-
JPMA. the Journal of the Pakistan... Mar 2023Synchronous pleomorphic adenoma in the parotid gland and parapharyngeal space are rare. We report a case of simultaneous pleomorphic adenoma in parotid gland and... (Review)
Review
Synchronous pleomorphic adenoma in the parotid gland and parapharyngeal space are rare. We report a case of simultaneous pleomorphic adenoma in parotid gland and parapharyngeal space in a 65-year-old male presenting to the ENT outpatient department at Northwest General Hospital, Peshawar. The patient presented with a left parotid lump, intra oral examination of which revealed the left palatine tonsil to have been pushed medially. CT of the neck showed a completely separate lump in the left parapharyngeal space, and FNAC of the parotid lump was suggestive of mucoepidermoid carcinoma. The superficial parotid lump was excised first, and the parapharyngeal growth was accessed intraorally and excised. Histopathology revealed both the growths to be pleomorphic adenomas. It is important to raise awareness of synchronous salivary gland tumours, which are a rare occurrence, to highlight its optimal investigation to ensure complete surgical excision, and appropriate management.
Topics: Male; Humans; Aged; Adenoma, Pleomorphic; Parotid Gland; Parotid Neoplasms; Parapharyngeal Space; Salivary Gland Neoplasms; Oral Ulcer
PubMed: 36932800
DOI: 10.47391/JPMA.4457 -
AJNR. American Journal of Neuroradiology Mar 1998We report the imaging findings of pericoccygeal hidrocystoma in a 52-year-old woman. Sonography showed a large cystic lesion with internal echoes in the pericoccygeal...
We report the imaging findings of pericoccygeal hidrocystoma in a 52-year-old woman. Sonography showed a large cystic lesion with internal echoes in the pericoccygeal region; it appeared as a well-defined, low-density mass on CT, and as a high-signal-intensity mass on T1- and T2-weighted MR images. Histopathologic examination revealed an apocrine hidrocystoma.
Topics: Female; Hidrocystoma; Humans; Magnetic Resonance Imaging; Middle Aged; Sacrococcygeal Region; Sweat Gland Neoplasms; Ultrasonography
PubMed: 9541324
DOI: No ID Found -
Cancer Cytopathology Jan 2021
Topics: Biopsy, Fine-Needle; Humans; Salivary Gland Neoplasms; Salivary Glands
PubMed: 32767831
DOI: 10.1002/cncy.22340 -
Ear, Nose, & Throat Journal Nov 2023Apocrine hidrocystoma is a cystic tumor originating from apocrine sweat glands. It is predominantly located in the eyelid margins. Here, we report a case of apocrine...
Apocrine hidrocystoma is a cystic tumor originating from apocrine sweat glands. It is predominantly located in the eyelid margins. Here, we report a case of apocrine hidrocystoma of the parotid gland in a 19-year-old man who was referred to our outpatient clinic with a 5-year history of a gradual swelling in the left parotid region. The patient underwent left superficial parotidectomy. Histological examination confirmed the diagnosis of apocrine hidrocystoma. The case is original by the tumor's location: to the best of our knowledge, this could be the first case in English and French literature reporting an apocrine hidrocystoma affecting the parotid gland. The purpose of this article is to report our case and discuss its clinical and anatomopathological features as well as its differential diagnoses.
Topics: Male; Humans; Young Adult; Adult; Hidrocystoma; Parotid Gland; Sweat Gland Neoplasms; Eyelids; Diagnosis, Differential
PubMed: 34219505
DOI: 10.1177/01455613211031028 -
The British Journal of Oral &... May 2018Pleomorphic adenoma is the most common tumour of the parotid gland, and can recur after excision. Recurrent pleomorphic adenoma can be a challenge to treat, and has... (Review)
Review
Pleomorphic adenoma is the most common tumour of the parotid gland, and can recur after excision. Recurrent pleomorphic adenoma can be a challenge to treat, and has variable outcomes. The aim of this review was to summarise current thinking in its management, which may be helpful to clinical teams and could improve patients' health-related quality of life. We searched several online databases using the key terms pleomorphic adenoma, recurrent pleomorphic adenoma, parotid gland tumours, parotid surgery, radiotherapy and parotid pleomorphic adenoma, and parotid surgery outcomes. Information collected included sample size, recurrence rate, condition of the facial nerve, type of operation, adjuvant treatments associated with recurrence, and clinical outcome. We screened 2301 papers, of which 49 were eligible. There was no consensus among authors about management. There are few if any randomised studies, and so conclusions in most papers were based on coherent arguments. Pleomorphic adenomas of the parotid tend to recur after long intervals, with a propensity towards multifocal disease, and the risk of recurrence (which depends on the initial surgical technique) is higher when the initial operation was done at a young age, after enucleation, and if the initial margins were invaded. Published conclusions suggest that the accepted management varies from observation in selected cases to total parotidectomy with or without postoperative radiotherapy.
