Heterotopic ossifying tumors in head and neck and heterotopic ossification and calcification

Ossifying Parotid Carcinoma ex Pleomorphic Adenoma

“…Ossification is a complex, incompletely understood process that depends on the local concentrations of calcium and phosphate, pH, calcium-binding protein, alkaline phosphatase, and proteoglycans [ 6 ]. Heterotopic ossification in tumor stroma is a well-known phenomenon in epithelial tumors of the breast, kidney, ovary, and digestive tract.…”

“…In the head and neck, the tongue is the most common site, while, in contrast, parotid tumor calcification is rare. When present, however, ossification in parotid masses is highly suggestive of pleomorphic adenoma [ 4 , 6 ]. PAs commonly contain mucoid, chondromyxoid, or hyalinized mesenchymal-like elements, but reports of extensive stromal ossification are limited [ 6 – 8 ].…”

“…When present, however, ossification in parotid masses is highly suggestive of pleomorphic adenoma [ 4 , 6 ]. PAs commonly contain mucoid, chondromyxoid, or hyalinized mesenchymal-like elements, but reports of extensive stromal ossification are limited [ 6 – 8 ]. Furthermore, whether this ossification is endochondral, originating from a cartilaginous precursor, or due to direct deposition by metaplastic myoepithelial cells within the tumor remains unclear.…”

“…The differential diagnosis of calcified parotid or parapharyngeal tumors is broad and includes pleomorphic adenoma, soft tissue chondroma or osteoma, extracranial meningioma, osteocartilaginous tumors arising from bone exostoses [ 7 ], vascular ossification of atherosclerotic lesions, or hereditary conditions such as Albright's syndrome and fibrodysplasia ossificans progressiva [ 6 ]. This case emphasizes the importance of clinical suspicion for a malignancy in the presence of an ossified mass.…”

A Rare Case of Multiple Calcifications and Vascular Malformation Within the Parenchyma of the Parotid Salivary Gland Coinciding With an Intracranial Meningioma

“…Differential diagnosis of this present case could include pleomorphic adenoma, soft tissue chondroma or osteoma, extracranial meningioma, osteocartilaginous tumors arising from bone exostoses, [37] vascular ossification of atherosclerotic lesions, or hereditary conditions such as Albright's syndrome and fibrodysplasia ossificans progressive. [38] In the present case, the patient was referred to an ENT surgeon and a Neurosurgeon to exclude any possible malignancies. The importance of clinical suspicion for a malignancy in the presence of a calcified mass has been highlighted in literature.…”