Pleomorphic adenoma overview: Difference between revisions
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==Overview== | ==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. Pleomorphic adenoma was first described by Minssen in Ahlbom's monograph in 1874. Mark and Dahlenfors in 1986 and Bullerdiek et al. in 1987 found clonal chromosome abnormalities related to pleomorphic adenoma, with a preponderance of aberrations involving 8q12. Pleomorphic adenoma can be classified on the basis of the histological appearance into 4 subgroups<ref name="pmid1002574">{{cite journal |vauthors=Seifert G, Langrock I, Donath K |title=[A pathological classification of pleomorphic adenoma of the salivary glands (author's transl)] |language=German |journal=HNO |volume=24 |issue=12 |pages=415–26 |date=December 1976 |pmid=1002574 |doi= |url=}}</ref>.Subgroup 1 (30,5%) is the classical pleomorphic adenoma with a stroma content of 30-50%, subgroup 2 (55%) has a stroma content of 80%,subgroup 3 (9%) has a poor stroma content of 20-30%,subgroup 4 has also a poor stroma content (6%). Pleomorphic adenoma shows chromosomal rearrangements involving PLAG1 and HMGA2.<ref name="MendozaJakobiec2013">{{cite journal|last1=Mendoza|first1=Pia R.|last2=Jakobiec|first2=Frederick A.|last3=Krane|first3=Jeffrey F.|title=Immunohistochemical Features of Lacrimal Gland Epithelial Tumors|journal=American Journal of Ophthalmology|volume=156|issue=6|year=2013|pages=1147–1158.e1|issn=00029394|doi=10.1016/j.ajo.2013.06.034}}</ref>. 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<ref name="PinkstonCole2016">{{cite journal|last1=Pinkston|first1=John A.|last2=Cole|first2=Philip|title=Incidence Rates of Salivary Gland Tumors: Results from a Population-Based Study|journal=Otolaryngology–Head and Neck Surgery|volume=120|issue=6|year=2016|pages=834–840|issn=0194-5998|doi=10.1016/S0194-5998(99)70323-2}}</ref>. 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.<ref name="pmid9279445">{{cite journal |vauthors=Swanson GM, Burns PB |title=Cancers of the salivary gland: workplace risks among women and men |journal=Ann Epidemiol |volume=7 |issue=6 |pages=369–74 |date=August 1997 |pmid=9279445 |doi= |url=}}</ref>. The most common presentation is a painless, slow growing and single palpable mass. | '''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. Pleomorphic adenoma was first described by Minssen in Ahlbom's monograph in 1874. Mark and Dahlenfors in 1986 and Bullerdiek et al. in 1987 found clonal chromosome abnormalities related to pleomorphic adenoma, with a preponderance of aberrations involving 8q12. Pleomorphic adenoma can be classified on the basis of the histological appearance into 4 subgroups<ref name="pmid1002574">{{cite journal |vauthors=Seifert G, Langrock I, Donath K |title=[A pathological classification of pleomorphic adenoma of the salivary glands (author's transl)] |language=German |journal=HNO |volume=24 |issue=12 |pages=415–26 |date=December 1976 |pmid=1002574 |doi= |url=}}</ref>.Subgroup 1 (30,5%) is the classical pleomorphic adenoma with a stroma content of 30-50%, subgroup 2 (55%) has a stroma content of 80%,subgroup 3 (9%) has a poor stroma content of 20-30%,subgroup 4 has also a poor stroma content (6%). Pleomorphic adenoma shows chromosomal rearrangements involving PLAG1 and HMGA2.<ref name="MendozaJakobiec2013">{{cite journal|last1=Mendoza|first1=Pia R.|last2=Jakobiec|first2=Frederick A.|last3=Krane|first3=Jeffrey F.|title=Immunohistochemical Features of Lacrimal Gland Epithelial Tumors|journal=American Journal of Ophthalmology|volume=156|issue=6|year=2013|pages=1147–1158.e1|issn=00029394|doi=10.1016/j.ajo.2013.06.034}}</ref>. 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<ref name="PinkstonCole2016">{{cite journal|last1=Pinkston|first1=John A.|last2=Cole|first2=Philip|title=Incidence Rates of Salivary Gland Tumors: Results from a Population-Based Study|journal=Otolaryngology–Head and Neck Surgery|volume=120|issue=6|year=2016|pages=834–840|issn=0194-5998|doi=10.1016/S0194-5998(99)70323-2}}</ref>. 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.