RESUMO
INTRODUCTION: The treatment of parotid benign tumor is in principle surgery, but observation may be necessary in some cases. The purpose of this study was to investigate the growth rates over time of unoperated parotid benign tumors. METHODS: We retrospectively reviewed the medical records of 63 patients with unoperated parotid benign tumors diagnosed at our institution between January 2010 and December 2022. RESULTS: Forty-nine of the 63 patients had a Warthin tumor and 13 patients had a pleomorphic adenoma. On average, the unoperated parotid benign tumors grew 0.02 cm in length and 0.4 cm3 in volume per year. Compared to pleomorphic adenomas, Warthin tumors were more predominant in male patients and in those with a smoking history and a longer duration of smoking history; patients with Warthin tumors were also followed up longer (p < 0.05). However, the length and volume growth rates of unoperated Warthin tumors and pleomorphic adenomas did not significantly differ. CONCLUSION: Surgery is the standard treatment for parotid benign tumors. However, small benign parotid tumors identified during preoperative examination can be observed through close follow-up, taking into account the patient's medical and general condition.
Assuntos
Adenolinfoma , Adenoma Pleomorfo , Neoplasias Parotídeas , Humanos , Masculino , Neoplasias Parotídeas/patologia , Neoplasias Parotídeas/cirurgia , Estudos Retrospectivos , Feminino , Adenolinfoma/patologia , Adenolinfoma/cirurgia , Adenoma Pleomorfo/patologia , Adenoma Pleomorfo/cirurgia , Pessoa de Meia-Idade , Idoso , Adulto , Fatores de Tempo , Idoso de 80 Anos ou mais , Conduta ExpectanteRESUMO
INTRODUCTION: There has been historical controversy regarding the extent of resection in the management of pleomorphic adenomas. This study aims to evaluate the extent of surgery and short-term postoperative outcomes of partial superficial parotidectomy (PSP) for the management of pleomorphic adenomas at a tertiary, high-volume center. METHODS: A retrospective chart review of patients who underwent PSP was performed. Variables included demographics, pre-operative facial nerve function, operative techniques, postoperative complications/facial nerve function, and recurrence. RESULTS: 151 adults who underwent PSP for pleomorphic adenoma from January 1st, 2000 to December 31st, 2022 were identified. Median age was 55 (IQR 40-66) years with females representing 74 % of the cohort. Median tumor size at presentation was 1.8 (IQR 1.3-2.3) cm. Baseline facial nerve function was excellent for most patients (House-Brackmann I, 99 %). Most patients underwent a superficial inferior parotidectomy (88 %). Modified Blair incision (70 %) was the most common incision. Intraoperatively, the facial nerve was identified in 149 (99 %) patients. The main trunk was identified in 126 (85 %) patients. No patient had tumor spillage. Only two patients required parotid bed reconstruction. The most common complication was ear numbness (60 %). Postoperatively, 114 patients were House-Brackmann grade I at both preoperative and postoperative assessment, 8 went from grade I to II, and 1 went from grade VI to II (Bell's palsy that resolved to grade II following surgery). Median follow-up was 1(IQR 1-5) month. CONCLUSION: PSP is efficacious in the management of pleomorphic adenomas with preservation of facial nerve function, and minimal post-operative complications. Future study is needed to assess long term recurrence risk.
Assuntos
Adenoma Pleomorfo , Neoplasias Parotídeas , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Glândula Parótida/cirurgia , Glândula Parótida/patologia , Adenoma Pleomorfo/cirurgia , Adenoma Pleomorfo/patologia , Neoplasias Parotídeas/cirurgia , Neoplasias Parotídeas/patologia , Estudos Retrospectivos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/patologia , Recidiva Local de Neoplasia/epidemiologia , Recidiva Local de Neoplasia/patologiaRESUMO
PURPOSE: Parotid pleomorphic adenomas present a risk of recurrence, higher when the tumour is a hypocellular subtype. The aim of the study was to determine whether it is possible to characterize this histological subtype with diffusion and perfusion sequences of the preoperative MRI. METHODS: This retrospective study included 97 patients operated between 2010 and 2020. Histologic slides review was performed to classify tumours into three histologic subtypes: hypocellular, classical and hypercellular. Univariate and multivariate analyses studied the correlation between histology and diffusion and perfusion MRI parameters obtained with OleaSphere® software. RESULTS: The hypocellular subtype had higher apparent diffusion coefficient values than the other two subtypes: 2.13 ± 0.23, 1.83 ± 0.42, and 1.61 ± 0.4 × 10-3 mm2/s for hypocellular, classical and hypercellular subtype respectively (p < 0.0001). Multivariate analysis showed that an ADCmean > 1.88 × 10-3 mm2/s was suggestive of a hypocellular pleomorphic adenoma in 79% of the cases, with a specificity and PPV of 94 and 96% (p < 0.001), respectively. CONCLUSION: The histological subtype of a pleomorphic adenoma can be predicted preoperatively with ADC values. A prospective and multicentric study on a larger cohort is needed to confirm our results.