Topics: Adenoma, Pleomorphic; Humans; Neoplasm Recurrence, Local; Parotid Gland; Parotid Neoplasms
PubMed: 29526342
DOI: 10.1016/j.bjoms.2018.01.021 -
Head and Neck Pathology Jun 2023Pleomorphic Adenoma (PA) and Basal cell adenoma (BCA) are benign salivary gland tumors that may pose a diagnostic challenge if typical features are not present. Due to...
BACKGROUND
Pleomorphic Adenoma (PA) and Basal cell adenoma (BCA) are benign salivary gland tumors that may pose a diagnostic challenge if typical features are not present. Due to the increased relapse and malignant transformation rate of the former, a correct diagnosis carries relevant prognostic information. Even though immunohistochemistry (IHC) plays a limited role in the diagnosis of these tumors, the use of IHC panels could increase diagnostic accuracy. In the present work, we aimed to demonstrate that the use of an IHC panel consisting of Glial Fibrillary Acid Protein (GFAP), B-Catenin and Discovered On GIST 1 (DOG-1) can aid in the differential diagnosis between PA and BCA.
METHODS
We analyzed 18 cases of benign salivary gland tumors (Pleomorphic adenomas and Basal cell adenomas) with overlapping histologic features. First, a head and neck pathologist diagnosed the cases relying on morphology alone. Afterwards, cases were re-evaluated considering the IHC panel results. Inter-observer IHC scoring concordance was evaluated with pre-defined marker cut-off points using Cohen's Kappa scores.
RESULTS
Based on morphology alone, 9 cases were classified as PA while the remaining tumors were considered to be BCA. Five out of nine BCA cases showed GFAP staining and absent nuclear B-catenin and DOG-1 positivity. Conversely, 2 PA cases showed absent GFAP and positive nuclear B-catenin with concurrent DOG-1 expression. Therefore, after IHC evaluation, up to 40% of morphologic diagnoses were reconsidered. Overall, the inter-observer concordance for IHC evaluation was good (resulting Kappa Scores between 0.78 and 1).
CONCLUSION
Our work supports the use of a concise IHC panel to improve the diagnostic accuracy of benign salivary gland tumors with overlapping histologic features.
Topics: Humans; Adenoma, Pleomorphic; Glial Fibrillary Acidic Protein; Catenins; Gastrointestinal Stromal Tumors; Biomarkers, Tumor; Salivary Glands; Adenoma; Salivary Gland Neoplasms
PubMed: 36307634
DOI: 10.1007/s12105-022-01498-7 -
Head and Neck Pathology Jun 2023Intercalated duct lesions (IDLs) are benign salivary gland proliferations that resemble normal intercalated ducts and are subdivided into hyperplastic, adenoma or hybrid...
BACKGROUND
Intercalated duct lesions (IDLs) are benign salivary gland proliferations that resemble normal intercalated ducts and are subdivided into hyperplastic, adenoma or hybrid types depending on circumscription. While IDLs were historically regarded as non-neoplastic, frequent association with basal cell adenoma (BCA) and epithelial-myoepithelial carcinoma (EMC) has raised the possibility that they are neoplastic precursors.
METHODS
In this study, we performed β-catenin immunohistochemistry and targeted molecular analysis on IDLs to clarify their pathogenesis.
