Abstract
Fat-containing tumors of the salivary glands are uncommon. Their wide histological spectrum varies from pure lipomatous neoplasms similar to their cutaneous and soft tissue counterparts to mixed lipoepithelial lesions specific to the salivary glands. With few exceptions, these uncommon lesions affect mainly the elderly, with a mean age at presentation of ≥50 years and show a predilection for males. A few cases occur in childhood; some of them represent congenital lesions. In decreasing order of frequency, ordinary (soft-tissue type) lipoma, oncocytic lipoadenoma, non-oncocytic sialolipoma, and pleomorphic adenoma/myoepithelioma with extensive lipometaplasia are the main variants of fat containing tumors encountered in the salivary glands. While pleomorphic adenoma/myoepithelioma with lipometaplasia behave in the same way as their non-fat-containing counterparts, other lipomatous salivary gland tumors listed above are cured with simple excision and do not carry a risk of recurrence. Other lipoma variants (spindle cell lipoma, osteolipoma, fibrolipoma, angiolipoma, pleomorphic lipoma, lipoblastoma and hibernoma) are exceptionally rare in the salivary gland. Atypical lipomatous tumors/liposarcoma have been only rarely reported in the salivary gland and they behave in a similar fashion to their soft-tissue counterparts. Diffuse lipomatosis and lobular fatty atrophy are the two tumor-like lesions that might closely mimic sialolipoma, particularly in limited biopsy material without knowledge of the gross findings. This review summarizes the clinicopathological features of the main types of salivary fat-containing lesions and discusses their differential diagnoses.
Similar content being viewed by others
References
Walts AE, Perzik SL. Lipomatous lesions of the parotid area. Arch Otolaryngol. 1976;102:230–2.
Barnes L, Eveson JW, Reichart P, Sidransky D, editors. World Health Organization Classification of Tumours. Pathology and Genetics of Head and Neck Tumours. Lyon: IARC Press, 2005; 275.
Ng WK, Ma L. Pleomorphic adenoma with extensive lipometaplasia. Histopathology. 1995;27:285–8.
Jin YT, Lian JD, Yan JJ, et al. Pleomorphic adenoma with extensive adipose content. Histopathology. 1996;28:87–9.
Seifert G, Donath K, Schäfer R. Lipomatous pleomorphic adenoma of the parotid gland. Classification of lipomatous tissue in salivary glands. Pathol Res Pract. 1999;195:247–52.
Korkmaz H, Adsay NV, Jacobs JR, et al. Lipomatous pleomorphic adenoma of parotid gland. Histopathology. 2002;40:487–8.
Ide F, Kusama K. Myxolipomatous pleomorphic adenoma: an unusual oral presentation. J Oral Pathol Med. 2004;33:53–5.
Haskell HD, Butt KM, Woo SB. Pleomorphic adenoma with extensive lipometaplasia: report of three cases. Am J Surg Pathol. 2005;29:1389–93.
Skálová A, Stárek I, Simpson RH, et al. Spindle cell myoepithelial tumours of the parotid gland with extensive lipomatous metaplasia. A report of four cases with immunohistochemical and ultrastructural findings. Virchows Arch. 2001;439:762–7.
Siddaraju N, Singh N, Muniraj F, Jothilingam P, Kumar S, Basu D, Saxena SK. Preoperative cytodiagnosis of pleomorphic adenoma with extensive lipometaplasia: a case report. Acta Cytol. 2009;53:457–9.
Ide F, Tanaka A, Kusama K. Further evidence for adipocytic differentiation by the neoplastic myoepithelium. J Oral Pathol Med. 2007;36:187–9.
Nagao T, Sugano I, Ishida Y, et al. Sialolipoma: a report of seven cases of a new variant of salivary gland lipoma. Histopathology. 2001;38:30–6.
Hornigold R, Morgan PR, Pearce A, et al. Congenital sialolipoma of the parotid gland first reported case and review of the literature. Int J Pediatr Otorhinolaryngol. 2005;69:429–34.
Kadivar M, Shahzadi SZ, Javadi M. Sialolipoma of the parotid gland with diffuse sebaceous differentiation in a female child. Pediatr Dev Pathol. 2007;10:138–41.
Bansal B, Ramavat AS, Gupta S, et al. Congenital sialolipoma of parotid gland: a report of rare and recently described entity with review of literature. Pediatr Dev Pathol. 2007;10:244–6.
