Pleomorphic adenoma with extensive adipose content

Jin, Ying‐Tai; Lian, Junbo; Yan, Jianhua; Hwang, Tzer Zen; Tsai, Shih-Jei

doi:10.1046/j.1365-2559.1996.t01-2-258289.x

Cited by 32 publications

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“…Although scattered, isolated adipocytes might be encountered in classical pleomorphic adenomas more commonly if thoroughly searched for, pleomorphic adenomas and myoepitheliomas with extensive lipometaplasia comprising C20 % of the tumor is exceedingly uncommon with less than 15 reported cases in the English literature to date (10 pleomorphic adenomas and 5 myoepitheliomas) [3][4][5][6][7][8][9][10]. Approximately 80 % of tumors involved major salivary glands (11/12 in the parotid) with only three cases in minor glands.…”

Section: Pleomorphic Adenoma and Myoepithelioma With Lipometaplasiamentioning

confidence: 99%

Fat-Containing Salivary Gland Tumors: A Review

Agaimy

2013

Head and Neck Pathol

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Fat-containing tumors of the salivary glands are uncommon. Their wide histological spectrum varies from pure lipomatous neoplasms similar to their cutaneous and soft tissue counterparts to mixed lipoepithelial lesions specific to the salivary glands. With few exceptions, these uncommon lesions affect mainly the elderly, with a mean age at presentation of C50 years and show a predilection for males. A few cases occur in childhood; some of them represent congenital lesions. In decreasing order of frequency, ordinary (soft-tissue type) lipoma, oncocytic lipoadenoma, non-oncocytic sialolipoma, and pleomorphic adenoma/myoepithelioma with extensive lipometaplasia are the main variants of fat containing tumors encountered in the salivary glands. While pleomorphic adenoma/myoepithelioma with lipometaplasia behave in the same way as their non-fat-containing counterparts, other lipomatous salivary gland tumors listed above are cured with simple excision and do not carry a risk of recurrence. Other lipoma variants (spindle cell lipoma, osteolipoma, fibrolipoma, angiolipoma, pleomorphic lipoma, lipoblastoma and hibernoma) are exceptionally rare in the salivary gland. Atypical lipomatous tumors/liposarcoma have been only rarely reported in the salivary gland and they behave in a similar fashion to their soft-tissue counterparts. Diffuse lipomatosis and lobular fatty atrophy are the two tumor-like lesions that might closely mimic sialolipoma, particularly in limited biopsy material without knowledge of the gross findings. This review summarizes the clinicopathological features of the main types of salivary fat-containing lesions and discusses their differential diagnoses.

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Section: Pleomorphic Adenoma and Myoepithelioma With Lipometaplasiamentioning

confidence: 99%

Fat-Containing Salivary Gland Tumors: A Review

Agaimy

2013

Head and Neck Pathol

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“…A further variation in the appearance of pleomorphic adenoma is that sporadically, squamous [4], mucous, sebaceous [6], oncocytic [21] or osteoid metaplasia can be seen. Lipomatosis, in the form of isolated small islands or scattered single lipocytes, is uncommon [22], and a large amount of adipose tissue in a pleomorphic adenoma and myoepithelioma is a rarity [12,14]. Here, we present four cases of spindle cell myoepithelial-rich adenomas of the parotid gland with extensive adipose metaplasia.…”

Section: Introductionmentioning

confidence: 96%

Spindle cell myoepithelial tumours of the parotid gland with extensive lipomatous metaplasia

et al. 2001

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We report four cases of parotid gland tumours composed predominantly of spindle-shaped myoepithelial cells and mature adipocytes. The central portion of one tumour showed extensive adipose differentiation, whereas in the peripheral parts there were small foci of ductal epithelium arranged in cords and tubules within an abundant myxoid stroma. The other cases were adipose spindle cell myoepitheliomas without an obvious glandular component. Under high-power examination, a transition between modified spindle-shaped myoepithelial cells and adipocytes was observed, and this was confirmed with immunohistochemistry. Ultrastructurally, the modified myoepithelial cells showed intracytoplasmic tonofilaments, bundles of actin microfilaments and lipid droplets. A possible pathogenesis is proposed of true metaplastic transformation of myoepithelial cells to adipocytes. This lesion is important to identify correctly, as inadequate surgery can lead to recurrence.

