Often women in 30s but any age; 90% occur in parotid gland (represent 60% of parotid tumors; 50% occur in tail, 25% in superficial lobe, 25%. Request PDF on ResearchGate | On Mar 1, , I. Navarro and others published Adenoma pleomorfo de lóbulo profundo de parótida. Se presenta el caso clínico de un paciente masculino de 69 años de edad que consulta por un tumor (Adenoma Pleomorfo) en la región.
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Palatal Pleomorphic Adenoma in a Pediatric Patient.
University of Guatemala, Quetzaltenango, Guatemala. Pleomorphic adenoma is the most common benign neoplasm of salivary glands. Their common location is in parotid gland, however, a lower percentage of these tumors might occur in minor glands. The epidemiology of this tumor shows that adults are the most affected, with rare occurrence in children or adolescents. We present the case report of pleomorphic adenoma located on the palate of a 10 year old.
Excisional biopsy of the lesion followed by histopathologic examination of the biopsy specimen revealed ductal structures p,eomorfo by plasmacytoid mioepithelial cells within a myxoid stroma, the final diagnosis corresponded to Pleomorphic Adenoma. Early detection and excision of this lesion in children are important to minimize potential recurrences or malignant transformation.
The usual location is parotid gland, however a small percentage arises in minor salivary glands Pusztaszeri et al. Clinical examination is key to identifying the PA, some of the characteristics of this tumor are: Among the complementary techniques to diagnose PA are the following: The use of these techniques could guide towards a definitive diagnosis, but no one replaces the biopsy as the gold standard for pldomorfo diagnosis of this neoplasia.
Histopathological elements of the PA include: The etiology of PA’s is unknown, however some authors mention the myoepithelial cell as responsible for the development of this pathology Ledesma-Montes et al. The aim of this study was to report a palatal pleomorphic adenoma in a year-old child. A year-old patient comes to the clinic of the Faculty of Dentistry, Mesoamerican University for pediatric dental treatment.
Within medical history he does not refer to anything of importance. The intraoral examination showed a ovoid nodule, located in right posterior third of the hard palate, sessile base, soft consistency, a little paler than the adjacent mucosa, smooth surface, asymptomatic and unknown evolution Fig.
Under this description presumptive diagnosis of Pleomorphic Adenoma was made. Core incisional biopsy was made and the preliminary diagnosis was Pleomorphic Adenoma. Excisional biopsy of the lesion to confirm the diagnosis was indicated. The patient was scheduled for surgical excision of the lesion. Next it was excised down to periosteum leaving a safety margin of 2 mm, complete resection of the lesion was achieved, obtaining a surgical specimen of 12 mm in diameter Fig.
The surgical wound was bleeding so cauterization and hemostasis with hydrogen peroxide and pressure was performed, the wound was covered with surgical cement using an acrylic splint.
Procedure was realized successfully. Patient with open mouth and is extubated without complications. The patient was reassessed at 15, 30 and 60 days after the procedure and did not show any post-operative complication Figs.
Histopathologicalal results of the specimen sent presented the following findings: It was determined as histopathological diagnosis Pleomorphic Adenoma. Initial aspect of the lesion located in right posterior third of the hard palate. Neoplasms of minor salivary glands in children are rare. The diagnosis of palatal PA is a real challenge because it can be confused with other entities such as odontogenic cysts or tumours, a palatal abscess, lymphoma, lipoma, fibroma, neurofibroma, neurilemoma schwannomamucoepidermoid carcinoma or even cystic adenoid carcinoma Hmidi et al.
The epidemiology of this neoplasm indicates that it is more common in female patients with a ratio of 2: The origin of this neoplasm is still debated, some authors ascribe the origin of the PA to the reserve cell of the intercalated duct, even so, it is possible that the myoepithelial cell also plays an important role in the development of this neoplasia Ledesma-Montes et al.
Recent research shows that chromosomal translocations between chromosomes 3 and 8 may be responsible for tumor formation by the juxtaposition of PLAG-1 and b-catenin gene, resulting in the activation of catenin pathway causing cell proliferation Rahnama et al.
Histologically the PA can be classified into different types: Myxoid type as its name suggests, is composed mostly of myxomatous stroma. The classic is a mixture of ductal structures and myoepithelial cell, and a myxomatous or hyaline stroma, The cellular type has a large number of cellular elements with little stroma Wu et al.
Our case was cataloged as a classic PA due to the characteristics presented histologically. The patient was treated with intraoral conservative surgical resection with safety margins of the lesion and healing by second intention which is mentioned as the most ideal treatment Barnes et al.
Adenoma Pleomorfo Palatino en un Paciente Pediátrico: Reporte de Caso
It has been reported that radiotherapy as an adjuvant improves the outcome in PA’s that have been resected with inadequate margins Mendenhall et al.
Oroantral communication, recurrence and malignant transformation due to incomplete excision of the lesion are some of the possible complications mentioned in the treatment of palatal PA’s Shaaban et sdenoma. None of these complications were observed in our case.
Pleomorphic adenoma should be considered as a differential diagnosis when a mass appears in palatal portions of children. Biopsy and histopathological study are the gold standard to diagnose this pathology. Conservative surgical resection should be the treatment of choice to avoid recurrence or malignant transformation.
Closure of palatal defects following excision of palatal pleomorphic adenomas. Lyon, IARC press, Pleomorphic adenoma of the palate.
Pleomorphic adenoma of the soft palate: Salivary gland pleomorphic adenoma. Rapidly progressing palatal pleomorphic adenoma in an adolescent. Minor salivary gland tumors: A clinicopathological study of 18 cases. Pleomorphic adenoma with predominant plasmocytoid myoepithelial cells: Case report and review of the literature. Pleomorphic adenoma of the palate: A pathological classification of pleomorphic adenoma of the salivary glands author’s transl.
Recurrent pleomorphic adenoma of the palate in a child. Clinicopathological study of 74 palatal pleomorphic adenomas. Patient Information A year-old patient comes to the clinic of the Faculty of Dentistry, Mesoamerican University for pediatric dental treatment.