• Maxillofacial Plastic and Reconstructive Surgery
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• v.13 no.4
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• pp.450-455
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• 1991

Pleomorphic adenoma is a circumscribed tumor characterized microscopically by its pleomorphic or mixed appearance, and its clearly recognizable tissue intermingled with areas of mucoid, myxoid, or chondroid appearance. Plemorphic adenoma, the most common tumor of the salivary glands, is now generally accepted as epithelial and benign, and therefore an adenoma. Pleomorphic adenoma occurs about 10 times more often in the parotid gland than in the submandibular gland, and is rare in the sublingual gland of the major salivary gland. And it occurs most often in the parotid and lip, but is very rare in the buccal mucosa of the minor salivary gland. The reported age of occurrence for pleomorphic adenoma ranges from 5 to 84 years, with a peak incidence during the third decade. We experienced a case of pleomorphic adenoma which occurring in buccal mucosa of 13-year-old boy. And so both the site of origin and age of occurrence make this case unusual. This lesion was treated with surgical excision. No specific change has seen in 1 year postoperative follow-up.

• Korean Journal of Head & Neck Oncology
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• v.19 no.2
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• pp.170-174
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• 2003

Pleomorphic adenoma is the most common benign tumor in the parotid gland and a parotidectomy with preservation of the facial nerve is a widely accepted treatment. We experienced a case of huge pleomorphic adenoma arising in the parotid gland with suspicious skin invasion. This present case was 67-year-old male presenting huge parotid mass $(12{\times}7cm)$ that has been present for 30 years and this tumor showed rapid-growing nature recently. The overlying skin surface was ulcerated with serous discharge and tightly adherent to the mass. The risk of malignant transformation of a pleomorphic adenoma increases with the duration of disease. The preoperative tentative diagnosis was carcinoma ex pleomorphic adenoma in the parotid gland. The initial pathologic diagnosis of fine needle aspiration biopsy was unsatisfactory smear. After parotidectomy, the histologic examination revealed that the parotid tumor was benign pleomorphic adenoma. We present a case of huge pleomorphic adenoma with skin invasion in the parotid gland with review of literatures.

• Korean Journal of Head & Neck Oncology
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• v.32 no.2
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• pp.15-18
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• 2016

Pleomorphic adenoma is the most common benign neoplasm of salivary glands. Pleomorphic adenoma can metastasis without malignant transformation. Metastasizing pleomorphic adenoma is equal to pleomorphic adenoma histologically yet metastasis to distant sites. Most Metastasizing pleomorphic adenoma are diagnosed many years following the initial treatment. 45-year-old man was found to have an asymptomatic right submandibular mass. A right submandibular gland excision and selective neck dissection was performed and pathology confirmed metastasizing pleomorphic adenoma. We report this case with a brief literature review.

• Korean Journal of Head & Neck Oncology
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• v.30 no.2
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• pp.71-73
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• 2014

Pleomorphic adenoma is the most common benign mixed salivary gland neoplasm that accounts for 65% of all benign salivary glands tumors. While the majority arises from the parotid, only a 10% arises from the minor salivary glands. Pleomorphic adenoma of minor salivary gland in the palate is a common entity. However, they occur in the lip, cheek, tongue oropharynx and nasal cavity etc., rarely. We experienced a case of a 80 years old female presented a 10 years history of a right cheek mass which was proved to the pleomorphic adenoma on the histopathologic examination. We resected the mass and obtained good postoperative results. We report this case with a review of literature.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.5
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• pp.348-352
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• 2020

Pleomorphic adenoma is the most prevalent benign tumor of the parotid gland, and shows potential malignancy. Carcinoma ex pleomorphic adenoma (CXPA) can occur in 3%-15% of pleomorphic adenoma cases. Owing to its clinical similarity to benign tumors, critical information related to CXPA can be easily overlooked, leading to frequent misdiagnosis of the condition. In this article, we report a rare case of CXPA found in the 55-year-old male patient with characteristic clinical, radiographic, and histological features, and subsequent treatment.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.4
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• pp.206-211
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• 2003