RESULTS
We identified 15 IDLs from the parotid glands of eight men and six women with a median age of 65 years (range 42-85 years). These lesions included nine hyperplastic, three adenoma, and three hybrid types. Nuclear β-catenin localization was present in 7 of 13 lesions tested (54%). Next generation sequencing was successfully completed in 12 IDLs, of which seven (58%) had likely oncogenic mutations. These included three recurrent CTNNB1 mutations in hyperplastic (n = 2) and hybrid (n = 1) lesions and two recurrent HRAS hotspot mutations in adenomas.
CONCLUSION
Despite substantial heterogeneity, these findings confirm that a majority of IDLs are genuinely neoplastic, and some demonstrate molecular overlap with both BCA and EMC, supporting their theorized role as precursors to these tumors. Nevertheless, no oncogenic drivers were present in a significant subset of cases, suggesting that some IDLs may be truly reactive and hyperplastic. As such, IDL appear to represent a diverse morphologic and molecular spectrum that include both neoplastic and hyperplastic lesions. Reconsideration of the boundary between IDL and BCA in the future may be necessary to simplify classification.
Topics: Male; Humans; Female; Adult; Middle Aged; Aged; Aged, 80 and over; Salivary Gland Neoplasms; beta Catenin; Biomarkers, Tumor; Carcinoma; Adenoma; Salivary Ducts; Mutation; Proto-Oncogene Proteins p21(ras)
PubMed: 36480093
DOI: 10.1007/s12105-022-01513-x -
Dento Maxillo Facial Radiology Jan 2023To evaluate the diagnostic performance of computed tomography (CT) radiomics analysis for differentiating pleomorphic adenoma (PA), Warthin tumor (WT), and basal cell...
OBJECTIVE
To evaluate the diagnostic performance of computed tomography (CT) radiomics analysis for differentiating pleomorphic adenoma (PA), Warthin tumor (WT), and basal cell adenoma (BCA).
METHODS
A total of 189 patients with PA ( = 112), WT ( = 53) and BCA ( = 24) were divided into a training set ( = 133) and a test set ( = 56). The radiomics features were extracted from plain CT and contrast-enhanced CT images. After dimensionality reduction, plain CT, multiphase-enhanced CT, integrated radiomics signature models and radiomics score (Rad-score) were established and calculated. The receiver operating characteristic (ROC) curve analysis was taken for the assessment of the model performance, and then comparison was conducted among these models. Decision curve analysis (DCA) was adopted to assess the clinical benefits of the models. Diagnostic performances including sensitivity, specificity, and accuracy of the radiologists were evaluated.
RESULTS
Seven, nine, fourteen, and fourteen optimal features were used to constructed plain scan, arterial phase, venous phase, and integrated radiomics signature models, respectively. ROC analysis showed these four models were able to differentiate PA from BCA and WT, with the area under the ROC curve (AUC) values of 0.79, 0.90, 0.87, and 0.94 in the training set, and 0.79, 0.89, 0.86, and 0.94 in the test set, respectively. The integrated model had better diagnostic performance than single-phase radiomics model, but it had similar diagnostic performance to that of the radiomics model based on the arterial phase ( > 0.05). The sensitivity, specificity, and accuracy in the diagnosis of PA were 0.86, 0.46, and 0.70 for the non-subspecialized radiologist and 0.88, 0.77, and 0.84 for the subspecialized radiologist, respectively. Six venous phase parameters were finally selected in differentiating WT from BCA. The predictive effect of the model was favorable, with AUC value of 0.95, sensitivity of 0.96, specificity of 0.83, and accuracy of 0.92. The sensitivity, specificity, and accuracy in the diagnosis between WT and BCA were 0.26, 0.87, and 0.45 for the non-subspecialized radiologist and 0.85, 0.58, and 0.77 for the subspecialized radiologist, respectively.
CONCLUSION
The CT-based radiomics analysis showed favorable predictive performance for differentiating PA, WT, and BCA, thus may be helpful in the clinical decision-making.
Topics: Humans; Adenolymphoma; Adenoma; Adenoma, Pleomorphic; Cell Differentiation; Parotid Neoplasms; Retrospective Studies; Tomography, X-Ray Computed; Parotid Gland
PubMed: 36367128
DOI: 10.1259/dmfr.20220009 -
European Review For Medical and... Jul 2018To investigate the effect of hMTH1 (human mutT homologue 1) on inducing the metastasis and recurrence of parotid adenoma, which may provide a new therapeutic direction...