<ref name="pmid9279445">{{cite journal |vauthors=Swanson GM, Burns PB |title=Cancers of the salivary gland: workplace risks among women and men |journal=Ann Epidemiol |volume=7 |issue=6 |pages=369–74 |date=August 1997 |pmid=9279445 |doi= |url=}}</ref>. The most common presentation is a painless, slow growing and single palpable mass. Pleomorphic adenoma is usually asymtomatic but some people present with dysphagia, hoarseness, difficulty with chewing. MRI is the imaging modality of choice for pleomorphic adenoma.<ref name="pmid8881252">{{cite journal |vauthors=Ikeda K, Katoh T, Ha-Kawa SK, Iwai H, Yamashita T, Tanaka Y |title=The usefulness of MR in establishing the diagnosis of parotid pleomorphic adenoma |journal=AJNR Am J Neuroradiol |volume=17 |issue=3 |pages=555–9 |date=March 1996 |pmid=8881252 |doi= |url=}}</ref>. Total parotidectomy is the mainstay of treatment for pleomorphic adenoma. The complications of parotidectomy include haematoma or haemorrhage, facial nerve palsy, frey's syndrome.<ref name="pmid9373550">{{cite journal |vauthors=Bjerkhoel A, Trobbe O |title=Frey's syndrome: treatment with botulinum toxin |journal=J Laryngol Otol |volume=111 |issue=9 |pages=839–44 |date=September 1997 |pmid=9373550 |doi= |url=}}</ref>. The prognosis of pleomorphic adenoma is excellent after complete surgical excision. | ||
==Historical Perspective== | ==Historical Perspective== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
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. Pleomorphic adenoma was first described by Minssen in Ahlbom's monograph in 1874. Mark and Dahlenfors in 1986 and Bullerdiek et al. in 1987 found clonal chromosome abnormalities related to pleomorphic adenoma, with a preponderance of aberrations involving 8q12. Pleomorphic adenoma can be classified on the basis of the histological appearance into 4 subgroups[1].Subgroup 1 (30,5%) is the classical pleomorphic adenoma with a stroma content of 30-50%, subgroup 2 (55%) has a stroma content of 80%,subgroup 3 (9%) has a poor stroma content of 20-30%,subgroup 4 has also a poor stroma content (6%). Pleomorphic adenoma shows chromosomal rearrangements involving PLAG1 and HMGA2.[2]. 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[3]. 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.[4]. The most common presentation is a painless, slow growing and single palpable mass. Pleomorphic adenoma is usually asymtomatic but some people present with dysphagia, hoarseness, difficulty with chewing. MRI is the imaging modality of choice for pleomorphic adenoma.[5]. Total parotidectomy is the mainstay of treatment for pleomorphic adenoma. The complications of parotidectomy include haematoma or haemorrhage, facial nerve palsy, frey's syndrome.[6]. The prognosis of pleomorphic adenoma is excellent after complete surgical excision.
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Xyz from Other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications, and Prognosis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X-ray
Echocardiography and Ultrasound
CT scan
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Interventions
Surgery
Primary Prevention
Secondary Prevention
References
- ↑ Seifert G, Langrock I, Donath K (December 1976). "[A pathological classification of pleomorphic adenoma of the salivary glands (author's transl)]". HNO (in German). 24 (12): 415–26. PMID 1002574.
- ↑ Mendoza, Pia R.; Jakobiec, Frederick A.; Krane, Jeffrey F. (2013). "Immunohistochemical Features of Lacrimal Gland Epithelial Tumors". American Journal of Ophthalmology. 156 (6): 1147–1158.e1. doi:10.1016/j.ajo.2013.06.034. ISSN 0002-9394.
- ↑ Pinkston, John A.; Cole, Philip (2016). "Incidence Rates of Salivary Gland Tumors: Results from a Population-Based Study". Otolaryngology–Head and Neck Surgery. 120 (6): 834–840. doi:10.1016/S0194-5998(99)70323-2. ISSN 0194-5998.
- ↑ Swanson GM, Burns PB (August 1997). "Cancers of the salivary gland: workplace risks among women and men". Ann Epidemiol. 7 (6): 369–74. PMID 9279445.
- ↑ Ikeda K, Katoh T, Ha-Kawa SK, Iwai H, Yamashita T, Tanaka Y (March 1996). "The usefulness of MR in establishing the diagnosis of parotid pleomorphic adenoma". AJNR Am J Neuroradiol. 17 (3): 555–9. PMID 8881252.
- ↑ Bjerkhoel A, Trobbe O (September 1997). "Frey's syndrome: treatment with botulinum toxin". J Laryngol Otol. 111 (9): 839–44. PMID 9373550.