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Objective@#To explore the clinical manifestations, histopathological characteristics, diagnosis, treatment, and prognosis of simultaneous unilateral primary tumors of different pathological types in the parotid gland.@*Methods@#A case of simultaneous unilateral primary parotid gland tumors, i.e., adenolymphoma and basal cell adenoma, was reviewed and analyzed in combination with the literature.@*Results@#The patient discovered a lump in the right parotid gland area one month prior to presentation, and a tumor was palpated in the shallow lobe of the right parotid gland before surgery. According to MR images, the initial diagnoses were tumors of the shallow and deep lobes of the right parotid gland. The tumors of the deep and shallow lobes were excised with part of the gland, and the facial nerves were dissected under general anesthesia. Postoperative pathology revealed an adenolymphoma in the shallow lobe of the right parotid gland and a basal cell adenoma with cystic transformation in the deep lobe. The surgical effect was good, with no complications, and there was no recurrence after 1 year of follow-up. A review of the relevant literature showed that multiple primary tumors of the parotid gland can manifest as the simultaneous presence of two or more types of tumors on both sides or on one side, and the disease is mainly treated with surgery.@*Conclusion@#Multiple unilateral primary parotid gland tumors are rare. Imaging examinations need to be combined with clinical evaluations to prevent missed diagnoses. Surgery is the first treatment option, and patients with benign tumors have a good prognosis.
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Introduction: Basal cell adenocarcinoma is a rare well recognized low grade malignant salivary gland tumor often resembles basal cell adenoma. the infiltrating growth pattern and likelihood of vascular and perineural involvement distinguishes basal cell adenocarcinoma with basal cell adenoma. Case presentation: Here we present histopathological and immune histochemical analysis of two such rare cases of basal cell adenocarcinoma and review of literature is discussed. Conclusion: Basal cell adeno carcinoma is a low grade malignancy and doesn’t metastasize. With only few hundreds of cases that has been reported in literature, basal cell adeno carcinoma should be included as differential diagnosis in salivary gland tumors in order not to miss the diagnosis
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Parotid gland tumors are usually solitary tumors, and multiple tumors of the parotid gland are extremely rare. We present a highly unusual case of bilateral and simultaneous pleomorphic adenoma and basal cell adenoma of the parotid gland. We review the literature and discuss the clinical manifestations, diagnosis, and treatment of these two rare tumors.
Subject(s)
Humans , Adenoma, Pleomorphic , Parotid Gland , Parotid Neoplasms/diagnosisABSTRACT
Objective To investigate the clinical and CT features of basal cell adenomas (BCA)of parotid gland,and to improve the understanding of the disease.Methods Clinical and CT data of 1 8 patients with BCA of parotid gland confirmed by surgery and pathology were collected.The characteristics of age,sex,clinical symptom,lesion site,number,size,shape,density and CT dualGphase enhancement of the lesions were retrospectively analyzed.Results (1)Age and sex of onset:1 2 cases(6 6.6 7%)of age stage from 30 to 5 9,5 cases (27.78%)of the elder over 60,1 case of the younger below 29,5 cases (27.78%)for males,1 3cases (72.22%)for females,the incidence ratio of male to female being 1 ︰ 2.5.(2)Clinical manifestations:there were sporadic masses in the parotid region,3 cases were accompanied by mild pain and all patients had no facial nerve symptoms.(3)Location site,number,size:23 lesions in 18 cases, of which 15 cases (83.3%)were single and 3 cases (16.7%)had multiple lesions on one side.17 lesions (73.9%)were located in superficial lobe, and 6 lesions (26.1%)were located in the deep lobe;(4)Shape and cross section diameter:the shape of the tumor was round or ellipse with wellG defined margin,13 cases (56.5%)of the round shape,10 cases (43.5%)of the ellipse;the maximum cross section diameter was (2.49±1.3 8)cm,the superficial lobe group was (2.05 ±1.02)cm,and the deep lobe group was (3.73 ±1.59)cm.The difference between the two groups on the maximum cross section diameter was significant (P＜ 0.05).(5)Density:the density of most lesions was heterogeneous.17 lesions were accompanied by central or peripheral cystic degeneration of varying degrees,of which 10 lesions with cystic regions ＞ 50% and 2 lesions with maximum transverse diameter ＜ 0.8 cm.(6)CT dualGphase enhancement:19 lesions showed obvious homogeneous or heterogeneous enhancement on the arterial phase,and persistent enhancement on the venous phase.4 lesions showed progressive heterogeneous enhancement,and the enhancement degree of venous phase was even higher than that of arterial phase.Conclusion The BCA of the parotid gland aremainly occuring in middleGaged and older women,displaying regular shape of lesions,developing to cystic degeneration easily and presenting＂fastGelevation and sustained enhancement＂or progressive enhancement patterns in the dualGphase enhanced scans.These characteristics are helpful to make a diagnosis preoperatively.