Assuntos
Adenoma Pleomorfo , Neoplasias Parotídeas , Neoplasias das Glândulas Salivares , Humanos , Adenoma Pleomorfo/diagnóstico por imagem , Adenoma Pleomorfo/cirurgia , Adenoma Pleomorfo/patologia , Glândula Parótida/diagnóstico por imagem , Glândula Parótida/patologia , Neoplasias Parotídeas/diagnóstico por imagem , Neoplasias Parotídeas/cirurgia , Neoplasias Parotídeas/patologia , Estudos Retrospectivos , Estudos Prospectivos , Imageamento por Ressonância Magnética/métodos , Imagem de Difusão por Ressonância Magnética/métodos , Diagnóstico DiferencialRESUMO
ABSTRACT: Chondroid syringoma is a benign, rare, asymptomatic, slow-growing mixed tumor. The authors present the case of a 17-year-old adolescent boy who had a tumor on the tip of his nose for a duration of 8 months. An excisional biopsy was performed under local anesthesia. Based on histopathologic analysis, the resected lesion was identified as a chondroid syringoma.
Assuntos
Adenoma Pleomorfo , Adolescente , Masculino , Humanos , Adenoma Pleomorfo/diagnóstico , Adenoma Pleomorfo/cirurgia , BiópsiaRESUMO
Minor salivary glands are widely distributed in the mucosal surface of the lips, palate, nasal cavity, pharynx, and larynx, thus can arise from any of these primary sites. Intra-oral minor salivary gland tumors (IMSGTs), while considered rare in the general population are relatively more common when compared to all the other extra-oral sites. Pleomorphic adenoma, as seen in the index patient, is the most commonly diagnosed benign IMSGT. Intra-oral minor salivary gland tumors are not uncommon and depending on their size, nature, and location can be associated with severe limitation of the Patient's ability to breathe, speak clearly, and/or swallow and consequent severe morbidity and even mortality. In addition to these deleterious effects, they present a major surgical challenge to the surgeon, who has to determine the safest, most feasible access to ensure complete, or near-complete excision, as well as to the anesthetist, who needs to secure a definitive airway through the nose or mouth, both of which could be significantly restricted by the presence of the tumor. The aim is to present our successful management of one of the largest intra-oral minor salivary gland tumors documented in the literature, highlighting the specific measures we undertook to tackle the peculiar surgical and anesthetic challenges we faced. It had been two years since surgery and the patient is thriving with a markedly improved quality of life and no features of recurrence. The patient is a 50-year-old male with a slowly growing painless, left palatal mass in the roof of the mouth of 10 years duration with recurrent spontaneous bloody discharge effluent and snoring. There was an associated history of dysphagia to solid with associated choking spells, a left-sided facial asymmetry with no cheek swelling, odynophagia, sore throat, or difficulty with breathing. There was ipsilateral loss of upper incisors and dental anarchy about two years before presentation. No other nasal, otologic, or ophthalmic symptoms were present. No neck swelling, stiffness, cough, or chest symptoms. The oropharyngeal physical examination was highly restricted due to the intra-oral size of the mass. Figure 1. There was facial asymmetry with a bulge of the left maxilla, left-sided levels 1b and 2 non-tender lymph node enlargements, freely mobile, not adhered to the skin. A craniofacial CT scan revealed extensive isodense heterogeneously enhancing intra-oral soft tissue mass occupying the entire palate/oral cavity and encroaching laterally on the masticator and the parapharyngeal space with erosion of the left maxillary floor and hyoid bone Figure 2. The patient had an excision biopsy of the palatal mass with a free margin. No frozen section at the time of surgery. Histology revealed Pleomorphic adenoma and was followed up for 2 years with no evidence of recurrence. Prognosticators are delay in presentation leading to an increase in size of the mass and severe limitation of the patient's ability to breathe, speak clearly, and/or swallow and consequent severe morbidity and even mortality, the surgeon not being overwhelmed, the skillful Anaesthesist that could maneuver the nasal cavity without us doing tracheostomy and the successful outcome of the surgery.
