Browse > Article

CLINICOPATHOLOGIC STUDY OF PLEOMORPHIC ADENOMA IN MINOR SALIVARY GLANDS  

Baik, Seok-Kee (Dept. of Oral & Maxillofacial Surgery, Yonsei University)
Cha, In-Ho (Dept. of Oral & Maxillofacial Surgery, Yonsei University)
Kim, Jin (Dept. of Oral Pathology College of Dentistry, Yonsei University)
Lee, Eui-Wung (Dept. of Oral & Maxillofacial Surgery, Yonsei University)
Publication Information
Journal of the Korean Association of Oral and Maxillofacial Surgeons / v.29, no.2, 2003 , pp. 116-122 More about this Journal
Abstract
Pleomorphic adenoma is the most common salivary neoplasm mainly occurring in the major salivary glands - especially in parotid gland, which is characterized by variable histopathologic appearances and high recurrence rate with malignant transformation according to surgical situations. And this benign mixed tumor occurring in minor salivary glands is believed to shows same clinicopathologic appearances and relatively low recurrent rate compared with the case in major salivary glands. But there are few comparative studies of large series of pleomorphic adenoma occurring in minor salivary glands which includes different histopathologic appearance, clinical characteristics, treatment methods, recurrence rate, and malignant transformation. We retrospectively studied the 54 patients who were pathologically confirmed with pleomorphic adenoma occurring in minor salivary glands, and analyzed the clinico-histopathological appearance, surgical methods, recurrent cases. The results obtained are as follows. 1. The incidence of the tumor was most frequent in 4th & 5th decade, and in female. 2. Palate(90%) including hard & soft palate was the most frequent site for pleomorphic adenoma in minor salivary glands. 3. The exact duration could not be known due to asymptomatic slow growth patterns of the tumor. 4. The mean tumor size was 2.3cm. 5. 28 (52%) pleomorphic adenomas were classified as Cellular type (cell-rich), 17 (31%) specimen as Intermediate type(equal cell to stroma ratio), and 9 (17%) as Myxoid type(stroma-rich). 6. Surgically 51 cases (94%) were showed well-encapsulated tumors, but histopathologically only 34 specimen (63%) were wellencapsulated. Therefore pleomorphic adenomas in minor salivary glands also have to be excised more widely, not enucleated. And in case of suspicious malignancy or large tumor, preoperative incisional biopsy can be applied in the center of the tumor for prevention of rupture of tumor cell, and total excision with use of frozen biopsy for detection of malignancy and confirming the excision margin, and closed follow-up according to final histopathologic results is recommended.
Keywords
Minor salivary glands; Pleomorphic adenoma; Encapsulation; Excision;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Lopes MA, Kowalski LP, Santos GC, Almeida OP: A Clinicoplathologic study of 196 intraoral minor salivary gland tumors. J Oral PAthol Mod 28 264-267, 1999.
2 Waldron CA, El-Mofty SK, Gnepp DR, St. Louis: Tumors of the intraoral minor salivary glands: A demographic and histologic study of 426 cases. Oral Surg Oral Med Oral Pathol 66:323-333, 1988.   DOI   ScienceOn
3 Bardwil JM, Reynolds CT, Ibanez ML, Luna MA: Report of one hundred tomors of the minor salivary glands. Am J Surg 112:493-497, 1966.   DOI   ScienceOn
4 Bradley PJ: Recurrent salivary gland pleomorphic adenoma: etiology, management, and results. Curr Opin Otolaryngol Head Neck Surg 9:100-108, 2001.   DOI   ScienceOn
5 Kanazawa T, Nishino H, Ichimura K: Pleomorphic adenoma of the pterygopalatine fossa: A case report. Eur Arch Oto Rhino Laryngol 257:433-435, 2000.   DOI   ScienceOn
6 Seifert G, Miehlke A, Haubrich J, Chilla R: Diseases of the Salivary Glands. Georg Thieme Verlag. 1992.
7 Kusama K, Iwanari S, Aisaki K, Wada M, Ohtani J, Itoi K, Hanai KI, Shimizu K, Komiyama K, Kudo I, Moro I: Intraoral minor salivary gland tumors: a retrospective study of 129 cases. J Nihon Univ Sch Dent 39:128-132, 1997.   DOI   PUBMED   ScienceOn
8 Pogrel MA: The management of salivary gland tumors of the palate. J Oral Maxillofac Surg 52:454-459, 1994.   DOI   ScienceOn
9 Natvig K, Soberg R: Relationship of intraoperative rupture of pleomorphic adenomas to recurrence: an 11-25 year follow-up study. Head Neck 16:213-217, 1994.   DOI   ScienceOn
10 Kesse KW, Manjaly G, Howlett DC, Pahor AL: Pleomorphic adenoma of retropharyngeal space: A rare location. J Laryngol Otol 114:639-640, 2000.   PUBMED
11 Motomura H, Harada T, Muraoka M, Taniguchi T: Elongated uvula with a pleomorphic adenoma: A rare cause of obstructive sleep apnea syndrome. Ann Plast Surg 45:61-63, 2000.   DOI   ScienceOn