Parente P, Longobardi G, Bigotti G. Hamartomatous sialolipoma of the submandibular gland: case report. Br J Oral Maxillofac Surg. 2008;46:599–600.
Sato K, Gotoh C, Uchida H, Kawashima H. Sialolipoma of the submandibular gland in a child. J Pediatr Surg. 2011;46:408–10.
Kidambi T, Been MJ, Maddalozzo J. Congenital sialolipoma of the parotid gland: presentation, diagnosis, and management. Am J Otolaryngol. 2012;33:279–81.
Jang YW, Kim SG, Pai H, et al. Sialolipoma: case report and review of 27 cases. Oral Maxillofac Surg. 2009;13:109–13.
Mitsimponas KT, Agaimy A, Schlittenbauer T, Nkenke E, Neukam FW. Oncocytic lipoadenoma of the parotid gland: a report of a new case and review of the literature. Int J Clin Exp Pathol. 2012;5:1000–6.
Agaimy A, Ihrler S, Märkl B, Lell L, Zenk J, Hartmann A, Michal M, Skalova A. Lipomatous salivary gland tumors. A series of 31 cases spanning their morphological spectrum with emphasis on sialolipoma and oncocytic lipoadenoma. Am J Surg Pathol. 2013;37:128–37.
Hirokawa M, Bando Y, Tashiro T, Kuma S, Kawata I, Sano T. Parotid lipoadenoma with sclerotic and polycystic changes. Virchows Arch. 2002;440:549–50.
Eliot CA, Smith AB, Foss RD. Sclerosing Polycystic Adenosis. Head Neck Pathol. 2012;6:247–9.
Skálová A, Gnepp DR, Simpson RH, Lewis JE, Janssen D, Sima R, Vanecek T, Di Palma S, Michal M. Clonal nature of sclerosing polycystic adenosis of salivary glands demonstrated by using the polymorphism of the human androgen receptor (HUMARA) locus as a marker. Am J Surg Pathol. 2006;30:939–44.
Gnepp DR, Wang LJ, Brandwein-Gensler M, Slootweg P, Gill M, Hille J. Sclerosing polycystic adenosis of the salivary gland: a report of 16 cases. Am J Surg Pathol. 2006;30:154–64.
Petersson F, Tan PH, Hwang JS. Sclerosing polycystic adenosis of the parotid gland: report of a bifocal, paucicystic variant with ductal carcinoma in situ and pronounced stromal distortion mimicking invasive carcinoma. Head Neck Pathol. 2011;5:188–92.
Pusiol T, Franceschetti I, Scialpi M, et al. Oncocytic sialolipoma of the submandibular gland with sebaceous differentiation: a new pathological entity. Indian J Pathol Microbiol. 2009;52:379–82.
Daboin KP, Ochoa-Perez V, Luna MA. Adenolipomas of the head and neck: analysis of 6 cases. Ann Diagn Pathol. 2006;10:72–6.
Dietrich CU, Pandis N, Andersen JA, et al. Chromosome abnormalities in adenolipomas of the breast: karyotypic evidence that the mesenchymal component constitutes the neoplastic parenchyma. Cancer Genet Cytogenet. 1994;72:146–50.
Ilie M, Hofman V, Pedeutour F, et al. Oncocytic lipoadenoma of the parotid gland: Immunohistochemical and cytogenetic analysis. Pathol Res Pract. 2010;206:66–72.
Klieb HB, Perez-Ordoñez B. Oncocytic lipoadenoma of the parotid gland with sebaceous differentiation. Study of its keratin profile. Virchows Arch. 2006;449:722–5.
Weinreb I, Simpson RH, Skálová A, et al. Ductal adenomas of salivary gland showing features of striated duct differentiation (‘striated duct adenoma’): a report of six cases. Histopathology. 2010;57:707–15.
Yau KC, Tsang WY, Chan JK. Lipoadenoma of the parotid gland with probable striated duct differentiation. Mod Pathol. 1997;10:242–6.
Seifert G, Oehne H. Analyse von 167 Tumorfällen des Speicheldrüsen-Registers. Laryngol Rhinol Otol (Stuttg). 1986;65:485–91.
Ethunandan M, Vura G, Umar T, Anand R, Pratt CA, Macpherson DW, Wilson AW. Lipomatous lesions of the parotid gland. J Oral Maxillofac Surg. 2006;64:1583–6.
Takahama A Jr, León JE, de Almeida OP, Kowalski LP. Nonlymphoid mesenchymal tumors of the parotid gland. Oral Oncol. 2008;44:970–4.