Les glandes salivaires mineures sont largement réparties à la surface muqueuse des lèvres, du palais, de la cavité nasale, du pharynx et du larynx, et peuvent donc survenir à partir de l'un de ces sites primaires. Les tumeurs des glandes salivaires mineures intra-orales (TGSMIO), bien que considérées comme rares dans la population générale, sont relativement plus courantes par rapport à tous les autres sites extra-oraux. L'adénome pléomorphe, tel que celui observé chez le patient index, est la TGSMIO bénigne la plus fréquemment diagnostiquée. Les tumeurs des glandes salivaires mineures intra-orales ne sont pas rares et, en fonction de leur taille, de leur nature et de leur emplacement, peuvent être associées à une limitation sévère de la capacité du patient à respirer, à parler clairement et/ou à avaler, avec une morbidité sévère et même une mortalité. Outre ces effets délétères, elles présentent un défi chirurgical majeur pour le chirurgien, qui doit déterminer l'accès le plus sûr et le plus faisable pour assurer une excision complète ou presque complète, ainsi que pour l'anesthésiste, qui doit assurer une voie aérienne définitive par le nez ou la bouche, tous deux pouvant être significativement restreints par la présence de la tumeur. L'objectif est de présenter notre prise en charge réussie de l'une des plus grandes TGSMIO documentées dans la littérature, mettant en évidence les mesures spécifiques que nous avons prises pour relever les défis chirurgicaux et anesthésiques particuliers auxquels nous avons été confrontés. Deux ans après l'intervention, le patient se porte bien avec une nette amélioration de sa qualité de vie et aucune manifestation de récurrence. Le patient est un homme de 50 ans présentant une masse palatine gauche en croissance lente et indolore dans le palais depuis 10 ans, avec des écoulements sanguins spontanés récurrents et des ronflements. Il y avait une histoire associée de dysphagie aux solides avec des épisodes d'étouffement, une asymétrie faciale du côté gauche sans tuméfaction de la joue, une odynophagie, un mal de gorge ou des difficultés respiratoires. Il y avait une perte ipsilatérale des incisives supérieures et une anarchie entaire environ deux ans avant la présentation. Aucun autre symptôme nasal, otologique, ophtalmique n'était présent. Aucun gonflement du cou, raideur, toux ou symptômes thoraciques. L'examen physique de l'oropharynx était fortement limité en raison de la taille intra-orale de la masse. Figure 1. Il y avait une asymétrie faciale avec une bosse du maxillaire gauche, des ganglions lymphatiques non douloureux des niveaux 1b et 2 du côté gauche, mobiles librement, non adhérents à la peau. La tomodensitométrie craniofaciale a révélé une masse tissulaire molle intraorale extensive, hétérogène, rehaussée de manière isodense occupant l'ensemble du palais/cavité buccale et empiétant latéralement sur les muscles masticateurs et l'espace parapharyngé, avec érosion du plancher du maxillaire gauche et de l'os hyoïde. Figure 2. Le patient a subi une biopsie d'excision de la masse palatine avec une marge libre. Aucune section congelée n'a été réalisée lors de la chirurgie. L'histologie a révélé un adénome pléomorphe et un suivi de 2 ans n'a montré aucun signe de récurrence. Les facteurs pronostiques comprennent le retard de la présentation entraînant une augmentation de la taille de la masse et une limitation sévère de la capacité du patient à respirer, à parler clairement et/ou à avaler, avec une morbidité sévère voire une mortalité, le chirurgien ne se laissant pas dépasser, l'anesthésiste compétent pouvant manÅuvrer dans la cavité nasale sans avoir recours à une trachéotomie, et le succès de l'intervention chirurgicale. MOTS-CLÉS: Intraoral; Glande salivaire mineure; Excision; Tumeur; Pronostiqueurs.