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“…From the published literature, it is understood that these tumours have variable histological features. The difficulty in the subclassification of these tumours may be due to the reasons that a lipomatous component may be present in pleomorphic adenoma or myoepithelioma [5]. In the recent WHO classification of salivary gland tumours, subclassification include a heterogenous group of tumours termed as sialolipoma.…”

Section: Discussionmentioning

confidence: 99%

“…The amount of fatty tissue present in the reported cases of sialolipoma was in the range of 40%-70%. The presence of well-encapsulated tumour on gross examination differentiates sialolipoma from the fatty infiltration of the salivary gland tissue [5][6][7]. A minor subset of biphasic tumours with oncocyticlipo epithelial lesions have predominantly epithelial component, which is helpful in categorizing these as "lipoadenoma containing abnormal oncocytic component" or oncocytic lipoadenoma.…”

Section: Discussionmentioning

confidence: 99%

Oncocytic Lipoadenoma of Submandibular Gland: A Case Report

Parmar¹

2015

JCDR

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A 45-year-old gentleman presented to ENT outpatient clinic, Christian Medical College, Vellore, India with complaints of gradually progressive, painless, left sided neck swelling since past one year. It had increased in size over the past two months. There was no history of dryness of mouth, no intraoral discharge,dysphagia, fever, loss of weight or appetite or any comorbid medical illness. Neck examination revealed a 5 x 6 cm, well-defined, mass below the left angle of mandible with smooth surface and without any scars or sinuses over it. On palpation, the inspectory findings were confirmed. The swelling was non-tender, having well-defined borders with soft to firm consistency and was not fixed to overlying skin. There were no palpable lymph nodes in the neck. There was no intraoral swelling on bimanual examination. Based on these clinical findings a clinical diagnosis of salivary gland neoplasm was made, FNAC of the swelling was done but was inadequate for proper evaluation. Other possibilities of a soft tissue tumour and rare low grade lymphoma were kept in mind. Sialography was not indicated in this case and hence it was not carried out. Ct FindingsLeft salivary gland was enlarged with a large fatty lesion, 55mm x 45mm x 20mm, having a large mural component. Lesion had solid component in it measuring approximately 27 x 17 mm. with a few mottled densities [Table/ Fig-1]. There was no significant Pathology SectionOncocytic Lipoadenoma of Submandibular Gland: A Case Report lymphadenopathy. Surgery was done under general anaesthesia. Patient was positioned on a shoulder roll with head tilted to right side. Painting with betadine lotion was done followed by drapping. The incision was made in the skin crease 5cm below the angle of mandible and deepened through platysma. Both superficial and deep lobes were identified with preservation of mandibular nerve and hypoglossal nerve with ligation of facial artery and facial vein. A 5 × 5 cm large mass arising from the left submandibular gland was excised and submitted for histopathological examination. After securing complete hemostasis, cervical fascia and skin flaps were sutured back in position. Grossly, the tumour was lobulated, encapsulated mass with well-defined brown areas and adjacent greasy-yellow soft areas [Table/ Fig-2]. Histopathology examination revealed circumscribed tumour composed of lobules and sheets of oncocytes [Table /Fig-3,4]. Also, present were sheets and lobules of mature adipocytes, some of which are entrapped by the oncocytic nodules [Table /Fig-3,4]. There was patchy periductal chronic inflammation and fibrosis. There was focal sebaceous metaplasia at the edges of oncocytic nodules [Table/ Fig-5]. There was no evidence of lymphovascular or perineurial invasion or any extra capsular invasion. Immunohistochemistry was not indicated in this case due to obvious morphological findings, which were consistent with those mentioned in the literature. On a telephonic follow up, no recurrence of symptoms so far. Patient is due for a yearly follow-up duri...

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Pleomorphic adenoma with extensive adipose content

Cited by 32 publications

References 0 publications

Fat-Containing Salivary Gland Tumors: A Review

Fat-Containing Salivary Gland Tumors: A Review

Spindle cell myoepithelial tumours of the parotid gland with extensive lipomatous metaplasia

Oncocytic Lipoadenoma of Submandibular Gland: A Case Report

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