The pleomorphic adenoma is the most common neoplasm involving both the major and minor salivary glands. It is a benign, slowgrowing tumor, but local recurrences can occur. The pleomorphic adenoma gene 1 (PLAG1), which is a novel zinc finger gene, is frequently activated by reciprocal chromosomal translocations involving 8q12 in a subset of salivary gland pleomorphic adenomas. This experimental study was preformed to observe the translocation patterns between PLAG1 gene and the three translocation partner genes. We also have analyzed the presence of PLAG1 transcripts by RT-PCR. CTNNB1/PLAG1 gene fusion was observed in three of nine pleomorphic adnomas. However, LIFR/PLAG1 and SII/PLAG1 gene fusions were not detectable. All of three gene fusions was not detectable in one Warthin's tumor and three inflammatory salivary gland tissues. PLAG1 transcripts were expressed in all inflammatory salivary gland tissues and tumors except for three pleomorphic adenomas. Of particular one pleomorphic adenoma showing CTNNB1/PLAG1 gene fusion did not express PLAG1 transcipt. Our data indicate that gene fusion involving PLAG1 is a frequent event in pleomorphic adenoma, but correlation between gene fusion involving PLAG1 and PLAG1 transcription is not definite.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.3
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• pp.247-255
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• 2007

The bone morphogenic protein(BMP) can promote migration and growth of mesenchymal cells and initiate process for bone and cartilage formation. Cartilage-derived morphogenic protein(CDMP)-1 and -2 belong to the bone morphogenetic protein family in the transforming growth factor(TGF)-${\beta}$ superfamily. Although pleomorphic adenoma of the salivary glands is an epithelial tumor, it frequently shows ectopic cartilaginous formation with biomolecular studies. The mechanism of pathogenesis in cartilaginous formation is still controversy. We examined the expression and localization of CDMP-1 and -2, in comparison with the localization of cartilaginous matrix proteins, in human normal salivary glands and 20 cases of pleomorphic adenoma using immunohistochemical methods. The results were followed. 1. CMP-1 was immunolocalized in the striated ducts and the intercalated ducts, but not expressed in excretory duct, CDMP-2 was not expressed in the normal salivary glands. 2. CMP-1 was immunolocalized in the ductal cell and cuboidal neoplastic myoepithelial cells around the chondroid areas of the pleomorphic adenomas, whereas these molecules were not localized in the spindle-shaped neoplastic myoepithelial cells of the myxoid element in these tumors. CDMP-2 was expressed neither in normal salivary glands nor in any elements of the pleomorphic adenomas. 3. In transmission electron microscopic view, the tumor cells are composed of modifed myoepithelial cells between hyaline and myxoid stroma. 4. In Immuno-blot analysis, strong overexpression of CDMP-1 was frequently seen in pleomorphic adenomas, but the level of CDMP-2 was expressed minimally in pleomorphic adenoma. From the these results, it should be suggested that undifferentiated neoplastic myoepithelial cells around the chondroid areas expressed CDMP-1 and suggested that this molecule may play a role in the differentiation of neoplastic myoepithelial cells in pleomorphic adenoma, but not CDMP-2.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.1
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• pp.53-56
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• 2010

Carcinoma ex pleomorphic adenoma is transformed at the incidence of 1-20% in pleomorphic adenoma and frequently recurred. It accounts for 10% of all malignant salivary tumors and its average age of occurrence is 60s. It will present in a large, long-standing pleomorphic adenoma or in one that was previously treated but has recurred. According to cell composition in malignant cell carcinoma, and clear cell adenocarcinoma. Most (75%) occur in parotid gland, while about 20% occur in the minor gland of the oral mucosa. The metastasis rate to regional lymph node is about 25%, and to distant organs about 33% and the 5-year survival rates are 40%. Though the treatment of the carcinoma ex pleomorphic adenoma is not established, it is treated ideally with and extensive resection, neck dissection, postoperative radiotherapy, and chemotherapy. When occurred in parotid gland, facial paralysis is reported. With a review of literatures, we report a case of carcinoma ex pleomorphic adenoma which operated with total parotidectomy and supraomohyoid neck dissection.

• Korean Journal of Head & Neck Oncology
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• v.14 no.1
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• pp.103-106
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• 1998

Pleomorphic adenoma is the most common tumor in the parotid gland and a parotidectomy with preservation of the facial nerve is a widely accepted treatment. With the advanced imaging methods such as CT scan or MRI and the developed surgical technique, the incidence of complications in parotid surgery declined considerably. However, when the tumor forms a huge mass after a prolonged period, surgeons tend to hesitate surgical treatment regarding the possibility of facial nerve injury and incomplete resection due to a malignant transformation of the tumor. And this is more likely when the huge tumor arised in the deep lobe of the parotid gland. We present a case of 39-year old man with a giant pleomorphic adenoma arising in the deep lobe of the parotid gland who was treated successfully by total parotidectomy without any complications. The size and weight of the tumor were 20x15x15cm and 1,100gm, respectively. In our experience, because pleomorphic adenoma is well encapsulated and not invasive to the adjacent tissue, even a giant pleomorphic adenoma arising in the deep lobe of the parotid gland can be treated by careful surgical resection with the preservation of the facial nerve.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.2
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• pp.116-122
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• 2003

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.