Int J Stomatol ›› 2022, Vol. 49 ›› Issue (3): 328-331.doi: 10.7518/gjkq.2022046

• Case Report • Previous Articles     Next Articles

Pleomorphic adenoma with extensive keratin cysts: a case report

Zhai Xiaojing1(),Cao Shi2,Xin Wenlong3,Cao Shan1,Zhang Hao3()   

  1. 1.The First Clinical Medical College of Lanzhou University, Lanzhou 730000, China
    2.Dept. of Pathology, The First Hospital of Lanzhou University, Lanzhou 730000, China
    3.Dept. of Radiology, The First Hospital of Lanzhou University, Lanzhou 730000, China
  • Received:2021-08-03 Revised:2022-01-08 Online:2022-05-01 Published:2022-05-09
  • Contact: Hao Zhang E-mail:691439893@qq.com;zhanghao@lzu.edu.cn

Abstract:

Pleomorphic adenoma, which has a diverse histology, is the most common benign tumor in the salivary glands. About 25% of pleomorphic adenoma is associated with squamous metaplasia, while cases with extensive squamous metaplasia and keratin cysts are unusual. Thus, there is a need to differentiate this from other cystic lesions, squamous cell carcinoma, mucoepidermoid carcinoma. In this work, we reported a case characterized by extensive keratin cyst formations. Squamous metaplasia and keratin cyst components account for about 40% of pleomorphic adenomas. Finally, through a literature review, we summarized the clinicopathological features, imaging examinations, differential diagnoses, treatments, and prognosis of pleomorphic adenoma with extensive keratin cysts.

Key words: pleomorphic adenoma, pleomorphic adenoma with extensive keratin cyst, pleomorphic adenoma with squamous metaplasia

CLC Number: 

  • R 739.87

TrendMD: 

Fig 1

Pleomorphic adenoma with extensive keratin cysts"

Tab 1

Clinical features of pleomorphic adenoma with keratin cysts in the literatures"