Rosenthal LS, Garzon S, Setty S, Yao M. Left-sided facial mass. Spindle cell lipoma of the parotid gland. Arch Pathol Lab Med. 2006;130:875–6.
Diom ES, Ndiaye IC, Ndiaye M, Thiam A, Tall A, Nao EE, Diallo BK, Diouf R, Diop EM. Osteolipoma: an unusual tumor of the parotid region. Eur Ann Otorhinolaryngol Head Neck Dis. 2011;128:34–6.
Saitoh Y, Hama T, Ishizaka S, Kawaguchi M, Terazono T, Hyuga M, Katoh G, Oshima W. Fibrolipoma of the parotid in a child. Am J Otolaryngol. 1995;16:433–5.
Maiorano E, Capodiferro S, Fanelli B, et al. Hamartomatous angiolipoma of the parotid gland (sialoangiolipoma). Head Neck Pathol. 2008;2:36–40.
Krempl GA, McGuff HS, Pulitzer DR, Otto RA. Lipoblastoma in the parotid gland of an infant. Otolaryngol Head Neck Surg. 1997;117:S234–7.
Vinayak BC, Reddy KT. Hibernoma in the parotid region. J Laryngol Otol. 1993;107:257–8.
Graham CT, Roberts AH, Padel AF. Pleomorphic lipoma of the parotid gland. J Laryngol Otol. 1998;112(2):202–3.
Cho KJ, Ro JY, Choi J, Choi SH, Nam SY, Kim SY. Mesenchymal neoplasms of the major salivary glands: clinicopathological features of 18 cases. Eur Arch Otorhinolaryngol. 2008;265(Suppl 1):S47–56.
Fanburg-Smith JC, Furlong MA, Childers EL. Liposarcoma of the oral and salivary gland region: a clinicopathologic study of 18 cases with emphasis on specific sites, morphologic subtypes, and clinical outcome. Mod Pathol. 2002;15:1020–31.
Trabelsi A, Ben Abdelkrim S, Jemni H, Stita W, Ouni C, Dhouibi A, Hmissa S, Mokni M, Korbi S. Metastatic liposarcoma to the parotid. J Oncol. 2008;2008:715153.
Tanahashi J, Daa T, Kashima K, Kondo Y, Yada N, Kuratomi E, Hirokawa M, Yokoyama S. Carcinosarcoma ex recurrent pleomorphic adenoma of the submandibular gland. APMIS. 2007;115:789–94.
Dutta SK, Dukehart M, Narang A, Latham PS. Functional and structural changes in parotid glands of alcoholic cirrhotic patients. Gastroenterology. 1989;96:510–8.
Cunningham AL, Taghi AS, Singh GK, Sandison A, Cohen CE, Grant WE. Surgical management of bilateral parotid lipomatosis in a patient with HIV. Head Neck; 2012. doi:10.1002/hed.23121.
Al-Arfaj AA, Arora RK, El Hassan AY, Al-Metwalli RR. Lipomatosis of the parotid gland in children. Saudi Med J. 2003;24:898–900.
Hohenwald H. Lipomatöse Atrophie als Parotistumor. HNO. 1968;16:58.
Rosai J, Limas C, Husband EM. Ectopic hamartomatous thymoma. A distinctive benign lesion of lower neck. Am J Surg Pathol. 1984;8:501–13.
Fetsch JF, Laskin WB, Michal M, Remotti F, Heffner D, Ellis G, Furlong M, Miettinen M. Ectopic hamartomatous thymoma: a clinicopathologic and immunohistochemical analysis of 21 cases with data supporting reclassification as a branchial anlage mixed tumor. Am J Surg Pathol. 2004;28:1360–70.
Michal M, Zámecník M, Gogora M, Mukensnabl P, Neubauer L. Pitfalls in the diagnosis of ectopic hamartomatous thymoma. Histopathology. 1996;29:549–55.
Lee JC, Fletcher CD. Malignant fat-forming solitary fibrous tumor (so-called “lipomatous hemangiopericytoma”): clinicopathologic analysis of 14 cases. Am J Surg Pathol. 2011;35:1177–85.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Agaimy, A. Fat-Containing Salivary Gland Tumors: A Review. Head and Neck Pathol 7 (Suppl 1), 90–96 (2013). https://doi.org/10.1007/s12105-013-0459-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12105-013-0459-7