Carcinoma ex pleomorphic adenoma: Diagnostic dilemma and treatment protocol

Keerthi, R; Raut, Rohan; Vaibhav, N.; Ghosh, Abhishek

doi:10.4103/0975-962x.140840

Cited by 11 publications

(12 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[ 4 ] Histologically, Ca-ex-PA contains both benign PA and malignant component. [ 5 ] The pathogenesis of Ca-ex-PA is not clear, but it is hypothesized that this tumor is malignant from the beginning or is a malignant transformation of a recurrent or a long-standing PA[ 6 ] as longevity and recurrence appear to increase the risk of malignant transformation. Malignant changes are present in 1.3%–7.5% of PAs.…”

Section: Introductionmentioning

confidence: 99%

BRCA1/2 mutations in salivary pleomorphic adenoma and carcinoma-ex-pleomorphic adenoma

Irani¹,

Bidari-Zerehpoush²

2017

J Int Soc Prevent Communit Dent

View full text Add to dashboard Cite

Objectives:It is hypothesized that carcinoma-ex-pleomorphic adenoma (Ca-ex-PA) is malignant from the beginning or is a malignant transformation of a recurrent or a long-standing pleomorphic adenoma (PA). The accumulation of genetic instabilities is suggested to be the main reason for malignant transformation in PA. The aim of this study was to determine the prevalence of BRCA1/2 mutations in PA and Ca-ex-PA.Materials and Methods:A total of ninety salivary gland tumors (45 Ca ex-PA and 45 PA) were selected. Immunohistochemistry was performed for all samples. Analyses were conducted through SPSS software version 22.0 (SPSS, Inc., Chicago, IL, USA). Chi-square test was used to examine the differences between the variables. Significant level was set at 0.05.Results:In general, 93.3% of PA samples showed positive staining for BRCA1 (in myoepithelial cells); however, BRCA2 positivity was found in 60% of samples (in myoepithelial cells). Among 45 samples of Ca-ex-PA, 93.3% of showed positivity for BRCA1 and 80% of samples showed positivity for BRCA2. Chi-square test found differences between PAs and Ca-ex-PAs regarding BRCA1/2 mutations in ductal cells and myoepithelial cells (P = 0.007, 0.000), respectively.Conclusions:The present study found a trend toward the presence of BRCA1/2 mutations in PA and Ca-ex-PA samples. Patients with BRCA1/2 mutation carriers are excellent cases for therapies, such as the poly (ADP) ribose polymerase inhibitor.

show abstract

Section: Introductionmentioning

confidence: 99%

BRCA1/2 mutations in salivary pleomorphic adenoma and carcinoma-ex-pleomorphic adenoma

Irani¹,

Bidari-Zerehpoush²

2017

J Int Soc Prevent Communit Dent

View full text Add to dashboard Cite

show abstract

“…Rarely, some CEPAs can carry a slow grow for over decades of years, making diffi cult a timely diagnosis [2]. Indeed, the disease often poses a diagnostic challenge to clinicians and pathologists, given that, although the pathological assessment is the gold standard for making the diagnosis, histopathologically the tumor comprises a wide morphological spectrum with variable proportion of the malignant component [12,13].…”

Section: Discussion/conclusionmentioning

confidence: 99%

“…Pleomorphic adenoma is the most common benign SG tumor and it's characterized by epithelial-mesenchymal gland tissue proliferation [12]. In the rare cases that PA undergo malignant transformation, a CEPA shows up.…”

Section: Discussionmentioning

confidence: 99%

“…The accurate CEPA pathogenesis is still controversial because some authors believe that these tumors are malignant from the onset [15] and others defend that CEPA is the result of a carcinomatous transformation of a benign mixed pre-existing lesion [16]. This suggests that as the mixed tumor grows, the cells collect several transformations that may induce a carcinomatous change, justifying the fact that the risk of CEPA seems to be related with the PA duration [12].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Carcinoma Ex Pleomorphic Adenoma of the Uvula - Case Report

