Metastasizing pleomorphic adenoma of the parotid gland. A case report and descriptive retrospective study of english literature
Keywords:
Salivary Gland Neoplasms, Parotid Gland, Adenoma, Pleomorphic, Neoplasm Metastasis, LungAbstract
The pleomorphic adenoma (PA) -ICD-O-8940/0- is the most common benign epithelial tumor of salivary glands, of pleomorphic histological appearance with ductal cells and myoepitheliocytes and hyalinized, chondroids and myxoids stromal areas. The metastasizing pleomorphic adenoma (MPA) it is an extremely rare tumor with an aggressive behavior since it produces metastasis but retains its benign phenotype. In the fourth edition (year 2017) of the Classification of head and neck tumors of the WHO occupies a subcategory of PA within the session of benign tumors. In this communication, we present a rare case of MPA of the parotid gland with multiple lung metastases. The histopathological study (H/E) of the surgical piece of total parotidectomy and lymphoid nodes was performed and a PA was diagnosed. In a routine control, a chest radiograph was requested, where multiple nodular images were observed in both lungs consistent with metastasis. A lung biopsy was performed, identifying tumor formations similar to the parotid tumor.
The majority of published cases occur after surgery of a primary or recurrent tumor and several authors suggest that surgical manipulation can cause tumor cell separation, hematogenous spread and subsequent implantation in distant sites.
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