12 Krolls SO, Boyers RC: Mixed tumors of salivary glands: Long term follow-up. Cancer 30: 276, 1972.
13 Mcgurk M, Renehan A, Gleave EN, Hancock BD: Clinical significance of the tumor capsule in the treatment of parotid pleomorphic adenomas. Br J Surg 83:1747-1749, 1996.   DOI   ScienceOn
14 Beckhardt RN, Weber RS, Zane R, Garden AS, Carrillo R, Luna MA: Minor salivary gland tumors on palate: Clinical and pathologic correlates of outcome. Laryngoscope 105:1155-1160, 1995.   DOI   ScienceOn
15 Batsakis JG, Kraemer B, Sciubba JJ: The pathology of head and neck tumors: The myoepithelial cell and its participation in salivary gland neoplasia, part17. Head Neck Surg 5:222-233, 1983.   DOI   ScienceOn
16 Sunger N, Akan IM, Ulusoy MG, O¨zdemir R, Kilin H, Ortak T: Clinicopathologic Evaluation of Parotid gland tumors: A REtrospective study. J Craniofac Surg 13:26-30, 2002.   DOI   ScienceOn
17 Pontius AT, Myers LL: Pleomorphic adenoma of the buccal space. Otolaryngol Head Neck Surg 126:695-696, 2002.   DOI   PUBMED   ScienceOn
18 Stennert E, Lichius OG, Klussmann JP, Arnold G: Histopathology of Pleomorphic Adenoma in the Parotid gland: A Prospective Unselected Series of 100 Cases. Laryngoscope 111:2195-2200, 2001.   DOI   ScienceOn
19 To EWH, Tsang WM, Tse GMK: Pleomorphic adenoma of the lower lip: Report of a case, J Oral Maxillofac Surg 60:684-686, 2002.
20 Rigual NR, Milley P, Lore JM, Kaufman S: Accuracy of frozen-section diagnosis in salivary gland neoplasms. Head Neck Surg 8:442-446, 1986.   DOI   ScienceOn
21 Phillips PP, Olsen KD: Recurrent pleomorphic adenoma of the parotid gland: Report of 126 cases and a review of the literature. Ann Otol Rhinol Laryngol 104:100-104, 1995.   DOI   PUBMED
22 Dardick I, Nostrand AW: Myoepithelial cells in salivary gland tumors-revisited. Head Neck Surg 7:395-408, 1985.   DOI   ScienceOn
23 Jansisyamont P, Blanchaert RH, Ord RA: Intraoral minor salivary gland neoplasm: a single institution experience of 80 cases. Int J Oral Maxillofac Surg 31:257-261, 2002.   DOI   ScienceOn
24 Yoav PT : View from beneath: Pathology in focus, true malignant mixed tumors of the parotid gland. J Laryngol Otol 104:360, 1990.
25 Buchman C, Stringer SP, Mendenhall WM, Parsons JT, Jordan JR, Cassisi NJ: Pleomorphic Adenoma: Effect of tumor spill and inadequate resection on tumor recurrence. Laryngoscope 104:1231-1234, 1994.   PUBMED
26 Bradley PJ: Recurrent salivary gland pleomorphic adenoma: etiology, management, and results. Curr Opin Otolaryngol Head Neck Surg 9:100-108, 2001.   DOI   ScienceOn
27 Cawson RA, Langdon JD, Everson JW: Surgical pathology of the mouth and jaws. Wright co. 1996.
28 Ellis GL, Auclair PL, Gnepp DR: Surgical Pathology of the Salivary Glands. W.B Saunders co. vol 25, 1991.
29 Spiro RH, Koss LG, Hajdu SI, Strong EW: Tumors of minor salivary origin Cancer 31:117-129, 1973.
30 Henriksson G, Westrin KM, Calsoo B, Silfversward C: Recurrent Primary Pleomorphic Adenomas of Salivary Gland Origin. Cancer 82:617-620, 1998.   DOI   ScienceOn
31 Yiotakis I, Dinopoulou D, Ferekids E, Monolopoulos L, Admopoulos G: Pleomorphic adenoma of the nose. Rhinology 39:55-57, 2001.   PUBMED