Assuntos
Neoplasias das Glândulas Salivares , Humanos , Neoplasias das Glândulas Salivares/cirurgia , Neoplasias das Glândulas Salivares/patologia , Masculino , Prognóstico , Pessoa de Meia-Idade , Adenoma Pleomorfo/cirurgia , Resultado do TratamentoRESUMO
OBJECTIVES: Surgical management of parotid pleomorphic adenoma ranges from total parotidectomy to extracapsular dissection (ECD). Minimalistic techniques aim to preserve function and minimize the rate of recurrence. This study assesses functional, aesthetic, and disease control outcomes post-ECD through a sole transverse cervical incision for parotid pleomorphic adenoma. MATERIALS AND METHODS: This longitudinal analysis enrolled 36 consecutive patients with pleomorphic adenoma who underwent ECD via a single cervical incision. Complications, satisfaction, salivary function, and tumor recurrence were evaluated. Salivary gland function was assessed using scintigraphy at 6 months post-surgery. RESULTS: Tumors occurred in superficial (83%) or deep (17%) parotid inferior parts according to the European Salivary Gland Society level classification. The median tumor size was 2.8 cm (1.8-6.0 cm); the median operation time was 42 min (30-65 min). No tumor spillage or facial nerve injuries occurred. Facial nerve paralysis was only temporary in two (6%) patients, with minimal other complications. Operated parotid gland function matched the unoperated side. No recurrence was found during the median follow-up of 44 months (24-60 months). CONCLUSIONS: ECD via a single transverse cervical incision is a safe approach for benign parotid tumors, yielding excellent functional and disease control outcomes. CLINICAL RELEVANCE: These findings can provide clinically meaningful minimally invasive recommendations to treat pleomorphic adenoma with minimal complications.
Assuntos
Adenoma Pleomorfo , Neoplasias Parotídeas , Humanos , Adenoma Pleomorfo/cirurgia , Adenoma Pleomorfo/patologia , Complicações Pós-Operatórias , Recidiva Local de Neoplasia/patologia , Estudos Retrospectivos , Estética Dentária , Neoplasias Parotídeas/diagnóstico por imagem , Neoplasias Parotídeas/cirurgia , Neoplasias Parotídeas/patologia , Glândula ParótidaRESUMO
Pleomorphic adenoma is very rare in the sinonasal region, with the most common localization on the nasal septum, followed by lateral nasal wall. In the case presented, a 72-year-old woman was complaining of the right sided nasal obstruction without any other symptoms. The symptom started a year before and increased progressively. Anterior rhinoscopy revealed a mucosa-covered, smooth-surfaced, soft, polypoid, pale, grayish-pink in color mass in the right nasal cavity, approximately 2x2 cm in size. Nasal endoscopy showed the mass to have a broad base on the lateral nasal wall. Computerized tomography scan showed a homogeneous, solid soft tissue mass, 25x18x12 mm in size, which was attached to the lateral nasal wall, behind the nasal vestibule, just in front of the inferior turbinate. Endonasal endoscopic complete tumor excision was performed, during which some spillage of the tumor occurred. Histology diagnosis was pleomorphic adenoma of minor salivary glands. The patient was followed up on regular basis and had no tumor recurrence in the 6th postoperative year. Intranasal pleomorphic adenoma arising from the lateral nasal wall in front of the inferior turbinate is extremely rare, so the presented case is probably the first ever published.