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Objective To investigate the CT imaging features of basal cell adenoma in the parotid gland and thus to improve the preoperative diagnostic accuracy.Methods The clinical materials and image findings of 8 cases with parotid basal cell tumor,which were proved by pathology,were retrospectively studied.Results All 8 patients had solitary BCA lesion,which involved both the superficial and deep lobe(n =1) and located at the superficial lobe of parotid gland(n =7).All the 6 tumors were clear boundary and round shape without lobular appearance.The diameters of the max lesions ranged from 10.3-27.6 mm.CT scan showed that all lesions were solid nodules with uniform or uneven density.Cystic degeneration was displayed in 5 lesions,among them,cystic area was ≥90％ in 1 lesion.At enhanced scanning phase,most tumors showed a strong enhancement at the arterial phase and a pattern of persistent strong enhancement or slow decline at the venous phase.Conclusion The multi-slice CT imaging features of BCA in parotid gland are characteristic,which is helpful to make qualitative diagnosis in combination with clinical materials.
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El adenoma de células basales de las glándulas salivares es un tipo deadenoma de aparición infrecuente. La localización más habitual es la superficie de la glándula parótida. Suele debutar clínicamente como una masa fi rme y desplazable de crecimiento lento, asintomática, que puede distinguirse a la palpación en el examen clínico. Afecta más a las mujeres, entre 35 y 80 años. Histológicamente: se observan cordonesy trabéculas de células epiteliales delimitadas por células basaloides y formaciones microquísticas, sin componente mixocondroide del tumormixto, como el presente caso. Se puede dividir en cuatro subtipos atendiendoa su morfología: sólido, tubular, trabecular y membranoso. El tratamiento preferido es la escisión quirúrgica conservadora que incluyeun reborde o margen de tejido normal no afectado. Describimos un caso clínico de adenoma de células basales de la glándula parótida; el hallazgo de esta patología en particular, es muy rara y poco documentada, además realizamos una revisión de la literatura y discutimos el manejo terapéutico y conservador de esta rara enfermedad.
Basal cell adenoma of the salivary glands is a rarely seen type of adenoma.Its most frequent location is the surface of the parotid gland. Itusually appears as a fi rm, mobile, slow-growing asymptomatic mass,which can be detected by palpation during clinical examination. Itis more prevalent in women between the age of 35 and 80 years.Histologically, cords and trabeculae of epithelial cells bounded bybasaloid cells and microcystic formations are visible, without themyxochondroid component of mixed tumors, as in the present case.The basal cell adenoma can be divided into four subtypes based onmorphology: solid, tubular, trabecular and membranous. The treatmentof choice is conservative surgical excision that includes a rimor margin of normal uninvolved tissue. We describe a clinical case ofbasal cell adenoma of the parotid gland, a particular disease that isvery rarely found and seldom documented. We also perform a reviewof the literature and discuss the conservative therapeutic managementof this unusual disease.
Subject(s)
Humans , Female , Middle Aged , Adenoma/surgery , Adenoma/classification , Parotid Neoplasms/pathology , Age and Sex Distribution , Adenoma/epidemiology , Biopsy/methods , Diagnosis, Differential , Diagnostic Imaging , Mexico , Oral Surgical Procedures/methods , Tomography, X-Ray Computed/methodsABSTRACT
Basal cell adenoma (BCA) is a rare, benign neoplasm that most frequently arises in the parotid gland. We treated a 54-year-old female patient with BCA that had developed in the deep portion of the left parotid gland. The patient presented with gradual facial swelling with no other symptoms. We performed a total parotidectomy to excise the mass, but we preserved the facial nerve. Histopathology revealed a well-encapsulated mass. The tumor was composed of islands of comparatively uniform, small, dark, basaloid epithelial cells in the stroma. Histologic and immunohistochemical studies concluded that the BCA tumors were mostly trabecular. Postoperatively, there was no facial nerve weakness, and the tumor did not recur during the 24-month follow-up period.
Subject(s)
Female , Humans , Middle Aged , Adenoma , Epithelial Cells , Facial Nerve , Follow-Up Studies , Islands , Parotid GlandABSTRACT
Objective To evaluate the clinical,pathological and imaging features of basal cell adenoma in the parotid. Methods The clinical,pathological and CT imaging data of 21 cases with parotid basal cell tumor confirmed by operation and pathology were retrospectively analyzed. Results All 21 patients(5 male,16 female ) had solitary BCA lesion,which located at the superficial lobe of parotid gland(n=17)and involved both the superficial and deep lobe(n=4). Twelve lesions were well-defined and cystic degeneration was displayed in 9 le-sions,3 lesions had punctate calcification at the edge of tumor. All lesions were significantly enhanced,the enhancement of BCA in the ve-nous phase was close to the arterial phase. Conclusion The CT features of BCA in parotid gland are characteristic,which is helpful to make qualitative diagnosis when in combination with clinical features.
