Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login 


 
 Table of Contents  
LETTER TO THE EDITOR
Year : 2018  |  Volume : 14  |  Issue : 2  |  Page : 476-477

Pleomorphic adenoma of palate with predominant chondroid tissue: A rarity


Department of Oral and Maxillofacial Pathology and Microbiology, D. Y. Patil University School of Dentistry, Navi Mumbai, Maharashtra, India

Date of Web Publication8-Mar-2018

Correspondence Address:
Dr. Treville Pereira
Department of Oral and Maxillofacial Pathology and Microbiology, D. Y. Patil University School of Dentistry, Sector 7, Nerul, Navi Mumbai - 400 706, Maharashtra
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-1482.202898

Rights and Permissions

How to cite this article:
Pereira T, Shetty S. Pleomorphic adenoma of palate with predominant chondroid tissue: A rarity. J Can Res Ther 2018;14:476-7

How to cite this URL:
Pereira T, Shetty S. Pleomorphic adenoma of palate with predominant chondroid tissue: A rarity. J Can Res Ther [serial online] 2018 [cited 2019 Nov 14];14:476-7. Available from: http://www.cancerjournal.net/text.asp?2018/14/2/476/202898



Sir,

The pleomorphic adenoma (PA) accounts for 73% of all salivary gland tumors, the palate being the most preferred intraoral site followed by the lip. Patients are usually in the fifth or sixth decade of life and about 60% of them are women.[1] They are usually slow growing, painless, and firm on palpation. Possible complications to treatment include the risk of recurrence and malignant transformation.[2]

A 64-year-old female reported to our clinic with a complaint of pain in the upper anterior teeth. Intraoral examination revealed the presence of a fixed prosthesis anteriorly. Further examination revealed an oval-shaped, hard, circumscribed lesion adherent to the underlying structures, covered with slightly erythematous mucosa on the right side of the palate. History revealed that this swelling was initially pea sized and had been slowly growing for the past 20 years to its present size of 3 cm × 3 cm. The slow painless growth and the poor socioeconomic status of the patient had prevented her from seeking any treatment. There was neither sensory nor motor deficiency nor any alteration in the general physical examination. After treating the initial complaint, the patient was advised a computed tomography (CT) scan. The CT scan showed a well-defined, lobulated hypodense lesion in the right posterior hard palate without any bone involvement [Figure 1]. An incisional biopsy was performed under local anesthesia. The histopathological diagnosis was of a PA. Under general anesthesia, excision of the mass was carried out with 1 cm margin. The surgical site was protected with a removable prosthesis with retainers. On histopathological examination, a biphasic population of epithelial and mesenchymal cells was observed. The former was composed of glandular structures lined by round, oval cells with large hyperchromatic nuclei, pink cytoplasm, and myoepithelial basal cell layer. The stroma was predominantly chondroid. The features confirmed the diagnosis of a PA [Figure 2]. Postoperative course was uneventful with no evidence of recurrence 1 year after surgery.
Figure 1: (a) Intraoral photograph of the patient showing an oval-shaped, hard, circumscribed lesion on the right side of the palate. (b) Computed tomography scan showing a well-defined, lobulated hypodense lesion in the right posterior hard palate

Click here to view
Figure 2: Photomicrograph showing tumor islands arranged in sheets with a predominant chondroid tissue. (a) H and E, ×10. (b) Orcein stain, ×10

Click here to view


Minor salivary gland tumors present with a variety of symptoms, depending on its site. Symptoms may include dysphagia, epistaxis, and difficulty in chewing. The consistency of adenomas ranges from soft in cases of mucinous lesions to hard in tumors with extensive chondroid or collagenous components. In the present case, the patient did not have any complaint with the swelling in spite of its long-standing nature and the tumor was hard in consistency due to the excessive cartilage formation. CT scan is an important diagnostic tool for these tumors.[3] Histopathologically, PA shows a great diversity in morphology. The mesenchymal components may be mucoid/myxoid, cartilaginous, osseous, or hyalinized. In a predominant chondroid stroma, it has been suggested that the myxoid stroma may undergo chondroid metaplasia. Immunohistochemically, Type II collagen can be localized in the intercellular matrix of the chondroid areas and in a few chondroid differentiating cells in myxoid areas, confirming its cartilage specificity. Long-standing tumors show increased hyalinization and in such fibrous areas using orcein staining, elastic fibers can be detected which are characteristic for PA.[4]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
 > References Top

1.
Frazell EL. Clinical aspects of tumors of the major salivary glands. Cancer 1954;7:637-59.  Back to cited text no. 1
    
2.
Reiland MD, Koutlas IG, Gopalakrishnan R, Pearson AG, Basi DL. Metastasizing pleomorphic adenoma presents intraorally: A case report and review of the literature. J Oral Maxillofac Surg 2012;70:e531-40.  Back to cited text no. 2
    
3.
Daniels JS, Ali I, Al Bakri IM, Sumangala B. Pleomorphic adenoma of the palate in children and adolescents: A report of 2 cases and review of the literature. J Oral Maxillofac Surg 2007;65:541-9.  Back to cited text no. 3
    
4.
Margaritescu C, Raica M, Simionescu C, Mogoanta L, Surpateanu M, Jaubert F, et al. Tumoral stroma of salivary pleomorphic adenoma – Histopathological, histochemical and immunohistochemical study. Rom J Morphol Embryol 2005;46:211-23.  Back to cited text no. 4
    


    Figures

  [Figure 1], [Figure 2]



 

Top
 
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

  >Article Figures
  In this article
>References

 Article Access Statistics
    Viewed1276    
    Printed42    
    Emailed0    
    PDF Downloaded86    
    Comments [Add]    

Recommend this journal


[TAG2]
[TAG3]
[TAG4]