Top PDF Imaging Characteristics of Recurrent Pleomorphic Adenoma of the Parotid Gland

Imaging Characteristics of Recurrent Pleomorphic Adenoma of the Parotid Gland

Imaging Characteristics of Recurrent Pleomorphic Adenoma of the Parotid Gland

nodules with peripheral enhancement were seen in 8 patients. Five patients had large infiltrative multiloculated T2 hyperin- tense lesions with both peripheral and solid enhancement. These patients had remote surgery ranging from 10 to 35 years (mean, 22.6 years) before presentation. The long time interval between initial surgery and recurrence presumably allowed these lesions to attain a sizeable volume. Two patients had T2 hypointense lesions with peripheral enhancement, which likely reflected the high proteinaceous content of the recurrent cystic lesions. The enhancement pattern of recurrent nodules was variable, ranging from solid and homogeneous to hetero- geneous to rim enhancement (cystic pattern). Heterogeneous enhancement is likely due to areas of fibrosis and necrosis. In our series, no bony destruction or calcification was noted with the recurrent lesions, though this was described in a prior case series. 23
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Current thinking about the management of recurrent pleomorphic adenoma of the parotid: a structured review

Current thinking about the management of recurrent pleomorphic adenoma of the parotid: a structured review

The management of recurrent pleomorphic adenoma (RPA) of the parotid gland presents a challenge to clinicians. This is because surgery is difficult, it is often multinodular 1 and can be associated with facial nerve compromise. Following recurrence there is an increased risk for further recurrences and a risk of malignant transformation that is recently reported as 3.3% 3 . The time interval from the initial treatment can be as long as 15 years 1. The recurrence rates reported in the literature are depended on the initial surgery type. When a superficial parotidectomy has been performed, the recurrence rate may be below 3% 4 . Tumour factors that may have an influence on recurrence include tumour size 5 pathological subtype 6 , satellite nodules 2, incompleteness of encapsulation 7 . In contemporary surgical practice, PA
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A Case of Pleomorphic Adenoma of the Parotid Gland with Multiple Local Recurrences through Facial to Cervical Regions

A Case of Pleomorphic Adenoma of the Parotid Gland with Multiple Local Recurrences through Facial to Cervical Regions

In December 2005, the patient presented with an enlarged mass: an MRI showed a multinodular mass of high intensity on T2-weighted images from the deep lobe into the superficial lobe of the right parotid gland (Figure 2). The maximum dimension of the lesion was its 22-mm dia. A surgical procedure was performed for the mass under general anesthesia in June 2006. An s-shaped preauricular incision and a submandibular extension were used to gain access to the mass. The facial nerve and all of its branches were identified with the aid of a nerve monitor. A possibly recurrent mass in the superficial lobe of the parotid gland was identified, and a nodule was dissected for an intraoperative pathology consultation. The specimen revealed a recurrent pleomorphic adenoma without malignant transformation. Therefore, partial parotidectomy of the superficial and deep lobes was per- formed with an elective neck dissection. A pathological evaluation identified the mass as a recurrent pleo- morphic adenoma of the right parotid gland. No malignant transformation was identified in the specimens. A neck dissection specimen was comprised of three free-of-disease lymph nodes.
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Pleomorphic adenoma of the hard palate

Pleomorphic adenoma of the hard palate

pleomorphic adenomas of the minor glands have little propensity for recurrence (a recurrence rate of 2 to 44%, but mainly of the parotid gland). Recurrent pleomorphic adenomas often form multiple, separate nodules within the remaining salivary gland, periparotid tissues, dermis, or scar tissue even a few or dozen years after the initial surgery. Inadequate surgical procedure was reported to be the main cause of failure. The most frequent surgical issues are pseudopodia, capsular penetration and tumor rupture. Distant metastases are also possible. 2, 19

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Case Report Multiple bilateral Warthin’s tumors of the parotid glands with pleomorphic adenoma: a case report

Case Report Multiple bilateral Warthin’s tumors of the parotid glands with pleomorphic adenoma: a case report