Assuntos
Adenoma Pleomorfo , Neoplasias Nasais , Feminino , Humanos , Idoso , Cavidade Nasal/cirurgia , Cavidade Nasal/patologia , Adenoma Pleomorfo/cirurgia , Adenoma Pleomorfo/patologia , Neoplasias Nasais/diagnóstico , Neoplasias Nasais/cirurgia , Neoplasias Nasais/patologia , Septo Nasal/cirurgia , Septo Nasal/patologia , EndoscopiaRESUMO
PURPOSE: This systematic review analyzed the clinical behavior and odds of malignancy of the palatal recurrent pleomorphic adenomas. METHODS: Systematic review of patients with recurrent pleomorphic adenoma arising in the palate. Database search: MEDLINE, Scopus, Web of Science, Cochrane, EMBASE, Virtual Health Library, Google Scholar, and OpenGrey. A binomial logistic regression was performed to assess the odds of detecting recurrence five, 10 and 20 years after the treatment of primary tumor. RESULTS: Thirteen studies (n = 18 patients) out of 336 were included. The recurrent pleomorphic adenoma in palate was more common in females (61.6%), average age was 49 years old (range 9-73 years old). Four patients progressed to malignant transformation. The odds ratio (OR) of detecting a recurrence at 10 (OR = 5.57; 95% confidence interval - 95%CI 1.13-27.52), and 20 years (OR = 18.78; 95%CI 3.18-110.84) after treatment of primary pleomorphic adenoma was significantly higher than at one-year follow-up. CONCLUSIONS: The recurrence of pleomorphic adenoma in palate remains a rare event of late occurrence. It mainly affects middle-aged female and carries a risk of malignant transformation. Although uncommon, patients with palatal pleomorphic adenoma should be warned about the possibility of recurrence or malignant transformation of tumor at advanced ages.
Assuntos
Adenoma Pleomorfo , Humanos , Adenoma Pleomorfo/cirurgia , Adenoma Pleomorfo/diagnóstico , Adenoma Pleomorfo/patologia , Palato/patologiaRESUMO
Objective:To explore the selection, efficacy and application of indications for parapharyngeal space tumor resection assisted by plasma and HD endoscopic system through oral approach. Methods:The clinical data of 23 patients with parapharyngeal space tumor resection assisted by plasma and HD endoscopic system were retrospectively analyzed in Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Bengbu Medical University from January 2013 to June 2023. All cases were examined by high-resolution CT and MRI before operation, and some cases were examined by CTA or DSA. During the operation, the high definition nasal endoscopic recording system was assisted, and low temperature plasma knife was used in some cases. The follow-up time was from 3 to 115 months, and the median follow-up time was 45 months. Results:There were no deaths in this group. All patients had complete tumor resection. The maximum tumor diameter was as follows: ï¼5.20±1.00ï¼ cm, the operation time wasï¼128.70±46.67ï¼ min, and the average blood loss wasï¼80.87±32.74ï¼ mL. One case of vascular smooth muscle tumor had more bleeding during the operation and was assisted by tracheotomy after operation. One case of nourishing vascular bleeding after operation of giant Schwannoma was investigated and hemostasis + external carotid artery ligation. Bleeding in the remaining cases was below 120 mL. Postoperative pathologies were all benign tumors, including 11 pleomorphic adenoma, 4 schwannoma, 2 base cell adenoma, 1 epidermoid cyst, 1 lymphatic cyst with infection, 1 angiomyoma, 1 solitary fibroma, 1 salivary gland cyst, and 1 tendon giant cell tumor. All patients were followed up. One patient originating from vagal schwannoma had 2-month vocal cord paralysis and 1 recurrenceï¼recurrence of the skull base of schwannomaï¼. Conclusion:Oral approach assisted by plasma and high-definition endoscopic system is suitable for partial selective resection of benign tumors in parapharyngeal space, which has the advantages of less trauma and rapid recovery. When the tumor is blood-rich, suspected to be malignant, the top of the tumor is deep into the cranial base nerve canal,located outside the internal carotid artery, and larger than 6.0 cm considering pleomorphic adenoma, it is recommended to conduct an external open or auxiliary cervical small incision approach.
Assuntos
Adenoma Pleomorfo , Neurilemoma , Neoplasias Faríngeas , Humanos , Adenoma Pleomorfo/cirurgia , Endoscopia , Neurilemoma/cirurgia , Espaço Parafaríngeo/patologia , Neoplasias Faríngeas/cirurgia , Neoplasias Faríngeas/patologia , Estudos RetrospectivosRESUMO
Chondroid syringoma (CS) is a benign, slow-growing mixed tumour that arises from the sweat glands and usually presents in the head and neck area. Histopathological examination is important for proper diagnosis, as CS is often confused with epidermal cysts due to its rare presentation. This article presents a man in his 40s with a right upper lip mass that emerged 6 months prior to presentation. An intraoral surgical excision was performed and the histopathological analysis revealed solid epithelial cells that formed multiple, non-branching ducts lined by cuboidal epithelium. Cystic spaces were filled by heterogeneous eosinophilic material embedded in chondromyxoid stroma. Histopathology identified the lesion as an eccrine-variant CS. The patient recovered well.
