Regarding pleomorphic adenoma of salivary gland true statement(s) is/are:
|A||Parotid gland is most commonly involved|
|B||Malignant transformation does not occur|
|C||Also called mixed tumour|
|D||More commonly found in men than women|
|E||Superficial parotidectomy is treatment of choice|
(Ref Bailey 261e p732, 251e p761; Devita 91e p774; Cancer of the Head and Neck by Suen and Myer 41e p414)
• It is MC benign salivary gland tumor and MC tumor of major salivary glands)
• MC site is parotid tail (superficial lobe)
• Less common in the submandibular glands and sublingual glands, relatively rare in minor salivary glands.
a. Known as mixed tumorQ as it is composed of both epithelial and mesenchymal components
b. Encapsulated but sends pseudopodia (finger-like projections) Q into surrounding glands, enucleation is not done to avoid recurrence.
• Pleomorphic adenoma is unicentric but recurrences are multicentric?
• Usually not involve the facial nerve.
• Presents as painless swelling without any appreciable change in size, with typical site at below, in front and behind the ear lobule.
• Slow growing lobular tumor affecting women around 40 years.
• Pleomorphic adenoma involving deep lobe may push the tonsil and pillars of fauces towards midline and known as dumbbell turn or with component both in neck and oral cavity.
• FNAC is diagnostic?
• Superficial parotidectomy (Patey's operation)?
• Excision of whole gland in cases of pleomorphic adenoma of submandibular gland
• Malignant change (3-5%)
- Known as carcinoma ex pleomorphic adenoma or malignant mixed tumor
- Rapid growth, pain, paraesthesia, enlarged cervical LN and restriction of jaw movements, facial weakness or skin invasion and fixation of mastoid tip is suggestive of malignant transformation
- Histological findings suggestive of malignant change are microscopic foci of necrosis, hemorrhage, calcification and excessive hyalinization.
- Prognosis for invasive carcinoma depends on degree of local infiltration
• Recurrence, particularly after enucleation