OBJECTIVE
To investigate the effect of hMTH1 (human mutT homologue 1) on inducing the metastasis and recurrence of parotid adenoma, which may provide a new therapeutic direction for the prevention and treatment of parotid adenoma.
PATIENTS AND METHODS
30 cases of paraffin-embedded specimens of parotid adenoid cystic carcinoma (ACC) tissues and fresh parotid glands surgically resected in our hospital were collected as experimental group. 30 cases of surgically resected pleomorphic adenoma (PA) in the same period were selected as another experimental group. Meanwhile, 30 cases of normal parotid gland tissues (N) were collected as control group. The mRNA and protein expressions of hMTH1 in parotid gland tissues of patients with parotid adenoma before and after surgery were detected by Quantitative Real-Time Polymerase Chain Reaction (qRT-PCR) and Western blotting, respectively. HMTH1 expression levels in parotid gland tissues were also detected by immunohistochemistry. Proliferation, apoptosis and DNA damage of ACC-M cells treated with S-Crizotinib were detected by cell counting kit-8 (CCK-8) assay, flow cytometry and single cell gel electrophoresis, respectively.
RESULTS
Both mRNA and protein expressions of hMTH1 in experimental group were significantly higher than those of control group. Moreover, a higher expression of hMTH1 was observed in ACC than that of PA, indicating that hMTH1 expression was positively correlated with the malignant degree of parotid adenoma. Furthermore, postoperative hMTH1 expression levels in patients with parotid adenoma were significantly lower than those before treatment, which were remarkably increased in recurrent patients. In vitro experiments demonstrated that S-Crizotinib, the hMTH1 inhibitor, could inhibit proliferation and induce apoptosis and DNA damage of ACC-M cells.
CONCLUSIONS
HMTH1 was upregulated in patients with parotid adenoma and recurrent patients after surgery. Meanwhile, S-Crizotinib induced DNA damage in ACC-M cells, indicating that hMTH1 induced the metastasis and recurrence of parotid adenoma by repairing DNA damage, providing a new strategy for the prevention and treatment of parotid adenoma.
Topics: Adenoma, Pleomorphic; Adolescent; Adult; Aged; Apoptosis; Carcinoma, Adenoid Cystic; Case-Control Studies; Cell Proliferation; Child; Crizotinib; DNA Damage; DNA Repair Enzymes; Humans; Middle Aged; Neoplasm Metastasis; Neoplasm Recurrence, Local; Parotid Gland; Parotid Neoplasms; Phosphoric Monoester Hydrolases; Young Adult
PubMed: 30024628
DOI: 10.26355/eurrev_201807_15435 -
Medicine Dec 2021Tubular apocrine adenoma (TAA) is a very rare benign neoplasm of the apocrine gland. The typical anatomical locations are mostly hair-bearing areas, where normal...
RATIONALE
Tubular apocrine adenoma (TAA) is a very rare benign neoplasm of the apocrine gland. The typical anatomical locations are mostly hair-bearing areas, where normal apocrine glands are abundant.
PATIENT CONCERNS
We report the case of a 40-year-old patient with a tubular apocrine adenoma on a non-hair-bearing area.
DIAGNOSES
Ultrasonography showed a 0.4-cm-sized hypoechoic nodule in the subcutaneous plane of the left palm at the fourth carpometacarpal joint level.
INTERVENTIONS
Surgical resection was performed and histopathological examination revealed lobules of well-differentiated dilated tubular structures at the dermis level.
OUTCOMES
At 1 year of postoperative follow-up, the patient was completely recovered without signs of recurrence.
LESSONS
Diagnosis of TAA can be misleading due to its unusual location and inconspicuous appearance. Immunohistochemistry for epithelial membrane antigen and gross cystic disease fluid protein-15 is crucial for the proper diagnosis. Complete excision is recommended to prevent recurrence.
Topics: Adult; Apocrine Glands; Epithelial Cells; Humans; Sweat Gland Neoplasms; Tubular Sweat Gland Adenomas
PubMed: 34889245
DOI: 10.1097/MD.0000000000028002