Metastasizing pleomorphic adenoma of the parotid gland

Unusual metastasizing pleomorphic adenoma of the parotid gland involving locoregional lymph nodes

Carcinoma ex-pleomorphic adenoma (PA) is a complex group of malignant neoplasms arising in PA. When microscopic features of the neoplastic cells are representative of carcinoma, the pathologist can easily make a definite diagnosis, but when worrisome morphology is replaced by metastatic behavior, the metastasizing PA (MPA) is a diagnostic challenge for the pathologist. Here, we present an unusual MPA to cervical lymph nodes and discuss diagnostic challenges.

Pleomorphic Adenoma of the Submandibular Gland with Skull Metastasis: A Case Report

Metastasizing pleomorphic adenoma is a rare entity that has the propensity for distant metastasis despite being histologically benign. We report the case of a 56-year-old woman with a long-standing right upper neck swelling and a recent-onset swelling over the left side of the scalp. Clinical workup did not reveal any other tumor deposits in the body. Complete excision of the right submandibular gland and the scalp swelling was performed. The case was diagnosed as metastasizing pleomorphic adenoma. The exact cause of the malignant manifestation of this histologically benign entity is unclear. The time of appearance of a metastatic deposit is highly variable and is usually preceded by a local recurrence. Further research on the malignant behavior of this entity is warranted.

Metastasizing pleomorphic adenoma of parotid gland: Case report

Pleomorphic adenoma is a benign tumor and the most common salivary gland neoplasm. Metastasizing pleomorphic adenoma shares histological characteristics with pleomorphic adenoma but exhibits malignant behavior, including local lymph node involvement and/or distant metastasis. Several potential risk factors for metastasizing pleomorphic adenoma have been identified, some of which are associated with incomplete tumor clearance due to inadequate surgical techniques used in the treatment of primary pleomorphic adenoma. Here, we present a rare case of metastasizing pleomorphic adenoma originating from the parotid gland and describe its clinical features. The patient was a 75-year-old female with a surgical history of enucleation of a pleomorphic adenoma in the left parotid gland. Total parotidectomy and left neck dissection were performed for the left parotid tumor this time, and the patient attended one postoperative outpatient visit but subsequently was lost to follow-up.

An unusual cytological presentation of solid pseudopapillary neoplasm of the pancreas mimicking adenoid cystic carcinoma: a case report and literature review

Endoscopic ultrasound-guided fine-needle aspiration has become the common procedure for the diagnosis of pancreatic mass, and cytological examination is usually the first approach. Solid pseudopapillary neoplasm (SPN) cytologically represents papillary structures of branching capillaries surrounded by discohesive neoplastic cells. However, it may present various degrees of tissue degeneration, causing diagnostic challenges. Here, we report a 21-year-old female who had a 2-cm-sized mass in the pancreas head. Cytological examination revealed clumps of small round/oval cells that represented microcystic configurations with mucus, mimicking adenoid cystic carcinoma or mucinous adenocarcinoma. Cercariform cells, nuclear grooves/folding, and cytoplasmic vacuoles were not observed. Histopathological examination revealed confluent small glandular structures containing acidic mucus. The tumor cells were positively stained for β-catenin, CD10, and CD56, and negative for chromogranin A and E-cadherin, suggesting SPN, micropseudocystic variant. This variant has been scarcely described, but we should recognize it for accurate cytological triage of pancreatic tumors.

Metastasizing pleomorphic adenoma of the parotid gland: A common tumour with a very unusual presentation

Metastasizing pleomorphic adenoma is recognized as a subtype of pleomorphic adenoma in WHO classification 5th edition of salivary glands. The controversy pertaining to the entity is the benign features of the disease even at a metastatic site. We present a rare case of left recurrent pre-auricular swelling in a young male reported as metastasizing pleomorphic adenoma. A nineteen-year-old male presented with left preauricular swelling seven years ago which was diagnosed as pleomorphic adenoma and underwent complete excision of tumour. The tumour recurred twice - two and five years after the surgery. At the second recurrence, the level II neck dissection showed multiple encapsulated deposits of pleomorphic adenoma having similar morphology in the cervical soft tissue with no features of high-grade transformation.