Such auxiliary examinations as B-ultrasound, computed tomography (CT) and magnetic reso- nance imaging (MRI) are deemed common in diagnosing parotid gland tumors. However, to obtain a more accurate diagnosing result, rich experience and comprehensive understanding of the sufferer’s medical history are necessary. But imaging tests are unreliable when diagnos- ing a co-existence of tumors with different his- tological types. MRI scan is a good choice of diagnosing parotid gland tumors because of its remarkable identifying ability towards soft tis- sue. For instance, pleomorphic adenomas usu- ally reflect round like and are enveloped by a layer of smooth surface [33], with bright signal areas on the T2-weighted images and prompts low-intensity edges where the envelope exists [34]. Ultrasound guided fine needle aspiration cytology (Ultrasound-guided FNAC) is consid- ered as a relatively simple examination of which the accuracy of identifying the benign tumors with the malignant tumors can reach to 85%- 97% [35]. But it’s diagnostic sensitivity towards the parotid disease sensitivity is not high. Pre- operative physical examinations, especially pal- pation is significant in the diagnosis of parotid tumor. The difficulty arises when diagnosing tumors from the deep lobe of parotid gland. Resection stands in the first place when deal- ing with multiple parotid gland tumors. Ethun- andan M [5] believes such benign multiple tumors basically happening in the superficial parotid should be adopted palpation during operation and superficial parotidectomy owing to the difficulty of precisely judging the number of tumors and their pathological types before operation. Whether to adopt the surgical meth- od of parotidectomy of total lobe should be decided by the position and features of the tumor.
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Basal Cell Adenoma of the Parotid Gland: MR Imaging Findings with Pathologic Correlation

Basal Cell Adenoma of the Parotid Gland: MR Imaging Findings with Pathologic Correlation

MR imaging findings of BCAs were well-defined and smooth marginal morphologies, dissimilar to the lobulated contour seen in pleomorphic adenomas, relatively low SI on both T1WI and T2WI, and rapid and prolonged enhancement on dynamic study. Although BCAs are a rarity, they should be suspected when a tumor shows all of the characteristics noted here.

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The usefulness of MR in establishing the diagnosis of parotid pleomorphic adenoma

The usefulness of MR in establishing the diagnosis of parotid pleomorphic adenoma

The study group consisted of 82 patients examined between January 1990 and August 1993 for a suspected solitary parotid gland tumor at a referral center for head and neck tumors. Patients with recurrent tumors were ex- cluded from the study. Among the 82 patients, 38 had pleomorphic adenomas, which were diagnosed at histo- logic examination; the remaining patients had Warthin tu- mor (16 cases) or other benign or malignant tumors (Table 1). The MR images in each case were reviewed retrospectively without knowledge of the histologic diag- nosis. MR images were acquired on a 1.5-T scanner with a quadrature head coil. Acquisitions in each case included a T1-weighted sequence in the axial plane (500/15–20/2 [repetition time/echo time/excitations]), 3- or 5-mm thick sections, and 256 3 256 matrix; plus a T2-weighted se- quence with parameters of 2000/80/1, 5-mm-thick sec- tions, and 256 3 256 matrix (Figs 1– 4). Flow-compensa- tion techniques were used. Supplementary images in the coronal plane were acquired in some cases. Additional T1-weighted MR images were acquired in 23 cases after intravenous injection of gadopentetate dimeglumine (0.1 mmol/kg). These cases included 8 pleomorphic adeno- mas, 5 benign parotid tumors, and 10 malignant tumors. In each study, eight MR features were evaluated and dichotomized. The capsule was classified as complete or incomplete, as lobulated or not lobulated, as well defined
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Case Report Giant pleomorphic adenoma of the parotid gland with a history more than forty years without malignant transformation

Case Report Giant pleomorphic adenoma of the parotid gland with a history more than forty years without malignant transformation

Abstract: Pleomorphic adenoma (PA) is the most common type of all salivary gland tumors. Although PAs are benign in pathology, they are malignant in biological behavior sometimes. The tumor could transform to malignancy as malignant pleomorphic adenoma (MPA), if the preexisting remains for long time or after multiple recurrent. Cases of giant pleomorphic adenomas (GPA) are rare, according to previous medical literatures, the majority of which were involving in the parotid gland. We presented a 73-year old woman with a giant pleomorphic adenoma in left parotid gland who had kept the mass for more than forty years and was successfully treated with surgery without any facial nerve injury.
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Original Article Different correlations between tumor size and cancer-related gene profiles according to histologic type of salivary gland tumor

Original Article Different correlations between tumor size and cancer-related gene profiles according to histologic type of salivary gland tumor

Salivary gland tumors, includ- ing malignancy, represent a he- terogeneous group of patholo- gy, so it is difficult to under- stand their molecular patho- genesis and genetic altera- tions. As is well known, PA is the most common benign tu- mor of the parotid gland, and the World Health Organization classification reported that 3-4% of all pleomorphic adenomas become malig- nant [31]. Carcinoma ex-pleomorphic adenoma (CXPA) is defined as a carcinoma arising from a primary or recurrent PA [8, 32]. Unlike PA, Warthin’s tumor presents less than a 1% risk of malignant transformation [12]. We collected 32 surgically treated salivary tumors and analyzed their clinicopathologic and molecular biologic Figure 2. Scatter plot of telomere length (A), PIK3CA amplification (B), and
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Hemangioendothelioma of the Parotid Gland in Infants: Sonography and Correlative MR Imaging

