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Pleomorphic Adenoma Consisting of Multiple Cysts with Squamous Epithelial Lining: Findings on MRI, FNAC, and Histopathological Examination

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Open Journal of Stomatology 2021年第6期11卷 221-230页

作者： Hiroshi Yamamoto Sakurako Yamaguchi Erika Iwai Yukiko Iizuka Shu Fushimi Kunio Hayashi Takumi Kondo Satoshi Tokunaga Masaaki Suemitsu Takashi Kaneda Kayo Kuyama masamichi komiya Department of Oral Surgery Nihon University School of Dentistry at Matsudo Chiba Japan Department of Radiology Nihon University School of Dentistry at Matsudo Chiba Japan Department of Pathology Nihon University School of Dentistry at Matsudo Chiba Japan

The incidence of pleomorphic adenoma (PA) of the minor salivary glands is reported to be 10%, and while the histological findings in PA can be diverse, keratin-filled cysts lined by squamous epithelium are rarely reported. The condition can, however, present with cyst formation in some cases. We review a rare case of pleomorphic adenoma in the buccal mucosa that involved the formation of multiple squamous epithelium-lined cysts in a 69-year-old woman. Magnetic resonance imaging (MRI), fine needle aspiration cytology, and histopathological examination were performed. Physical examination revealed a painless, mobile, elastic hard mass in the right buccal mucosa, measuring 2.5 × 1.0 cm. The MRI revealed a well-defined lesion with different signal intensities in the medial and distal regions of the right cheek. The medial side of the lesion showed a low signal intensity on T1-weighted imaging (T1WI) and T2-weighted imaging (T2WI), while the distal side showed a low signal intensity on T1WI, and a high signal intensity on T2WI and short tau inversion recovery (STIR) imaging. Fine needle aspiration of the lesion was performed under local anesthesia and a cytological diagnosis of an epidermoid or dermoid cyst was made. The tumor was completely resected under local anesthesia combined with intravenous sedation. The histopathological examination demonstrated the proliferation of atypical tumor cells with poor atypia and the formation of glandular, alveolar, large, and small cysts. The cysts were lined by keratinized squamous epithelial cells, their cavities were filled with keratinous material, and foreign body reaction was observed after rupture. Histopathological evaluation led to the diagnosis of pleomorphic adenoma. The patient had no evidence of recurrence, 2 years and 3 months after the surgery. In conclusion, the presence of multiple cysts lined by squamous epithelium can pose a significant diagnostic challenge in patients with PA. It is important to make the correct

关键词： Salivary Gland Tumor Pleomorphic Adenoma Cystic Formation

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Minor Salivary Gland Tumors: A Retrospective Study of 37 Cases

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Open Journal of Stomatology 2022年第12期12卷 363-371页

作者： Hiroshi Yamamoto Yukiko Iizuka Erika Iwai Shu Fushimi Ryutaro Tsuchimoto Minami Akagi Shina Kato Kunio Hayashi Mitsuko Nakayama Masaaki Suemitsu Tadahiko Utsunomiya Yoshikazu Nakayama Kayo Kuyama masamichi komiya Department of Oral Surgery Nihon University School of Dentistry at Matsudo Chiba Japan Nihon University Graduate School of Dentistry at Matsudo Oral and Maxillofacial Surgery Chiba Japan Department of Pathology Nihon University School of Dentistry at Matsudo Chiba Japan Nihon University Graduate School of Dentistry at Matsudo Oral Pathology Chiba Japan

Salivary gland tumors represent 2% - 6.5% of all head and neck tumors. Since salivary gland tumors have various clinical features and histological types, it is often difficult to diagnose and treat them. The aim of this study was to conduct a retrospective clinical-statistical analysis of 37 minor salivary gland tumors (MSGTs) treated in the Department of Oral Surgery at Nihon University School of Dentistry at Matsudo over a 16-year period. The frequencies and distributions of sex, age, occurrence site, preoperative examination (fine needle cytology and/or biopsy), treatment, and prognosis of the tumors were analyzed and compared with previous reports. The average age at diagnosis was 58.1 years (range 22 - 91 years). The peak occurrence of tumors was in the sixties (10 cases, 27.0%), followed by the forties (8 cases, 21.6%) and the seventies (7 cases, 18.9%). The average age of patients with benign tumors was 56.8 years (range 22 - 91 years). For malignant tumors, the average age was 61.7 years (range 42 - 81 years). The male-female ratio was 1:2.1 for all minor salivary gland tumors, 1:2.4 for benign tumors, and 1.5:1 for malignant tumors. There were 27 (73.0%) benign and 10 (27.0%) malignant tumors. Pleomorphic adenoma (PA) was the most common tumor (24 (64.9%) cases). Most salivary gland tumors originated from the palate (21 cases, 56.8%);the second most common site was the buccal mucosa (14 cases, 37.8%). For most patients, an intraoral mass was the primary presentation, and the second most common symptom was swelling. Surgical treatment was performed for all cases, both benign and malignant tumors. There was one case of local recurrence of PA, as well as one of multiple lung metastases after surgery for adenoid cystic carcinoma. Diagnosis and treatment of MSGTs are often delayed because the patients have few symptoms, and it is difficult to distinguish benign from malignant tumors. More cases need to be examined in the future, and the diagnostic accuracy of im

关键词： Minor Salivary Gland Tumor Clinical Statistics Intraoral Japanese

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