Assuntos
Adenoma Pleomorfo , Neoplasias Labiais , Neoplasias das Glândulas Sudoríparas , Humanos , Masculino , Adenoma Pleomorfo/patologia , Adenoma Pleomorfo/cirurgia , Adenoma Pleomorfo/diagnóstico , Adenoma Pleomorfo/diagnóstico por imagem , Neoplasias das Glândulas Sudoríparas/patologia , Neoplasias das Glândulas Sudoríparas/cirurgia , Neoplasias das Glândulas Sudoríparas/diagnóstico , Neoplasias Labiais/patologia , Neoplasias Labiais/diagnóstico , Neoplasias Labiais/cirurgia , Adulto , Diagnóstico Diferencial , Lábio/patologia , Lábio/cirurgia , Glândulas Écrinas/patologiaRESUMO
BACKGROUND: Anatomic landmarks such as the tympanomastoid suture line, posterior belly of the digastric muscle, tragal pointer, and styloid process can assist the parotid surgeon in identifying and preserving the facial nerve. Vascular structures such as the posterior auricular artery and its branch, the stylomastoid artery, lay in close proximity to the facial nerve and have been proposed as landmarks for the identification of the facial nerve. In this case report, we describe an anatomic variation in which the stylomastoid artery has fenestrated the main trunk of the facial nerve, dividing it in two. METHODS: Two patients underwent parotidectomy (one for a pleomorphic adenoma, the second for a parotid cyst) through a standard anterograde approach with identification of the usual facial nerve landmarks. RESULTS: The appearance of the main trunk of the facial nerve was unusual in both patients due to its being fenestrated by the stylomastoid artery. The stylomastoid artery was divided, and the remainder of the facial nerve dissection was performed uneventfully with subsequent resection of the parotid mass in both patients. CONCLUSIONS: In rare instances, the stylomastoid artery can penetrate through the common trunk of the facial nerve. This is an important anatomic variant for the parotid surgeon to be aware of, as it can increase the difficulty of facial nerve dissection.
Assuntos
Nervo Facial , Glândula Parótida , Neoplasias Parotídeas , Humanos , Nervo Facial/cirurgia , Nervo Facial/anatomia & histologia , Glândula Parótida/cirurgia , Neoplasias Parotídeas/cirurgia , Neoplasias Parotídeas/patologia , Masculino , Feminino , Adenoma Pleomorfo/cirurgia , Adenoma Pleomorfo/patologia , Pessoa de Meia-Idade , Variação Anatômica , Dissecação , Pontos de Referência Anatômicos , Adulto , Osso Temporal/cirurgia , Osso Temporal/anormalidadesRESUMO
When neglected for a long time, salivary gland pleomorphic adenoma (PA) can attain a considerable size, increasing the patient's morbidity along with the risk of malignant transformation. Very few case reports are available describing PA of the parotid glands presenting as a large cervicofacial mass. We report a case of epithelial myoepithelial carcinoma -a rare subtype of carcinoma ex-PA (Ca-Ex-PA) of non-luminal differentiation, that developed over a long period in a primary PA of the parotid gland and presented as a giant cervicofacial mass.
Assuntos
Adenoma Pleomorfo , Neoplasias Parotídeas , Humanos , Adenoma Pleomorfo/patologia , Adenoma Pleomorfo/diagnóstico , Adenoma Pleomorfo/diagnóstico por imagem , Adenoma Pleomorfo/cirurgia , Neoplasias Parotídeas/patologia , Neoplasias Parotídeas/diagnóstico , Neoplasias Parotídeas/diagnóstico por imagem , Masculino , Glândula Parótida/patologia , Glândula Parótida/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Pessoa de Meia-Idade , Carcinoma/patologia , Carcinoma/diagnóstico , Neoplasias das Glândulas SalivaresRESUMO
BACKGROUND: Lacrimal gland adenoma is a benign tumour of the lacrimal gland mostly involving the orbital part of the gland and composed of epithelial and myoepithelial components. It involves the third and fourth decade of life as a gradual painless enlargement of the lacrimal gland. CASE: This is a case report of a 30-year-old female presenting with the forward bulging of the right eye causing the eye to be displaced medio-inferiorly over the course of one year. After careful clinical examination and MRI, a clinical diagnosis of lacrimal gland adenoma was established and was planned for right lateral orbitotomy (without marginotomy) via eyelid crease incision and transcutaneous-transseptal approach with complete excision of the tumour under general anaesthesia. OBSERVATIONS: This case was presented to the out patient department with mild painful non-axial proptosis of the right eye. After clinical examination, her MRI report showed a well-defined altered signal intensity enhancing lesion on the extraconal compartment of the right orbit in the antero-supero-lateral aspect. After complete surgical removal of the mass, it was sent for histopathological analysis and it confirmed it as a pleomorphic adenoma. The patient has been following up every 6 months for 2 years and is asymptomatic. CONCLUSION: Being the most prevalent lacrimal gland tumour, pleomorphic adenoma affects the unilateral lacrimal gland causing non-axial proptosis. Complete removal of mass has an excellent prognosis with complete resolution of symptoms.