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Purpose To study the clinicopathologic features and immunophenotype of the basal cell adenoma ( BCA) with a focal crib-riform pattern in salivary gland. Methods Four cases of BCA with a focal cribriform pattern were retrospectively analyzed with their clinical findings, histopathology and immunohistochemical staining for CK, CK14, CK8/18, CK19, EMA, CD10, CD117, BCL-2, CDX-2, SMA, S-100, p63, p53, EGFR and Ki-67. Results Four cases of BCA with a focal cribriform structure all appeared as slow-growing neoplasms with good circumscription and lack of infiltrative properties, with capsular invasion but without capsular break-through. There are have at least a 50% area of cribriform structure in tumors under microscope. Immunohistochemical profiles exhibi-ted weak positivity for CK, EMA, CD10, CD117, BCL-2, CDX-2, p53 and EGFR, moderate for CK14, CK8/18, SMA and S-100, and strong for CK19, p63 and Ki-67 index<1%. Conclusions Cribriform type of salivary bacal cell adenoma is relatively rare and has difficulty in distinction from adenoid cystic carcinoma ( ACC) . Clinicopathologic features and immunophenotype are the most relia-ble points for differential diagnosis of BCA from ACC.
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Objective: The objective of this study was to investigate the distribution of β-catenin in pleomorphic adenomas and the basal cell adenomas to clarify its possible role in the etiopathogenesis of these two lesions. Material and Methods: The expression of β catenin (BD Transduction Laboratories) was analyzed by immunohistochemistry in formalinfixed, paraffin-embedded specimens by the avidinbiotin- peroxidase complex method in 10 pleomorphic adenomas and 2 basal cell adenomas. The specimens were analyzed taking into account intensity, distribution and association with myoepithelial cells. Results: The results showed that all cases of pleomorphic adenomas exhibited membranous and cytoplasmic immunostaining and the 2 cases of basal cell adenomas displayed nuclear staining. Higher β-catenin index rates were seen mainly in ductal structures of pleomorphic adenomas and in the nuclei of myoepithelial stromal and myoepithelial cells of solid clusters in basal cell adenomas. Conclusion: In conclusion, this immunohistochemical study may suggests the different degree of differentiation of the myoepithelial cells in these two tumors
Objetivos: O objetivo deste estudo foi investigar a distribuição da β-catenina em adenomas pleomorfos e os adenomas de células basais para esclarecer o seu possível papel na etiopatogenia dessas duas lesões. Material e Métodos: A expressão de β-catenina (BD-Transdução Laboratories) foi analisada por imunohistoquímica em espécimes parafinados fixados em formalina pelo método avidina-biotinaperoxidase em 10 adenomas pleomórficos e 2 adenomas de células basais. Os espécimes foram analisados levando-se em conta a intensidade, quantidade de células marcadas e distribuição em estruturas morfológicas. Resultados: Os resultados mostraram que todos os casos de adenomas pleomorfos exibiram imuno marcação membranosa e citoplasmática e os 2 casos de adenomas de células basais exibiram coloração nuclear. Marcação mais intensa de β-catenina foi vista principalmente em estruturas ductais de adenomas pleomorfos e nos núcleos de células mioepiteliais de estruturas tubulares e trabeculares em adenomas de células basais. Conclusão: Concluindo, este estudo imunohistoquímico sugere distintos graus de diferenciação das células mioepiteliais em cada um destes dois tumores
Subject(s)
Adenoma , Adenoma, Pleomorphic , beta Catenin , ImmunohistochemistryABSTRACT
Several types of cyst may occur in the neck. Branchial cleft cyst is the most common cystic lesion, but the first branchial cleft cyst is a very rare disease. Cystic cervical lesions may be mistaken for enlarged lymph nodes or tumors. To avoid interpretation errors, aspiration of all cysts or cystic lesions must be followed by careful palpation and reaspiration of any residual mass. Further, a careful analysis of the patient's clinical data is of value. In questionable cases, surgical excision of the cystic tumor for histologic examination is recommended. We report a case of basal cell adenoma arising in the first branchial cleft cyst. This case support the hypothesis that lymphoepithelial cysts of the major salivary glands arise from inclusions of salivary gland tissue in lymph node.