International Journal of Clinical and Medical Case Reports
Assistant professor, SIMS and RC, Mukka, Mangalore - 574146
We describe a case of a middle-aged man who had a single, asymptomatic tumour in his palate. Pleomorphic adenoma was discovered when the tumour underwent fine needle aspiration cytology (FNAC). The second specimen's histopathologic analysis supported the FNAC diagnosis. Key words: small salivary gland, FNAC, and pleomorphic adenoma
Minor salivary organ growths address a heterogeneous gathering of neoplasms, with an expansive reach of histological kinds and development designs [1]. Salivary organ growths comprise about under 4% of all head what's more, neck cancers [2].Tumours of the minor salivary organs address 10-15% of generally salivary organ neoplasms [3]. Pleomorphic adenomas are harmless salivary organ growths that address around 3-10% of the neoplasms of the head and neck locale [4].
A long term male revealed with a gradually developing mass on delicate sense of taste which was available for the beyond 6 years and continuously advancing in sits size. On looking at intraorally, a nodular mass was available in connection to the left half of the sense of taste estimating generally around 5 × 4.5 cm broadening mediolaterally from the mid- palatal region to the lingual surface of molar teeth.The mucosa over the enlarging appeared to be ordinary with no optional changes. On palpation the mass was non - delicate, firm in consistency, non-compressible, showed no vacillation or discharge release.
A clinical differential conclusion of dentigerous pimple with nodulous start (because of its nearness to molar teeth) and a cancer of minor salivary organ beginning (harmless or dangerous) were thought of. Fine needle desire was performed, which yielded mucoid inadequate material. Spreads were stained with hematoxylin and eosin stain, showed moderate cellularity contained inadequately durable epithelial like cells having boring ovoid core in a foundation of fibromyxoid stroma Determination of pleomorphic adenoma of minor salivary organ was delivered. Histopathological assessment of the example showed affirmed the FNAC determination. Histopathological segments showed epithelial part organized in ropes tubules, homes and sheets, centrally showing squamous metaplastic changes, intermixed with mesenchymal myxoid part and pseudocartilaginous stroma.
Larger part of the cancers emerging in the minor salivary organs are dangerous with just 18% being harmless [5]. Harmless cancers of minor salivary organ beginning are most often pleomorphic adenoma [6].The signs and side effects of cancers related with minor salivary organs fluctuate as per their different physical destinations. The most successive site of beginning is the oral depression and oropharynx and, inside the oral pit, most cancers foster in the area of the hard sense of taste since this is the region with the most noteworthy thickness of minor salivary organs.
The vast majority of patients present an effortless nonulcerative, submucosal enlarging[3].Histopathologically, pleomorphic adenoma is an epithelial growth of complicated morphology, having epithelial and myoepithelial components organized in various examples and implanted in a mucopolysaccharide stroma [7].These growths are typified and consequently complete evacuation guarantees fix. Care ought to be taken to leave something like 1mm edges around the sore. While eliminating the mass, burst of the case is to be stayed away from to limit repeat. Long haul follow-up is suggested, as the gamble of repeat might remain long lasting for such patients [8, 9].
Despite the fact that harmless cancers like pleomorphic adenoma are viewed as normal for major salivary organs, they are nearly a more uncommon substance for minor salivary organs. FNAC and biopsy plays very significant job in diagnosing these growths emerging from minor salivary organs, hence forestalling over conclusion.
1. Vicente OP, Marqués NA, Aytés LB, Escoda CG; Minor salivary gland tumours: a clinicopathological study of 18 cases. Med Oral P Patol Oral Cir Bucal., 2008; 13(9): 582-588.
2. Luna MA, Batasakis JG, ELNaggar AK;Salivary gland tumours in children. Ann Otol Rhinol Laryngol., 1991; 100(10): 869-871.
3. Vander Poorten VL, Balm AJ, Hilgers FJ, Tan IB, Keus RB, Hart AA; Stage as major longterm outcome predictor in minor salivary gland carcinoma. Cancer, 2000; 89(6): 1195-1204.
4. Garcia Berrocal JR, Ramirez Camacho R,Trinidad A, Salas C; Mixed tumour(pleomorphic adenoma) of the head and neck.Typical and atypical patterns. An Otorrinolaringol Ibero Am., 2000; 27(4):333-340.
5. Stanley RE; Parapharyngeal space tumours.Ann Acad Med Singapore, 1991; 20(5): 589-596.
6. Lopes MA, Kowalski LP, da Cunha Santos G,Paes de Almeida O; A Clinicopathologic Studyof 196 intraoral minor salivary gland tumours.J Oral Pathol Med., 1999; 28(6): 264-267.
7. Work PW, Gates GA; Tumours of parapharyngeal space. Otolaryngol Clin NAm., 1969: 479-514.
8. Ogata H, Ebihara S, Mukai K; Salivary glandneoplasms in children. Jpn J Clin Oncol.,1994; 24(2): 88-93.
9. Milford CA, Mugliston TA, O'Flynn P,McCarthy K; Carcinoma arising in a Pleomorphic Adenoma of the Epiglottis. JLaryngol Otol., 1989; 103(3): 324-327.
Medha Shankarling. Diagnosed by Fine Needle Aspiration Cytology: Pleomorphic Adenoma of Hard Palate Emerging from Minor Salivary Gland. Insights of Clinical and Medical Images 2022.