参考文献年龄/岁性别部位病程临床表现大小/mm治疗随访
[3]50硬腭1周硬腭后外侧肿胀50×50×15手术不详
[4]16右侧腮腺浅叶1~2年缓慢生长的肿块20×20手术9个月未复发
[5]52上腭1年上腭肿胀15×13×13手术不详
[6]16右侧脸颊部3年右脸颊肿胀15×15手术不详
[7]26右侧腮腺3年坚固、无痛、活动缓慢的肿块30×25×25手术不详
[8]50下颌下腺6个月颌下肿胀50×30手术不详
[9]37口腔前庭10年无痛性肿块20手术不详
[10]62硬腭3~4个月无痛性肿块25×15×8手术不详
[11]21左侧下颌下腺6个月肿块62×75手术不详
[12]54右侧腮腺浅叶20年右侧腮腺区疼痛肿胀1月余17×12×12手术18个月未复发
[13]28眶内颊部6年肿块20×20×15手术不详
[14]28上腭7~8年缓慢生长的无痛肿块10×10手术不详
[15]37左侧腮腺浅叶2年缓慢生长的无痛肿块20×20手术不详
[16]36右侧腮腺4年缓慢生长的无痛肿块70×130×70手术7年未复发
本例32右侧腮腺2年缓慢生长的肿块40×25×20手术6个月未复发
1 王健, 窦红漫, 程平, 等. 腮腺多形性腺瘤伴鳞化及黏液化生1例[J]. 临床与实验病理学杂志, 2019, 35(12): 1492-1493.
Wang J, Dou HM, Cheng P, et al. Pleomorphic adenoma of parotid gland with squamous and mucinous metaplasia: a case report [J]. Chin J Clin Exp Pathol, 2019, 35(12): 1492-1493.
2 Lim S, Cho I, Park JH, et al. Pleomorphic adenoma with exuberant squamous metaplasia and keratin cysts mimicking squamous cell carcinoma in minor salivary gland[J]. Open J Pathol, 2013, 3(3): 113-116.
3 Sharma S, Mehendiratta M, Chaudhary N, et al. Squamous metaplasia in pleomorphic adenoma: a dia-gnostic and prognostic enigma[J]. J Pathol Transl Med, 2018, 52(6): 411-415.
4 Brachtel EF, Pilch BZ, Khettry U, et al. Fine-needle aspiration biopsy of a cystic pleomorphic adenoma with extensive adnexa-like differentiation: differential diagnostic pitfall with mucoepidermoid carcinoma[J]. Diagn Cytopathol, 2003, 28(2): 100-103.
5 Dardick I, Jeans MT, Sinnott NM, et al. Salivary gland components involved in the formation of squamous metaplasia[J]. Am J Pathol, 1985, 119(1): 33-43.
6 Lam KY, Ng IO, Chan GS. Palatal pleomorphic adenoma with florid squamous metaplasia: a potential diagnostic pitfall[J]. J Oral Pathol Med, 1998, 27(8): 407-410.
7 Batrani M, Kaushal M, Sen AK, et al. Pleomorphic adenoma with squamous and appendageal metaplasia mimicking mucoepidermoid carcinoma on cyto- logy[J]. Cytojournal, 2008, 6: 5.
8 Ramraje SN, Sisodia SM, Goel A. Fine-needle aspiration cytology of pleomorphic adenoma: cytologic variations and diagnostic pitfalls: a report of two ca-ses[J]. Natl J Integr Res Med, 2014, 5(3): 133-137.
9 Siddaraju N, Murugan P, Basu D, et al. Preoperative cytodiagnosis of cystic pleomorphic adenoma with squamous metaplasia and cholesterol crystals: a case report[J]. Acta Cytol, 2009, 53(1): 101-104.
10 Hamdan K, Maly B, Elashar R, et al. Mucinous and squamous metaplasia in benign tumors of the paro-tid gland: a potential pitfall in the diagnosis[J]. Otolaryngol Head Neck Surg, 2005, 133(6): 987-988.
11 Hegde PN, Prasad HLK, Kumar YS, et al. A rare case of an epidermoid cyst in the parotid gland-which was diagnosed by fine needle aspiration cytology[J]. J Clin Diagn Res, 2013, 7(3): 550-552.
12 AlKindi M, Ramalingam S, Hakeem LA, et al. Giant parotid pleomorphic adenoma with atypical histological presentation and long-term recurrence-free follow-up after surgery: a case report and review of the literature[J]. Case Rep Dent, 2020, 2020: 1-18.
13 Goulart MC, Freitas-Faria P, Goulart GR, et al. Pleomorphic adenoma with extensive squamous metaplasia and keratin cyst formations in minor salivary gland: a case report[J]. J Appl Oral Sci, 2011, 19(2): 182-188.
14 Jaishankar HP, Hegde U, Nagpal B. Florid squamous metaplasia and keratin cyst formation in palatal minor salivary gland tumor: a diagnostic challenge[J]. Int J Heal Sci Res, 2016, 6(4): 516-520.
15 Bajpai M, Pardhe N. Pleomorphic adenoma of submandibular gland with extensive cystic keratinization[J]. J Coll Physicians Surg Pak, 2018, 28(1): 84.
16 Onodera K, Hu JM, Yamamura Y, et al. A case of pleomorphic adenoma with formation of a large cyst: histomorphometric analysis of tumor cells[J]. Oral Med Pathol, 1998, 3(2): 89-92.
17 Aker H, Oztürk M, Ozeç I, et al. An unusual buccal adenoma with extensive squamous metaplasia and cyst formation[J]. J Chin Med Assoc, 2003, 66(3): 184-188.
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[3] HU Yu- hua, LI Jiang.. Advances in the study of mechanisms of malignant tr ansformation of salivary pleomorphic adenoma [J]. Inter J Stomatol, 2007, 34(06): 449-451.
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