Abstract
Pleomorphic adenomas, or benign mixed tumors, make up 65% of all salivary gland tumors. They also can be found as solid tumors in other parts of the head and neck region, such as the auditory canal, the eyelids, and the orbital area. In this study, we investigated extra-major salivary gland pleomorphic adenomas of the head and neck region retrospectively at a tertiary care center. Between March 1998 and June 2009, 37 patients underwent primary surgery for extra-major salivary gland pleomorphic adenoma of the head and neck. The duration of symptoms, radiographic findings, operative procedures, and pathologic findings were documented. Of the 37 patients enrolled, 22 were male and 15 were female, with a median age of 57 years. Tumors were found in the soft palate, hard palate, nasopharynx, orbital area, trachea, buccal mucosa, cheek, nasal septum, upper lip, lower eyelid, and external auditory canal. Cellular variant of the pleomorphic adenoma was found in four patients, while the remaining patients presented with the classic variant. No myxoid subgroup was noted in our study. Carcinoma ex pleomorphic adenoma was observed only in one patient for whom radical surgery was performed. Twenty-eight patients (76%) had long-term follow-ups, with the average follow-up period being 4.5 years. Local recurrence was observed in three patients, and they underwent revision surgery during the follow-up period. Our results indicate that extra-major salivary gland pleomorphic adenomas are most commonly found in the soft palate. Wide excision was the treatment of choice, although its efficacy might be compromised with cosmetics and functional structures of the head and neck. Therefore, long-term follow-up of patients is necessary.
Similar content being viewed by others
References
Lopes MA, Santos GC et al (1999) A clinicopathologic study of 196 intraoral minor salivary gland tumors. J Oral Pathol Med 28:264–267
Waldron CA, Gnepp DR (1998) Tumors of the intraoral minor salivary glands: a demographic and histologic study of 426 cases. Oral Surg Oral Med Oral Pathol 66:323–333
Heraguchi HH, Tanaka H, Komatuzaki A (1996) Pleomorphic adenoma of the external auditory canal: a case report and review of the literature. J Laryngol Otol 110:52–56
Shields CL, Shields JA, Eagle RC et al (1989) Clinicopathologic review of 142 cases of lacrimal gland lesions [In Polish]. Ophthalmology 96:431–435
Wright JE, Krohel GB (1979) Clinical presentation and management of lacrimal gland tumours. Br J Ophthalmol 63:600–606
Rose GE (1992) Pleomorphic adenoma of the lacrimal gland. Br J Ophthalmol 76:395–400
Stuteville OH, Corley RD (1967) Surgical management of tumors of intraoral minor salivary glands. Cancer 10:1578–1586
Torske K (2006) Benign neoplasm of the salivary glands. In: Thompson LDR (ed) Head and neck pathology, 1st edn. Elsevier, Philadelphia, pp 295–300
Seifert GD (1996) Multiple tumors of the salivary glands: terminology and nomenclature. Eur J Cancer B Oral Oncol 32:3–7
Compagno JW (1977) Intranasal mixed tumors. Am J Clin Pathol 68:213–218
Vellios F, Shafer WG (1959) Tumors of minor salivary glands. Surg Gynecol Obstet 108:450–456
Bergman F (1969) Tumors of the minor salivary glands. Cancer 23:538–543
Mendenhall WM, Mendenhall CM, Werning JW et al (2008) Salivary gland pleomorphic adenoma. Am J Clin Oncol 31:95–99
Frable WJ, Elzay RP (1970) Tumors of minor salivary glands. A report of 73 cases. Cancer 4:932–941
Gnepp DR et al. (2009) Salivary gland (major and minor) and lacrimal gland. In: Gnepp DR (ed) Diagnostic surgical pathology of the head and neck, 2nd edn, WB Saunders, Philadelphia, pp 434–449
Krolls SO, Boyers RC (1971) Mixed tumor of salivary glands. Long-term follow-up. Cancer 30:276–281
Patrick J, Bradley M (2001) Recurrent salivary gland pleomorphic adenoma: etiology, management, and results. Curr Opin Otolaryngol Head Neck Surg 9:100–108
Li TS (1990) Minor salivary gland tumors of the nasopharynx. Zhonghua Zhong Liu Za Zhi 12:127–129 [In Chinese]
Lee ScottL, Lee CY, Steven M et al (2006) Nasopharyngeal pleomorphic adenoma in the adult. Laryngoscope 116:1281–1283
Grossniklaus HE, Abbuhl MF, McLean IW (1990) Immunohistologic properties of benign and malignant mixed tumor of the lacrimal gland. Am J Ophthalmol 110:540–549
Stewart WB, Krohel GB, Wright JE (1979) Lacrimal gland and fossa lesions: an approach to diagnosis and management. Ophthalmology 86:886–895
Chen AH, Houston B, Funk GF (1996) Chondroid syringoma of the head and neck: clinical management and literature review. Ear Nose Throat J 75:104–108
Mandeville JT, Roh JH, Woog JJ et al (2004) Cutaneous benign mixed tumor (chondroid syringoma) of the eyelid: clinical presentation and management. Ophthal Plast Reconstr Surg 20:110–116
Toback TG (1989) Chondroid syringoma. J Am Podiatr Med Assoc 79:563–565
Collins RJ, Yu HC (1989) Pleomorphi cadenoma of the external auditory canal: an immunohistochemical and ultrastructural study. Cancer 64:870–875
Hicks GW (1983) Tumors arising from the glandular structures of the external auditory canal. Laryngoscope 93:326–340
Mansour PG, Pahor AL (1992) Ceruminous gland tumours: a reapprasial. J Laryngol Otol 106:727–732
Masumura CA, Mishiro Y, Inohara H et al (2003) Magnetic resonance imaging of pleomorphic adenoma arising from the external auditory canal. J Laryngol Otol 117:908–909
Koyuncu MF, Kiliacarslan H (2005) Pleomorphic adenoma of the external auditory canal. Eur Arch Otorhinolaryngol 262:969–971
TR LeversteinH, Snow GB et al (1997) The surgical management of recurrent or residual pleomorphic adenomas of the parotid gland: analysis and results in 40 patients. Eur Arch Otorhinolaryngol 254:313–317
Gnepp DR, Nagger AK et al (2005) Carcinoma ex pleomorphic adenoma. In: Barnes L, Evesson JW, Richart PA et al (eds) World Health Organization classification of tumours: pathology and genetics of head and neck tumours. IARC Press, France, pp 242–243
Nowak K (2007) Carcinosarcoma arising from a preexisting pleomorphic adenoma: true malignant mixed tumor of the parotid gland. Otolaryngol Pol 61:1024–1027 In Polish
Acknowledgment
The project was supported by Taipei Veterans General Hospital research grants. No. V98C1-176 and V99C1-196 to T.-Y. Tu.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kuo, YL., Tu, TY., Chang, CF. et al. Extra-major salivary gland pleomorphic adenoma of the head and neck: a 10-year experience and review of the literature. Eur Arch Otorhinolaryngol 268, 1035–1040 (2011). https://doi.org/10.1007/s00405-010-1437-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00405-010-1437-2