Extra-major salivary gland pleomorphic adenoma of the head and neck: a 10-year experience and review of the literature

Abstract

Pleomorphic adenomas, or benign mixed tumors, make up 65% of all salivary gland tumors. They also can be found as solid tumors in other parts of the head and neck region, such as the auditory canal, the eyelids, and the orbital area. In this study, we investigated extra-major salivary gland pleomorphic adenomas of the head and neck region retrospectively at a tertiary care center. Between March 1998 and June 2009, 37 patients underwent primary surgery for extra-major salivary gland pleomorphic adenoma of the head and neck. The duration of symptoms, radiographic findings, operative procedures, and pathologic findings were documented. Of the 37 patients enrolled, 22 were male and 15 were female, with a median age of 57 years. Tumors were found in the soft palate, hard palate, nasopharynx, orbital area, trachea, buccal mucosa, cheek, nasal septum, upper lip, lower eyelid, and external auditory canal. Cellular variant of the pleomorphic adenoma was found in four patients, while the remaining patients presented with the classic variant. No myxoid subgroup was noted in our study. Carcinoma ex pleomorphic adenoma was observed only in one patient for whom radical surgery was performed. Twenty-eight patients (76%) had long-term follow-ups, with the average follow-up period being 4.5 years. Local recurrence was observed in three patients, and they underwent revision surgery during the follow-up period. Our results indicate that extra-major salivary gland pleomorphic adenomas are most commonly found in the soft palate. Wide excision was the treatment of choice, although its efficacy might be compromised with cosmetics and functional structures of the head and neck. Therefore, long-term follow-up of patients is necessary.

Sinonasal Tract Adenoid Cystic Carcinoma Ex-Pleomorphic Adenoma: A Clinicopathologic and Immunophenotypic Study of 9 Cases Combined with a Comprehensive Review of the Literature

“…A review of publications in English (MEDLINE 1966-2012) was performed, with all cases reported as carcinoma ex-pleomorphic adenoma, malignant mixed tumor, carcinoma ex-mixed tumor of the sinonasal tract included in the review [8][9][10][11][12][13][14][15][16][17][18]. However, many cases were excluded if the lesion arose primarily in the oral cavity, upper lip or oropharynx or represented a different tumor type, or if the information was too generalized and nonspecific to make a meaningful interpretation of the demographics, histologic features, or patient outcome.…”

Sinonasal Tract and Nasopharyngeal Adenoid Cystic Carcinoma: A Clinicopathologic and Immunophenotypic Study of 86 Cases

“…The English literature contains many case reports, small series, and a few larger series, all of which focus on a particular feature. Specifically, the series often present all salivary gland tumor types together [39,40,57,67,89,91,97,99,106,[120][121][122][123][124][125][126][127], encompass all head and head anatomic sites, describe adenoid cystic carcinoma only but in all sites [5, 6, 12, 17, 22, 31, 32, 35, 39, 47, 50, 52, 57, 59, 66, 73, 75, 76, 87, 91-93, 98, 100, 101, 106, 112, 113, 117, 128-130], or only one subsite but all tumors combined. Many small series focus on the radiographic findings alone [36, 62, 88, 96, 99, 108-110, 112, 117, 131-134], or specifically address a particular therapy (radiation) [8,20,24,25,33,54,63,66,69,86,92,95,111] for all tumor types of a particular anatomic site.…”

Ceruminous Pleomorphic Adenoma of the External Auditory Canal: Two Case Reports and Review of the Literature

“…There was no sex predilection. Common symptoms related to primary PA of the EAC included obstruction of the EAC meatus, hearing loss, otalgia, and otorrhoea [3][4][5][6][7][8][9][10][11][12][13].…”

“…However, PA may also arise from the external auditory canal (EAC), although reports are very rare. Since 1951, when Mark and Rothberg published their first EAC pleomorphic adenoma report [2], at least 35 similar cases have been reported [3][4][5][6][7][8][9][10][11][12][13]. PA of the EAC is classified as a type of ceruminal gland tumour.…”