capsule infiltration (9.5%), and necrosis. The presence of cystic structures occurred significantly in patients older than 30 years (P = .04) and mitoses were more observed in PA from buccal mucosa (P = .026). All cases that presented plasmacytoid cells were smaller than 1.5 cm (P = .015). All tumors with up to 50% stroma area presented with size smaller than 2.0 cm (P = .013). Intraoral PA presents a large morphological spectrum and several microscopic features are associated with clinical findings.

Pleomorphic Adenoma of Minor Salivary Glands in Child

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.

Cartilaginous choristoma of the lip in a dog

A six-year-old castrated male Maltese dog presented to a private animal clinic with a mass on the dog’s lower lip without any other clinical signs. The mass (3 × 2 × 2 cm) was whitish and grossly well circumscribed, and a histopathological examination revealed that the mass was composed of normal cartilage tissue surrounded by fibrous connective tissues. Based on the gross findings, histopathology and anatomical location of the mass, the first diagnosis of a cartilaginous choristoma in a dog was made.

Juvenile pleomorphic adenoma of masticator space: The first case report

Pleomorphic adenoma (PA), also called benign mixed tumor, is the most common tumor of the salivary glands. About 90% of these tumors occur in the parotid gland and 10% in the minor salivary glands. Juvenile PAs are uncommon and about 5-10% of minor salivary gland PA affects patients aged 20 years and under. The most common sites of PA of the minor salivary glands are the palate followed by lips and cheek. Other rare reported sites include the throat, floor of the mouth, tongue, tonsil, pharynx, retromolar area and nasal cavity. The masticator space is a deep facial space with a complex anatomical structure where PA is not known to occur. Here, we report an unusual case of PA of left masticator space in a 16-year-old girl patient, which to the best of our knowledge is the first reported case in English language literature.

A clinical analysis of nine new pediatric and adolescent cases of benign minor salivary gland neoplasms and a review of the literature

INTRODUCTION

Minor salivary gland neoplasms of epithelial origin are rare in children and adolescents and most are not well documented, except for a few small series and case reports. This study represents a retrospective clinical analysis of nine cases of benign epithelial salivary gland neoplasms accessioned over a 35-year period at the Louisiana State University School of Dentistry and combines the data with well-documented cases from the English-language literature.

METHODS

A retrospective clinical analysis of nine cases of benign epithelial salivary gland neoplasms was performed over a 35-year period at the Louisiana State University School of Dentistry and combined with data of well-documented cases from the English-language literature.

RESULTS

The nine benign salivary gland neoplasms in patients aged 19 months to 18 years accounted for 2.3% of the Louisiana State University School of Dentistry accessioned salivary gland tumors. These nine cases comprised eight pleomorphic adenomas and one cystadenoma. There were 40 cases in the literature, of which 34 were pleomorphic adenomas. Combining the data for the 42 pleomorphic adenomas resulted in a mean age of 12 years with a 2.8:1 female predilection. The hard palate and/or soft palate were the most common site (69.1%). The average duration and size was 2.1 years and 2.4cm, respectively. Bone involvement occurred in seven cases. Wide local excision was the treatment most often employed. Cases followed for two years or more had a recurrence rate of 13.0%. The remaining seven neoplasms in the combined data comprised myoepithelioma, cystadenoma and sialadenoma papilliferum.

CONCLUSIONS

A relatively long duration (2 years) of a submucosal mass in a minor salivary gland-bearing area with or without bone involvement occurring in a child or adolescent should raise the question of a possible salivary gland neoplasm. A pleomorphic adenoma is the most common benign salivary gland neoplasm in the first and second decade of life. Complete surgical excision affords the best chance of preventing recurrence for pleomorphic adenomas. The recurrence rate of pleomorphic adenomas with two or more years follow-up is 13.0%. Other types of minor salivary gland neoplasms are exceedingly rare and therefore data is sparse, precluding any valid conclusions.

Pleomorphic adenoma of the palate

Pleomorphic adenoma is the most common mixed benign tumor of major salivary glands. Approximately 80% of these tumors arise in the parotid gland, whereas 7% arise in the minor salivary glands. The most common sites for minor salivary gland where pleomorphic adenoma arises are the palates followed by lips and cheek. We report a palate mass in a 46-year-old male patient. The initial cytologic diagnosis by fine-needle aspiration biopsy was pleomorphic adenoma. This report describes a case of pleomorphic adenoma regarding all distinctive diagnoses with the review of the literature.

Pleomorphic adenoma of the palate

Pleomorphic adenoma (PA) is the most common salivary gland tumor, accounting for about 40-70% of all major and minor salivary gland tumors. The commonest sites for intraoral PA are palate, buccal mucosa and lips. Palatal PA presents clinically as a painless, slow-growing mass found on posterior lateral aspect. The aim of this article is to present a case of palatal PA, which was treated successfully by surgical excision.

Pleomorphic Adenoma of Minor Salivary Gland in a 14 year Old Child

Salivary gland tumours are rare in childhood, and almost all of them occur in parotid gland. Minor salivary gland tumours are even rarer, pleomorphic adenoma being the most frequently found tumour. Only seventeen cases of pleomorphic adenoma arising in the minor salivary gland tumour have been reported in children and adolescents. Pleomorphic adenoma of minor salivary gland represents about 45% of all the tumours of the minor salivary glands. Pleomorphic adenoma is slowly enlarging tumour indistinguishable from adenoid cystic carcinoma clinically, except for pain and ulceration, which is more common in the latter. Carcinoma arising from pleomorphic adenoma has been reported in 3% cases amongst the minor salivary gland tumours. This report presents a case of pleomorphic adenoma of minor salivary gland in a 14 year old female patient with a brief review of literature.