Variable metaplastic entities in pleomorphic adenoma - a review of a rare case report with a note on its significance
Abstract
Pleomorphic adenoma is the most common benign salivary gland neoplasm principally affecting the parotid gland of the salivary gland and the palate of the minor salivary gland. The term pleomorphic is assigned due to its varied histopathological presentation. We hereby describe a rare case of pleomorphic adenoma in a male patient in his 7th decade of life complaining of swelling in the hard palate for the past 3 years. This case report emphasizes the unique representation of squamous and lipomatous differentiation which was erroneously diagnosed as OSCC or mucoepidermoid carcinoma. We have also included a literature search of such cases that exhibited lipomatous and squamous differentiation in PA listed from the last 10 years.
Key words: Pleomorphic adenoma, minor salivary gland, lipomatous differentiation, squamous differentiation.
References
References
1. Balan N, Mani M, Ahamad S, Divya D.Pleomorphic adenoma: Case report and review of literature. Journal of Indian Academy of Dental Specialist Researchers 2017; 4(2): 61.
2. Sunil s, Gopakumar D. Pleomorphic adenoma. A case report and review of literature. Int. J. Odontostomat 2013;7(2):171-174.
3. Tandon A, Jaiswal R, Siddiqui S, Bordoloi B. Keratinizing pleomorphic adenoma: An unusual case report. J Oral Maxillofac Pathol. 2018;22(Suppl 1):S69-S72.
4. Brisebois S, Chababi Atallah M, Borduas M, Fortier PH. A challenging case of squamous metaplasia in a pleomorphic adenoma: diagnostic and clinical pitfalls. J Surg Case Rep. 2015;9.
5. Shivapathasundaram B. Shafer’s Textbook of Oral Pathology, 8th edition Elsevier,2019.
6. Shah A, Sayed A, Sayed H, Khutwad G. Pleomorphic adenoma: A case report. IJDR 2018; 3(1): 10-12.
7. Sharma S, Mehendiratta M, Chaudhary N, Gupta V, Kohli M, Arora A. Squamous Metaplasia in Pleomorphic Adenoma: A Diagnostic and Prognostic Enigma. J Pathol Transl Med. 2018;52(6):411-415.
8. Shah SS, Moustafa TZ. An Unusual Variant of a Common Palatal Salivary Gland Tumor: Case Report of a Pleomorphic Adenoma with Significant Lipomatous Metaplasia. Case Rep Dent. 2018.
9. Thomas DC, Nair VV, Thomas S. Pleomorphic adenoma: An unusual presentation on upper lip - A case report. J Indian Acad Oral Med Radiol 2017; 29:217-9.
10. Periasamy S, Manoharan A, Garg H, Kumar SP. Pleomorphic Adenoma of the Cheek: A Case Report. Cureus. 2019 Aug 3;11(8): e5312.
11. Griffith CC, Schmitt AC, Little JL, Magliocca KR. New Developments in Salivary Gland Pathology: Clinically Useful Ancillary Testing and New Potentially Targetable Molecular Alterations. Archives of Pathology & Laboratory Medicine. 2017;141: 381-395.
12. Almeslet AS. Pleomorphic Adenoma: A Systematic Review. Int J Clin Pediatr Dent. 2020;13(3):284-287.
13. Jain S, Hasan S, Vyas N, Shah N, Dalal S. Pleomorphic Adenoma of the Parotid Gland: Report of a Case with Review of Literature. Ethiop J Health Sci. 2015;25(2):189-194.
14. Arumugam P, Christopher PJ, Kumar S, Kengasubbiah S, Shenoy V. Pleomorphic Adenoma of the Palate: A Case Report. Cureus. 2019 Mar 25;11(3): e4308.
15. Mittal G, Aggrawal A, Garg R, Rathi A, Ganguly A. Pleomorphic adenoma: A case report. International Journal of Applied Dental Sciences 2017; 3(2): 154-155.
16. Neville, Brad W. Oral and Maxillofacial Pathology ,3rd edition.
17. Brisebois S, Chababi Atallah M, Borduas M, Fortier PH. A challenging case of squamous metaplasia in a pleomorphic adenoma: diagnostic and clinical pitfalls. J Surg Case Rep. 2015.
18. Shah SS, Moustafa TZ. An Unusual Variant of a Common Palatal Salivary Gland Tumor: Case Report of a Pleomorphic Adenoma with Significant Lipomatous Metaplasia. Case Rep Dent. 2018.
19. Khalesi S. A Review of Carcinoma Ex-Pleomorphic Adenoma of the Salivary Glands. Int J Pathol Clin Res.2016;2(3).
20. F. Farah-Klibi, D. Bacha, M. Ferjaoui, S. Ben Jilani, and R. Zermani. Lipomatous pleomorphic adenoma of the hard palate.La Tunisie Médicale.2011;8: 719-720.
21. J. Musayev, B. Önal, A. Hasanov, and I. Farzaliyev.Lipomatous pleomorphic adenoma in the hard palate: report of a rare case with cyto-histo correlation and review. Journal of Cytology.2014;31(1):36–39.
22. E. Donohoe, R. Courtney, S. Phelan, P.J. McCann. A case report of pleomorphic adenoma squamous metaplasia resembling metastatic oral squamous cell carcinoma. Advances in Oral and Maxillofacial Surgery.2021;2.
23. Kaveri H, Gopalkrishnana K, Venkatesh A. Cystic and florid squamous metaplasia in pleomorphic adenoma of palate – A diagnostic dilemma. Asian J Med Sci. 2014;5(4):108-10.
24. Ito H, Ishida M, Okano K, Sandoh K, Ebisu Y, Yoshioka S, Fujisawa T, Iwai H, Tsuta K. Spontaneous infarction of pleomorphic adenoma of the parotid gland: A case report. Mol Clin Oncol. 2020 Dec;13(6):68.
25. Singh, A, Phulware, R.H, Ahuja, A. Pleomorphic Adenoma with Extensive Squamous and Adipocytic Metaplasia Mimicking as Low Grade Mucoepidermoid Carcinoma on FNAC. Indian J Otolaryngol Head Neck Surg. 2020.
26. Sharma S, Mehendiratta M, Chaudhary N, Gupta V, Kohli M, Arora A. Squamous Metaplasia in Pleomorphic Adenoma: A Diagnostic and Prognostic Enigma. J Pathol Transl Med. 2018;52(6):411-415.
27. Jitendra NG, Gauravi D. Extensive squamous metaplasia with cystic change in pleomorphic adenoma: A potential diagnostic pitfall in fine needle aspiration cytology.2013;2(2): 166-169.
28. Rajana ST, Vandanaa S, Malathia N, Ravindran C, Thamizhchelvana H. Pleomorphic adenoma of a minor salivary gland- report of a case. SRJM 2015; 8:20-22.
29. Brisebois S, Chababi Atallah M, Borduas M, Fortier PH. A challenging case of squamous metaplasia in a pleomorphic adenoma: diagnostic and clinical pitfalls. J Surg Case Rep. 2015;9.
30. Patnayak Rashmi, Mohanty Sandip, Sahoo Anjan Kumar, Panda Adya Kinkara, Jena Amitabh
31. Rashmi P, Sandip M, Kumar SA, Kinkara PA,Amitabh J.Pleomorphic adenoma of soft palate with extensive squamous metaplasia – A diagnostic enigma. 2019;8(4): 268-271.