Assuntos
Exoftalmia , Neoplasias Oculares , Doenças do Aparelho Lacrimal , Aparelho Lacrimal , Imageamento por Ressonância Magnética , Humanos , Feminino , Exoftalmia/diagnóstico , Exoftalmia/etiologia , Adulto , Neoplasias Oculares/diagnóstico , Neoplasias Oculares/cirurgia , Aparelho Lacrimal/patologia , Aparelho Lacrimal/cirurgia , Aparelho Lacrimal/diagnóstico por imagem , Doenças do Aparelho Lacrimal/diagnóstico , Doenças do Aparelho Lacrimal/cirurgia , Adenoma Pleomorfo/diagnóstico , Adenoma Pleomorfo/cirurgia , Procedimentos Cirúrgicos Oftalmológicos/métodos , Diagnóstico DiferencialAssuntos
Adenoma Pleomorfo , Espaço Parafaríngeo , Humanos , Adenoma Pleomorfo/cirurgia , Adenoma Pleomorfo/patologia , Espaço Parafaríngeo/cirurgia , Espaço Parafaríngeo/patologia , Carcinoma Ductal/cirurgia , Carcinoma Ductal/patologia , Masculino , Feminino , Cirurgia Endoscópica por Orifício Natural/métodos , Neoplasias Faríngeas/cirurgia , Neoplasias Faríngeas/patologia , Pessoa de Meia-Idade , Neoplasias das Glândulas Salivares/cirurgia , Neoplasias das Glândulas Salivares/patologia , Resultado do TratamentoRESUMO
O siringoma condroide, também conhecido como tumor misto cutâneo, é uma neoplasia benigna rara, originada das glândulas sudoríparas, composta por estruturas epiteliais imersas em um estroma mixocondroide. Geralmente, apresenta-se como tumor sólido, único, localizado em face ou pescoço, com evolução crônica e assintomática. Relata-se caso de mulher, 75 anos, com lesão discretamente elevada na fronte, cujo diagnóstico foi definido pela análise histopatológica.
Chondroid syringoma, also known as a cutaneous mixed tumor, is a rare benign neoplasm originating from the sweat glands, composed of epithelial structures immersed in a myxochondroid stroma. It usually presents as a solid, single tumor located on the face or neck with a chronic and asymptomatic course. We report the case of a 75-year-old woman with a slightly elevated lesion on the forehead, whose diagnosis was defined by histopathological analysis.
Assuntos
Humanos , Feminino , Idoso , Neoplasias das Glândulas Salivares/diagnóstico , Adenoma Pleomorfo/diagnóstico , Neoplasias das Glândulas Salivares/cirurgia , Adenoma Pleomorfo/cirurgiaRESUMO
Pleomorphic adenoma is the most common benign neoplasia of the salivary glands and affects mostly the parotid gland, less frequently the minor salivary glands. Minor salivary gland tumors have a higher risk of malignancy compared to tumors of the major salivary glands, so appropriate diagnostic evaluation should be prompt. In this case report, we present a case of an extensive pleomorphic adenoma of soft palate in an adult patient. After preoperative investigation using Fine Needle Aspiration (FNA) and imaging tests, the patient was successfully treated by surgical resection under general anesthesia. There was no recurrence seen after a follow-up period of 1 year.