Hemangioendothelioma of the Parotid Gland in Infants: Sonography and Correlative MR Imaging

The large, solid component of HAE shown by sonography and MR imaging distinguishes this le- sion from most vascular malformations, including cystic lymphatic malformations (cystic hygromas). Solid lymphatic malformations usually show exten- sion beyond the parotid (3, 14), and do not contain prominent blood vessels (1, 10). In general, vascular malformations grow at about the same rate as the child, which also helps distinguish them from HAE. Although rhabdomyosarcoma often arises in the head and neck region, it is unusual in infancy. Rhabdomyosarcoma is rarely confined to the pa- rotid gland (15), but often arises in the infratem- poral fossa and involves neighboring structures with an infiltrative growth pattern. It appears to be less vascular than HAE (16).
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Isolated Adenoma with Neuroendocrine Differentiation Involving Both the Facial Nerve and Parotid Gland

Isolated Adenoma with Neuroendocrine Differentiation Involving Both the Facial Nerve and Parotid Gland

Objective: To report an extremely rare case of neuroendocrine tumour with simultaneous in- volvement of both the facial nerve and the deep lobe of parotid gland. Method: case report and English language literature review concerning neuroendocrine neoplasm involving the facial nerve with emphasis on clinical presentation. Results: We report a unique case of adenoma with neuroendocrine differentiation which involved both the mastoid segment of the right facial nerve and also the deep lobe of the parotid gland on the ipsilateral side. Both tumours were not con- tiguous and were anatomically separate from each other. A CT scan of the whole body revealed no other neuroendocrine tumours. Conclusion: To the best of our knowledge, this is the first report in the English language literature of a neuroendocrine tumour to involve both the vertical mastoid segment of the facial nerve with simultaneous involvement of the deep lobe of parotid gland as a separate lesion.
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Quantitative promoter methylation differentiates carcinoma ex pleomorphic adenoma from pleomorphic salivary adenoma

Quantitative promoter methylation differentiates carcinoma ex pleomorphic adenoma from pleomorphic salivary adenoma

The archives of the oral pathology laboratories of the Liverpool and Manchester University Hospital Dental Schools were searched using SNOMED code (M89413). Electronic databases were searched from 1993-2007. Diagnosis was confirmed through review of all potential H&E stained slides and cases with a demonstrable pre-existing PSA or its “ghost” were included in the study (n=24). Additional cases (n=7) were also included where the clinical presentation indicated Ca ex PSA: history of a long-standing stable swelling with recent rapid alteration in size and with histological confirmation of a malignant tumour, usually high grade and often showing multiple patterns of differentiation. Presence of multiple patterns of malignant salivary gland type tumours or diverse differentiation alone was not accepted as definite evidence of Ca ex PSA. All cases were reviewed independently by two pathologists (GH, JAW). Cases of PSA were identified by database searching (SNOMED code M89400) (n=28).
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An Immunohistochemistry Study of Ki67 and P63 Expression of Salivary Gland Neoplasms in a Tertiary Care Hospital of Southern Tamilnadu

An Immunohistochemistry Study of Ki67 and P63 Expression of Salivary Gland Neoplasms in a Tertiary Care Hospital of Southern Tamilnadu

has a superficial and a deep lobe. The facial nerve, retromandibular vein and the external carotid artery are enclosed by the Parotid. The gland is situated in the pre - auricular area. It is paired and bilateral and is situated on either side upon the mandibular ramus. It is encapsulated by the masseteric fascia. The parotid plexus is formed by the branches of the facial nerve. It passes through the parotid gland and divides it into a superficial and a deep part but does not innervate it. The parotid duct is called as Stensen's duct. It opens through parotid papilla opposite to the upper second molar tooth (8) . Accessory parotid
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Invasive salivary duct carcinoma ex pleomorphic adenoma of the parotid gland: a teaching case giving rise to the genuine diagnostic difficulty on an inadequate cytology specimen

Invasive salivary duct carcinoma ex pleomorphic adenoma of the parotid gland: a teaching case giving rise to the genuine diagnostic difficulty on an inadequate cytology specimen

