J Korean Assoc Oral Maxillofac Surg.  2020 Oct;46(5):348-352. 10.5125/jkaoms.2020.46.5.348.

High grade carcinoma ex pleomorphic adenoma of parotid gland: a case report

• Kim JK
• Kim MY
• Choi SK

• KMID: 2508260
• DOI: http://doi.org/10.5125/jkaoms.2020.46.5.348

Abstract

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.

Keyword

Pleomorphic adenoma; Carcinoma; Cancer of the head; Parotid gland

Figure

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  Fig. 1 Magnetic resonance (MR) images. MR images showing a 7 cm sized, well-circumscribed, multiseptated solid and cystic mass with variable signal which located in the right parotid gland. A. T2-weighted image. Boundary of mass is marked with arrows. B. T1-weighted image. C. Enhanced T1-weighted image.

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  Fig. 2 A. Resected superficial and deep lobe of parotid gland. The top is superficial lobe, and the bottom is deep lobe. B. Parotid bed following total parotidectomy.

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  Fig. 3 A. Low-power view revealed well circumscribed high-grade carcinoma showing variable sized cysts and irregular ductal structures with marked necrosis (H&E staining, ×20). B. The ductal carcinoma component exhibited marked cytologic atypia and comedo necrosis (arrowheads) (H&E staining, ×40).

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  Fig. 4 Postoperative magnetic resonance (MR) images. A. Axial T2-weighted MR image. B. Coronal T2-weighted image. Subtle high signal on operation site showing postoperative change (arrows).

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  Fig. 5 Small portion of the tumor showed hyalinized area suggestive of pre-existing pleomorphic adenoma (arrowhead) (H&E staining, ×100).

Reference

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