Surgical approach to pleomorphic adenomas arising in the palate: a 10-year retrospective study in a Brazilian population
DOI:
https://doi.org/10.5935/2525-5711.20160001Keywords:
epidemiology, oral pathology, salivary gland neoplasmsAbstract
Salivary gland tumors represent an important group of neoplasms characterized by a great diversity of types and morphological variants. Pleomorphic adenoma is the most common benign tumor occurring in the major and minor salivary glands. The majority of case series described in the literature refers to epidemiological data of major and minor salivary gland tumors, generally being of a benign or malignant nature. Studies reporting exclusively surgical treatment experience with pleomorphic adenomas of the palate are scarce. Therefore, the aim of this study was to report data on the treatment experience with surgical removal of leomorphic adenoma of the palate together with to nearby mucosal lining with or without ostectomy. Clinical records of all patients diagnosed with pleomorphic adenoma of the palate seen at Brazilian public service dental clinic (Oral and Maxillofacial Surgery Division) and at a private clinic between March 1999 and November 2010 were reviewed. The analysis of the biopsied specimens yielded 10 cases during the 10-year period. Of all the patients 8 were women, with mean age 39 years. The most common main complaint was asymptomatic increase in volume (n = 9), with mean tumor size 2.1 cm. Most patients (n = 8) underwent excision of tumor and mucosal lining. One patient underwent bone ostectomy and in another, the tumor regressed after incisional biopsy.The mean follow-up was 26,8 months (12-42 months) with no recurrences, and the main complication was local discomfort and dysphonia (n = 2). In summary, surgical excision of the tumor and mucosal lining, with or without ostectomy, was shown to be an effective treatment modality for pleomorphic adenomas of the palate.
References
Luksic I,Virag M, Manojlovic S, Macan D. Salivary gland tumours: 25 years of experience from a single institution in Croatia. J Craniomaxillofac Surg. 2012;40(3):e75-81.
Ansari MH. Salivary gland tumors in an Iranian population: a retrospective study of 130 cases. J Oral Maxillofac Surg. 2007;65(11):2187-94. DOI: http://dx.doi.org/10.1016/j.joms.2006.11.025
Speight PM, Barrett AW. Salivary gland tumours. Oral Dis. 2002;8(5):229-40. DOI: http://dx.doi.org/10.1034/j.1601-0825.2002.02870.x
Burzlaff JB, Puricelli E. [Immunohistochemical study in pleomorphic adenomas of salivary glands]. Rev Fac Odontol Porto Alegre. 1996;37(2):19-24. Portuguese.
Pogrel MA. The management of salivary gland tumors of the palate. J Oral Maxillofac Surg. 1994;52(5):454-9. PMID: 8169706 DOI: http://dx.doi.org/10.1016/0278-2391(94)90339-5
Lomeo P, Finneman J. Pleomorphic adenoma of the soft palate. Otolaryngol Head Neck Surg. 2001;125(1):122. PMID: 11458234 DOI: http://dx.doi.org/10.1067/mhn.2001.116784
da Cruz Perez DE, Pires FR, Alves FA, Almeida OP, Kowalski LP. Salivary gland tumors in children and adolescents: a clinicopathologic and immunohistochemical study of fifty-three cases. Int J Pediatr Otorhinolaryngol. 2004;68(7):895-902. PMID: 15183580 DOI: http://dx.doi.org/10.1016/j.ijporl.2004.02.004
Curran AE, White DK, Damm DD, Murrah VA. Polymorphous low-grade adenocarcinoma versus pleomorphic adenoma of minor salivary glands: resolution of a diagnostic dilemma by immunohistochemical analysis with glial fibrillary acidic protein. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;91(2):194-9. DOI: http://dx.doi.org/10.1067/moe.2001.111306
Isacsson G, Shear M. Intraoral salivary gland tumors: a retrospective study of 201 cases. J Oral Pathol. 1983;12(1):57-62. DOI: http://dx.doi.org/10.1111/j.1600-0714.1983.tb00316.x
Chau MN, Radden BG. Intra-oral salivary gland neoplasms: a retrospective study of 98 cases. J Oral Pathol. 1986;15(6):339-42. DOI: http://dx.doi.org/10.1111/j.1600-0714.1986.tb00636.x
Waldron CA, el-Mofty SK, Gnepp DR. Tumors of the intraoral minor salivary glands: a demographic and histologic study of 426 cases. Oral Surg Oral Med Oral Pathol. 1988;66(3):323-33. PMID: 2845326 DOI: http://dx.doi.org/10.1016/0030-4220(88)90240-X
Loyola AM, de Araújo VC, de Sousa SO, de Araújo NS. Minor salivary gland tumours. A retrospective study of 164 cases in a Brazilian population. Eur J Cancer B Oral Oncol. 1995;31B(3):197-201.
Jones AS, Beasley NJ, Houghton DJ, Helliwell TR, Husband DJ. Tumours of the minor salivary glands. Clin Otolaryngol Allied Sci. 1998;23(1):27-33. PMID: 9563662 DOI: http://dx.doi.org/10.1046/j.1365-2273.1998.00088.x
Lopes MA, Kowalski LP, da Cunha Santos G, Paes de Almeida O. A clinicopathologic study of 196 intraoral minor salivary gland tumours. J Oral Pathol Med. 1999;28(6):264-7. DOI: http://dx.doi.org/10.1111/j.1600-0714.1999.tb02036.x
Jaber MA. Intraoral minor salivary gland tumors: a review of 75 cases in a Libyan population. Int J Oral Maxillofac Surg. 2006;35(2):150-4. DOI: http://dx.doi.org/10.1016/j.ijom.2005.07.006
Pires FR, Pringle GA, de Almeida OP, Chen SY. Intra-oral minor salivary gland tumors: a clinicopathological study of 546 cases. Oral Oncol. 2007;43(5):463-70. PMID: 16979373 DOI: http://dx.doi.org/10.1016/j.oraloncology.2006.04.008
Sacks HG, Holly R, Blum D, Blum B, Rappaport SC. The "pedicle flap": a technique for complete excision of benign salivary gland tumors of the palate. Oral Surg Oral Med Oral Pathol. 1985;59(6):572-4. PMID: 2989754 DOI: http://dx.doi.org/10.1016/0030-4220(85)90182-3
Chen YK, Lin CC, Lai S, Chen CH, Wang WC, Lin YR, et al. Pleomorphic adenoma with extensive necrosis: report of two cases. Oral Dis. 2004;10:54-9. DOI: http://dx.doi.org/10.1046/j.1354-523X.2003.00966.x
Allen CM, Damm D, Neville B, Rodu B, Page D,Weathers DR. Necrosis in benign salivary gland neoplasms. Not necessarily a sign of malignant transformation. Oral Surg Oral Med Oral Pathol. 1994;78:455-61. DOI: http://dx.doi.org/10.1016/0030-4220(94)90038-8