Costa¹,

Gonçalves²,

Carção³

et al. 2021

J Biomed Res Environ Sci

View full text Add to dashboard Cite

Introduction: Carcinoma Ex Pleomorphic Adenoma (CEPA) results from the malignant transformation of a benign tumor of the Salivary Glands (SG), the Pleomorphic Adenoma (PA). PA is considered the most common salivary tumor with a 5% risk of malignant transformation and its excision is recommended. CEPA is a rare tumor, corresponding to 3.6% of all salivary tumors and 11.6% of all GS carcinomas. About 18% of CEPAs affect minor SG, with the palate being the most common location. The present work serves to describe a case of a CEPA of the Uvula Minor SG (UMSG). Case Report: We present a case report of a 57-year-old patient, with no relevant medical history, referred to the ENT consultation due to the appearance and progressive growth of a painless uvula lesion. The objective ENT examination showed a 15 mm ulcerative-vegetating lesion with apparent origin on the posterior face of the uvula. The lesion was biopsied and histopathological examination identified the presence of a neoplasm of the minor SG, probably NOS adenocarcinoma. The patient underwent Computed Tomography (CT) scan that showed an irregularity of the uvula, with no signs of invasion of the remaining soft palate, without other significant pharyngo-laryngeal changes. The patient underwent partial pharyngectomy and bilateral selective cervical ganglion dissection, and the histopathology of the surgical specimen confirmed that it was an invasive CEPA, the malignant component of the tumor corresponding to a NOS adenocarcinoma of the UMSG. The patient has been followed up in the ENT consultation, with no signs so far of loco-regional recurrence. Discussion/Conclusion: In the presented case, the patient probably developed an undiagnosed PA that had become malignant over time. Given that it is a poor prognosis neoplasm, it’s essential that the ENT specialists are aware of this disease, in order to facilitate and anticipate the diagnosis and treatment as much as possible.

show abstract

“…If malignant transformation of a PA to a carcinoma ex pleomorphic adenoma (CA ex PA) does occur, the treatment and prognosis radically change. Surgery followed by radiation treatment is considered as the standard of care for a patient with CA ex PA. Generally, patients with CA ex PA have a poor prognosis with common regional metastases and high mortality [15]. The WHO reports that local or distant metastasis occurs in as many as 70% of cases and the 5-year survival rate is 25-65% [13].…”

Section: Discussionmentioning

confidence: 99%

An Unusual Variant of a Common Palatal Salivary Gland Tumor: Case Report of a Pleomorphic Adenoma with Significant Lipomatous Metaplasia

Shah

Moustafa

2018

Case Reports in Dentistry

View full text Add to dashboard Cite

Introduction Salivary gland tumors are relatively common in the junction of the hard and soft palate area of the oral cavity. Pleomorphic adenoma is considered the most common benign salivary gland tumor in this location. Some of the rarer subtypes of this tumor may have a misleading clinical presentation. Recognition of these variants is important since long-standing pleomorphic adenomas have the potential to become malignant. Case Presentation A healthy 24-year-old male was referred for a painless, large, slowly growing, exophytic swelling of the right hard and soft palate. Interestingly, the lesion was yellowish in color and soft to palpation, suggestive of an innocuous lipoma or cystic lesion. An incisional biopsy was performed and the diagnosis was consistent with pleomorphic adenoma with a significant adipose tissue component. The patient was referred to an oral surgeon and underwent a complete surgical excision. Upon two-year follow-up, the patient is doing well with no recurrences. Conclusion This case highlights a rare microscopic variant of pleomorphic adenoma with altered clinical presentation that led to an erroneous clinical diagnosis. The importance of taking a biopsy for definitive diagnosis and appropriate management is reinforced.

show abstract

Carcinoma ex pleomorphic adenoma: Diagnostic dilemma and treatment protocol

Cited by 11 publications

References 15 publications

BRCA1/2 mutations in salivary pleomorphic adenoma and carcinoma-ex-pleomorphic adenoma

BRCA1/2 mutations in salivary pleomorphic adenoma and carcinoma-ex-pleomorphic adenoma

Carcinoma Ex Pleomorphic Adenoma of the Uvula - Case Report

An Unusual Variant of a Common Palatal Salivary Gland Tumor: Case Report of a Pleomorphic Adenoma with Significant Lipomatous Metaplasia

Contact Info

Product

Resources

About