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Submandibular gland carcinoma ex pleomorphic adenoma with calcification

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Abstract

We report an unusual case of carcinoma ex pleomorphic adenoma (CXPA) in the submandibular gland. The mass had a unique calcification. Panoramic tomography revealed sponge-like calcification. The central portion displayed heterogeneous high signal intensity on T1-weighted image (T1WI) and T2-weighted image (T2WI), and heterogeneously moderate signal intensity on a short-TI inversion recovery (STIR) image. The ADC was low (0.78 × 10−3mm2/sec). After surgical excision, a pathological examination revealed that the mass contained CXPA as a minor component. Tumor cells with large hyperchromatic nuclei and eosinophilic or clear cytoplasm proliferated in irregular small tubule formations or cribriform or Roman-bridge structures in hyalinized or focally ossified stroma. The entire mass was calcified, particularly in the central region. Taken together, the reduced T1 relaxation times were related to the surface effects of diamagnetic particles, which were observed at calcium particle concentrations of up to 30%. We report a CXPA with unusual sponge-like calcification, which appeared unusually hyperintense on T1WI due to a surface effect.

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Authors and Affiliations

  1. Section of Oral and Maxillofacial Image Diagnosis, Department of Diagnostics and General Care, Fukuoka Dental College, Tamura 2-15-1, Sawara-ku, Fukuoka, 814-0193, Japan

    Tomoko Shiraishi, Shoko Yoshida, Tomoko Fukui & Toyohiro Kagawa

  2. Section of Oral and Maxillofacial Radiology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan

    Toru Chikui

  3. Section of Pathology, Department of Morphological Biology, Fukuoka Dental College, Fukuoka, Japan

    Kazuhiko Okamura

  4. Section of Oral Oncology, Department of Oral and Maxillofacial Surgery, Fukuoka Dental College, Fukuoka, Japan

    Kenichiro Hashimoto

Authors
  1. Tomoko Shiraishi
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  2. Toru Chikui
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  3. Shoko Yoshida
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  4. Kazuhiko Okamura
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  5. Kenichiro Hashimoto
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  6. Tomoko Fukui
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  7. Toyohiro Kagawa
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Correspondence to Tomoko Shiraishi.

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None. As a case report, our institution does not require ethics committee approval. We have the patient’s consent.

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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). Informed consent was obtained from the patient for being included in this manuscript.

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Shiraishi, T., Chikui, T., Yoshida, S. et al. Submandibular gland carcinoma ex pleomorphic adenoma with calcification. Oral Radiol 40, 314–318 (2024). https://doi.org/10.1007/s11282-023-00724-4

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  • DOI: https://doi.org/10.1007/s11282-023-00724-4

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