The fine-needle aspiration cytology specimens were in- adequate but consisted of few small clusters of cohesive and three-dimensional pleomorphic tumor cells in a papillary-like fashion without necrotic or hemorrhagic backgrounds (Figure 1A), along with flat sheets of be- nign monomorphic myoepithelial cells and a small amount of metachromatic fibromyxoid stroma, repre- sentative of benign PA (Figure 1A, inset). At the peri- phery of these clusters and sheets, there were few, scattered and tiny malignant tumor cells (Figure 1B). The tumor cells showed large, polygonal, and round to oval with moderate to marked pleomorphism and had relatively abundant and finely granular cytoplasm (Figure 1B). Additionally, the nuclei were hyperchro- matic, medium to large in size, pleomorphic, and often had prominent nucleoli (Figure 1B). Based on that, we first interpreted it as an adenocarcinoma, NOS, and an ordinary radical parotidectomy was performed.
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Myoepithelial Cells (MEC) of the Salivary Glands in Health and Tumours

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Numerous functions of MEC have been elucidated but the most important role as far as pathologists are concerned is its ability to suppress tumour formation and hence acts as a prognostic marker. These cells have been studied under varied conditions and various stains but still a proper IHC marker for either the normal or NMEC has not been found. Also the fact that these cells have complex make- up, the NMEC has the ability to take any of several very different morphological forms, and another important aspect regarding the MEC is that it plays a significant role in tumour pathogenesis and understanding this cell in detail is required to comprehend the pathogenesis of numerous salivary gland tumours. Hence, proper research and techniques has to be applied to obtain significant knowledge regarding MEC and its role in salivary gland tumours.
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A Study on Knowledge, Perceptions and Attitudes about Screening and Diagnosis of Diabetes in Saudi Population

A Study on Knowledge, Perceptions and Attitudes about Screening and Diagnosis of Diabetes in Saudi Population

A young male of 22 years presented with 3x2 cm cystic parotid swelling for last 5 months. Aspiration was dark brown fluid and cytology revealed plenty of lymphoid cells with occasional oncocytic cells in a dirty fluidy background. Cytologically it was diagnosed as warthin’s tumor but in histology it was diagnosed as lymphatic cyst. The histiocytes and metaplastic lining epithelial cells were misinterpreted as oncocytic cells. Oncocytic metaplasia of lining epithelium of lymphatic cyst is a close differential diagnosis of warthin’s tumor in cytology. 28
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F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET)-positive parotid incidentaloma: Prevalence and clinical significance

F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET)-positive parotid incidentaloma: Prevalence and clinical significance

Eight out of 18 patients (44%) underwent surgical evaluation. In those eight patients, we found benign tumors in four and infectious disease in two patients. Metastatic disease and a non-Hodgkin’s lymphoma were found in one patient each. Our results should be viewed with caution because only 44% (8/18) of patients with positive parotid F-18 FDG PET fi ndings had a biopsy or underwent resection. Because not all patients consented to surgical evaluation, the incidence of benign and malignant parotid disease in our study may not refl ect the actual rate. Our results may have been skewed because of inherent selection bias in the patients who were ultimately biopsied or underwent a parotidectomy. These may have been patients whose tumors were larger and palpable or for whom the detection rate of malignant disease may be higher. Despite a probable selection bias, it is noteworthy that for those individuals who underwent surgical evaluation, no primary malignancy of the parotid
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Pleomorphic Adenoma Of The Hard Palate – A Clinical StudySharma Pramod

Pleomorphic Adenoma Of The Hard Palate – A Clinical StudySharma Pramod

The treatment of pleomorphic adenoma of the hard palate is surgical excision with a surrounding cuff of normal tissue. The excision should include periosteum or bone if these are included. These tumors usually do not recur after adequate surgical excision. Most recurrences can be attributable to inadequate surgical techniques such as simple enucleation leaving behind microscopic pseudopod-like extensions, or tumor spillage 8 .Malignant transformation, although

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Congenital Salivary Gland Anlage Tumor of the Nasopharynx

Congenital Salivary Gland Anlage Tumor of the Nasopharynx

Results. A male neonate presented with complaints of nasal obstruction and feeding difficulties. A common diagnostic approach to neonatal nasal obstruction was performed, resulting in an unexpected and potentially life-threatening, albeit curative, result. Cannulation of the nasal cavity to rule out choanal atresia resulted in a burst of bleeding from the nose and mouth. A finger sweep of the oropharynx produced a dislodged mass lesion. Pathology revealed a salivary gland anlage tumor of the nasopharynx.

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Pleomorphic Adenoma of the Hard and Soft Palate: A Case Presentation and Literature Review of Minor Salivary Gland Neoplasms

Pleomorphic Adenoma of the Hard and Soft Palate: A Case Presentation and Literature Review of Minor Salivary Gland Neoplasms

Pleomorphic Adenoma of the Hard and Soft Palate: A Case Presentation and Literature Review of Minor Salivary Gland Neoplasms Panagiotis Saravakos1, Ioannis Kastanioudakis2, Afshin Fayyaz[r]

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