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Pleomorphic adenoma (or benign mixed tumor) is a common benign salivary gland neoplasm characterised by neoplastic proliferation of epithelial (ductal) cells along with myoepithelial components, having a malignant potentiality. It is the most common type of salivary gland tumor and the most common tumor of the parotid gland.
Benign tumour of the submandibular gland, also known as pleomorphic adenoma, presented as a painless neck mass in a 40-year-old man. At the left of the image is the white tumour with its characteristic cartilaginous cut surface.
In approximately 75% of cases ca ex PAs arise in a pleomorphic adenoma that is apparent when the tumour is excised. [2] In the other approximately 25% of cases the individual had a pleomorphic adenoma excised previously and the diagnosis is made based on (1) the presence of a carcinoma, and (2) the history of a pleomorphic adenoma at that location.
Pleomorphic adenomas may recur after a very long time from primary surgery, on average over 7–10 years and up to 24 years. [10] [11] Survival rates due to malignancy depends on the patient and extent of disease. [4] A 10-year survival ranges from 32-83%. [4] Of all cancers, salivary gland tumors account for only 1%. [4] Parotid tumors account ...
Relative incidence of parotid tumors, with Warthin's tumor near top right. [4] The gland most likely affected is the parotid gland. In fact, it is the only tumor virtually restricted to the parotid gland. Warthin's tumor is the second most common benign parotid tumor after pleomorphic adenoma, but its prevalence is steadily increasing. [5]
The myoepithelial cells may be spindled, plasmacytoid, eithelioid or clear. Tubules or epithelium are absent, or present in a small amount (<5%) by definition. Tumours with myoepithelial cells and a large amount of tubules are classified as pleomorphic adenomas (which must also contain the characteristic chondromyxoid stroma, which is normally absent in myoepithelioma).
Most salivary gland tumors are benign – that is, they are not cancer and will not spread to other parts of the body. These tumors are almost never life-threatening. There are many types of benign salivary gland tumors, with names such as adenomas, oncocytomas, Warthin tumors, and benign mixed tumors (also known as pleomorphic adenomas).
The most common salivary gland neoplasms in children are hemangiomas, lymphatic malformations, and pleomorphic adenomas. [13] Diagnosis of benign lesions require a fine-needle-like aspiration biopsy. [13] With various benign lesions, most commonly the pleomorphic adenoma, there is a risk of developing malignancy over time. [13]