El adenoma pleomoÌrfico es la neoplasia benigna maÌs comuÌn de las glaÌndulas salivales y afecta principalmente la glaÌndula paroÌtida, con menos frecuencia en las glaÌndulas salivales menores. Los tumores de las glaÌndulas salivales menores tienen un mayor riesgo de malignidad en comparacioÌn con los tumores de las glaÌndulas salivales mayores, por lo que la evaluacioÌn diagnoÌstica apropiada debe ser raÌpida. En este reporte de caso, presentamos un caso de un extenso adenoma pleomoÌrfico de paladar blando en un paciente adulto. DespueÌs de la investigacioÌn preoperatoria utilizando aspiracioÌn con aguja fina y pruebas de imagen, el paciente fue tratado con eÌxito con la reseccioÌn quiruÌrgica bajo anestesia general. No se observoÌ recurrencia despueÌs de un periÌodo de seguimiento de 1 anÌo.
Assuntos
Humanos , Masculino , Adulto , Palato Mole/cirurgia , Neoplasias das Glândulas Salivares/cirurgia , Adenoma Pleomorfo/cirurgia , Glândulas Salivares MenoresRESUMO
ABSTRACT: Pleomorphic adenoma (PA), also called benign mixed tumor, is the most common tumor of the salivary glands. About 70 % of these tumors occur in the parotid gland and an uncommon site are the minor salivary glands. The most common sites of PA of the minor salivary glands are the palate followed by lips and cheek. Other rare reported sites include the fauces, floor of the mouth, tongue, tonsil, pharynx, retromolar area and nasal cavity. Here we report a case of pleomorphic adenoma of minor salivary glands of the cheek in a 22-year-old male. The mass was removed by wide local excision with adequate margins, and the patient was followed for 1-year post operatively with no recurrence.
RESUMEN: El adenoma pleomórfico (AP), conocido también como tumor mixto benigno, es el tumor más común de las glándulas salivales. Alrededor del 70 % de estos tumores ocurren en la glándula parótida y con menor frecuencia en las otras glándulas salivales. Los lugares más comunes de AP en las glándulas salivales son el paladar, seguido de labios y mejillas. Otros sitios poco frecuentes reportados, incluyen las fauces, el piso de la boca, la lengua, las tonsilas palatinas, la faringe, el área retromolar y la cavidad nasal. En este estudio se presenta un caso de adenoma pleomórfico de las glándulas salivales menores de la mejilla en un hombre de 22 años. Se extirpó la masa mediante escisión local amplia con márgenes adecuados, con un seguimiento del paciente durante un año después de la operación sin recurrencia.
Assuntos
Humanos , Masculino , Adulto Jovem , Neoplasias das Glândulas Salivares/cirurgia , Neoplasias das Glândulas Salivares/diagnóstico , Adenoma Pleomorfo/cirurgia , Adenoma Pleomorfo/diagnóstico , Neoplasias das Glândulas Salivares/patologia , Bochecha , SeguimentosRESUMO
Pleomorphic Adenoma (PA) is the most common benign salivary gland tumor. The most common sites for minor salivary gland from which PA arises are the palate followed by the lips and buccal mucosa. Calcifications are a common finding in major salivary glands with chronic inflammatory disorders. Major salivary gland tumors rarely show calcifications and it is less common to find them in minor salivary gland tumors. We report a case of pleomorphic adenoma of the hard palate in a 67-year-old female patient with intra-tumoral, irregular and scattered calcifications visible on computed tomography (CT). The treatment was complete surgical excision of the lesion. The diagnosis was confirmed with the histopathological study.
El adenoma pleomórfico (AP) es el tumor benigno de las glándulas salivales más común. Los sitios de mayor frecuencia donde surge el AP en glándulas salivales menores es el paladar seguido de los labios y la mucosa bucal. Las calcificaciones son un hallazgo común en las glándulas salivales mayores con trastornos inflamatorios crónicos, pero en el caso de tumores rara vez muestran calcificaciones y es menos común encontrarlos en tumores de las glándulas salivales menores. Presentamos un caso de adenoma pleomórfico del paladar duro en una paciente de 67 años con calcificaciones intratumorales, irregulares y dispersas visibles en la tomografía computarizada. El tratamiento fue la extirpación quirúrgica completa de la lesión. El diagnóstico se confirmó con el estudio histopatológico