Pleomorphic adenoma (patient information)

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Pleomorphic adenoma

Overview

What are the symptoms?

What are the causes?

Who is at highest risk?

When to seek urgent medical care?

Diagnosis

Treatment options

Prevention

Where to find medical care for Pleomorphic adenoma?

What to expect (Outlook/Prognosis)?

Possible complications

Prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Maneesha Nandimandalam, M.B.B.S.[2]

Overview

Pleomorphic adenoma also known as ("Benign mixed tumor of the salivary glands") is a benign neoplastic tumor of the salivary glands. It is the most common type of salivary gland tumor and the most common tumor of the parotid gland. In 1874, pleomorphic adenoma was first described by Minssen in a monograph named Ahlbom's. Later Mark and Dahlenfors in 1986 and Bullerdiek et al. in 1987 found some clonal chromosome abnormalities related to pleomorphic adenoma, with a majority of aberrations involving 8q12. Pleomorphic adenoma can be classified on the basis of the histological appearance into 4 subgroups. Subgroup 1 is the classical pleomorphic adenoma with a stroma content of 30-50%, subgroup 2 has a stroma content of 80%, subgroup 3 has a poor stroma content of 20-30%, subgroup 4 has also a poor stroma content (6%). Pleomorphic adenoma shows chromosomal transposition mainly involving PLAG1 and HMGA2. Pleomorphic adenoma's are usually firm, mobile, well demarcated and encapsulated on gross apperance. On microscopy it is characterized by both epithelial elements and stromal matrix which can be either hyaline, myxoid or cartilaginous. The incidence of pleomorphic adenoma is approximately 2-3.5 cases per 100,000 population. Females are predominantly affected by Pleomorphic adenoma than males. The various risk factors for the development of pleomorphic adenoma are prior irradiation to head and neck, working in rubber, asbestos industries. The most common presentation is a painless, slow growing and single palpable mass. Pleomorphic adenoma is usually asymptomatic but some people present with dysphagia, hoarseness, difficulty with chewing. MRI is the imaging modality of choice for pleomorphic adenoma. Total parotidectomy is the mainstay of treatment for pleomorphic adenoma. The complications of parotidectomy include haematoma or haemorrhage, facial nerve palsy, frey's syndrome. The prognosis of pleomorphic adenoma is excellent after complete surgical excision.

What are the symptoms of pleomorphic adenoma?

What causes (disease name)?

Who is at highest risk?

The risk factors for the development of Pleomorphic adenoma are as follows:

Diagnosis

  • Physical examination of the tumor is always done first.
  • CT is usually the first imaging modality of choice for pleomorphic adenoma.
  • It helps in identifying the lesion and also helps the physician in assessing the extension of the tumor.
  • MRI is the usually ordered investigation next after CT, for an even more detailed study.
  • It is a non-ionizing modality with excellent soft tissue distinction.
  • FNA and biopsy is the definitive method of diagnosis for pleomorphic adenoma.

When to seek urgent medical care?

  • This section should focus on the symptoms that may indicate impending life threatening situations, or significant worsening.
  • For an example of a section detailing this on a patient information page, click here

Treatment options

Where to find medical care for pleomorphic adenoma?

Medical care for pleomorphic adenoma can be found here.

Prevention

What to expect (Outlook/Prognosis)?

Possible complications

Intra-operative complications include:

Post-operative complications include:

Apart from the above mentioned other complications include facial disfigurement and multiple recurrences.

Sources

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