Metastasizing Pleomorphic Adenoma of Parotid Gland: A Case Report and Literature Review

The authors hereby present a case report of metastasizing pleomorphic adenoma (MPA) of the parotid gland with multiple metachronous cervical lymph node metastases and sternocleidomastoid muscle infiltration. Diagnostic evaluation, surgical management, and follow-up are discussed along with a brief review of the literature.

Treatment of relapses of benign latero-cervical pathology: a narrative literature review

Benign laterocervical pathologies are not without pitfalls. Many may relapse after many years and, sometimes, they cannot be predicted. The purpose of this review is to describe the surgical measures necessary for the treatment of relapses of the most common benign laterocervical masses. We searched PubMed, Embase and Cochrane Central Register of Controlled Trials databases for articles describing the treatment of the most common benign cervical disease recurrences, and summarised available evidence in this narrative review. We overviewed observations about recurrent benign mixed tumour (pleomorphic adenoma), parapharyngeal space tumours and carotid body paragangliomas, thyroglossal duct anomalies and branchial cleft anomalies. Proper surgical technique is crucial for safely and effectively managing the relapses of benign latero-cervical diseases. Radiotherapy is indicated in several cases of recurrence such as pleomorphic adenoma and unresectable paraganglioma. Long-term follow-up is of utmost importance to promptly recognise and treat recurrencies.

Solitary Scalp Metastases of Parotid Pleomorphic Adenoma: A Case Report

Pleomorphic adenoma (PA) of the parotid gland is considered one of the commonest benign salivary gland neoplasms in both adults and pediatrics. However, metastatic pleomorphic adenoma (MPA) is extremely rare. In the past three decades, multiple cases were reported in the literature of MPA, where the metastatic phase has been preceded by a local recurrence for the majority of the cases. Metastases to the lungs, liver, bone, head and neck were reported. This paper will discuss a rare case presentation of MPA that metastasised solely to the face and scalp subcutaneous tissue with no other sites of metastases in a male adult.

Metastasising Pleomorphic Adenoma: A Rare Entity

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.

A case of initially metastasizing pleomorphic adenoma of parotid gland

Metastasis of pleomorphic adenoma (PA) is rare and usually presented as a locoregional recurrence developed many years after excision of the primary tumor although the PA is the most common neoplasm in the parotid gland. We described a case of a 48-year-old male with a parotid tumor with multiple enlarged ipsilateral lymph nodes which suggested a malignancy. The tumors had been neither evaluated nor excised and preoperative evaluation revealed benign PA in both lesions. After the complete surgical excision, the final pathology was notable for benign PA with metastasis to regional lymph nodes. At 1 year follow up he was clinically and radiographically free of disease. This implies that pleomorphic adenoma can occur as initially metastasis to regional lymph node even though benign neoplasm.

Maxillofacial diagnostic features of the enigmatic metastasizing pleomorphic adenoma

Considering the confusion in the literature regarding local recurrence, spread, or metastases of pleomorphic adenoma (PA) in the head and neck region, the aim of this study was to enhance understanding of the characteristics of metastasizing pleomorphic adenoma (MPA) by reviewing the literature and presenting a case. English language articles with proof of metastases were included in the literature review. Of the 80 cases in the literature with MPA, 46 were female and 33 were male (sex missing for one case). Thirty-five percent of the neoplasms affected the bones; the maxilla was affected in five cases and the mandible in three. The parotid was the primary site in 72.5% of cases and the submandibular gland in 16.2% of cases. The local recurrence rate was 70%. The mean interval between primary PA and MPA was 15.52 years. The total mortality rate was 8.7%. A case of PA of the submandibular gland that recurred after surgical excision and metastasized (confirmed by the presence of intact cortical borders) to the ipsilateral mandibular body, upper lip, and neck is described. The high mortality rate in a histologically defined benign disease that metastasizes demands that management include careful primary excision and long-term clinical follow-up.