Association between ELL2 polymorphism and susceptibility to pleomorphic adenoma of salivary gland / 解放军医学杂志

Objective To analyze the correlation between the ELL2 gene 1119 T>C polymorphism and the susceptibility to pleomorphic adenoma of the salivary gland.Methods The pedigree of the pleomorphic adenoma family of salivary gland was drawn.The exons of ELL2 gene in 5 members of salivary pleomorphic adenoma family were sequenced.A case-control study was conducted.One hundred and twelve patients with pleomorphic adenoma of the salivary gland who visited the Department of Oral and Maxillofacial Surgery of Shanxi Bethune Hospital from January 2016 to July 2020 were taken as case group,and 176 healthy examinees from January 2019 to January 2020 were taken as control group with age and sex as matching conditions.The 1119 T>C polymorphism of ELL2 genes in the two groups were detected with high resolution melting(HRM)curve.Chi-square test was adopted to analyze the correlation between gene polymorphism and the occurrence of pleomorphic adenoma of the salivary gland,stratified analysis was performed to evaluate the synergistic effect of smoking and genotype,and real time quantitative reverse transcription polymerase chain reaction(RT-PCR)was used to detect the expression level of ELL2 in individuals with different genotypes.Results The 1119 T>C polymorphism site existed in the exon 8 of ELL2 gene in a family with pleomorphic adenoma of salivary gland.The results of case-control study showed that the genotype frequency of homozygous CC was significantly higher in patients with pleomorphic adenoma of salivary gland than that in the controls(24.1%vs.11.9%,P=0.002).Homozygous CC was associated with increased risk for developing pleomorphic adenoma of salivary gland(OR=3.059,95%CI 1.494-6.263)in this cohort.Stratification analysis showed that smoking and 1119C allele cooperated to increase the risk of pleomorphic adenoma of salivary gland(OR=3.200,95%CI 1.460-7.014).The expression level of ELL2 mRNA in CC genotype was significantly higher than that in individuals with CT or TT genotype(P<0.05).Conclusion The genetic variation of ELL2 may play an important role in the occurrence of pleomorphic adenoma of salivary gland,and smoking combined with the 1119C allele increased the risk of this disease.

Clinical behavior of recurrent pleomorphic adenoma in the palate: a systematic review

Purpose: This systematic review analyzed the clinical behavior and odds of malignancy of the palatal recurrent pleomorphic adenomas. Methods: Systematic review of patients with recurrent pleomorphic adenoma arising in the palate. Database search: MEDLINE, Scopus, Web of Science, Cochrane, EMBASE, Virtual Health Library, Google Scholar, and OpenGrey. A binomial logistic regression was performed to assess the odds of detecting recurrence five, 10 and 20 years after the treatment of primary tumor. Results: Thirteen studies (n = 18 patients) out of 336 were included. The recurrent pleomorphic adenoma in palate was more common in females (61.6%), average age was 49 years old (range 9-73 years old). Four patients progressed to malignant transformation. The odds ratio (OR) of detecting a recurrence at 10 (OR = 5.57; 95% confidence interval - 95%CI 1.13-27.52), and 20 years (OR = 18.78; 95%CI 3.18-110.84) after treatment of primary pleomorphic adenoma was significantly higher than at one-year follow-up. Conclusions: The recurrence of pleomorphic adenoma in palate remains a rare event of late occurrence. It mainly affects middle-aged female and carries a risk of malignant transformation. Although uncommon, patients with palatal pleomorphic adenoma should be warned about the possibility of recurrence or malignant transformation of tumor at advanced ages.

EZH2 immunoexpression in pleomorphic adenoma and adenoid cystic carcinoma and clinicopathological features

Abstract The aim of this study was to evaluate the expression of the EZH2 protein and describe the clinical and microscopic characteristics of adenoid cystic carcinoma (ACC) and pleomorphic adenoma (PA). The study included 16 ACC cases and 12 PA. All ACC and PA cases were positive for EZH2 and the ACC samples showed significantly higher EZH2 expression. The clinical and microscopic covariates were described in relation to EZH2 staining in ACC samples. The highest mean values of EZH2 were observed in cases with local metastasis, recurrence, perineural invasion, and predominantly cribriform growth pattern without solid areas. EZH2 is a potential marker of malignancy.

Lacrimal gland pleomorphic adenoma: a narrative review / Adenoma pleomórfico de glândula lacrimal: uma revisão narrativa

ABSTRACT We present a literature review of 57 publications describing this pathology, published from the year 2012. In all these studies patients were reported to depict a slow-growing, motionless mass, which is painless at most times. All cases were managed by total excision, except for one report where adjuvant radiotherapy was applied. Among the several therapeutic strategies, the total tumor resection, preserving the tumor pseudocapsule intact, appears to be a consensus in treating the disease efficiently. Furthermore, fine-needle aspiration biopsy, including the assessment of genetic alterations, has proved to be a valuable tool in the diagnosis of challenging cases. Our literature survey also suggests that an incisional biopsy before the surgery may lead to the pseudocapsule disruption, thus considerably increasing the chances of adenoma recurrence, enabling its malignization. At present, genetics studies indicate that the molecular aberrations involved in the adenoma are similar to those represented in the salivary gland tumor pathogenesis. Further, in the recurrent cases, the pathology becomes difficult to treat and multiple surgeries may be required, occasionally, leading to radical surgery treatment.

RESUMO Uma revisão narrativa da literatura de 57 publicações que descrevem esta patologia, publicada a partir de 2012. Os pacientes têm uma massa de crescimento lento e imóvel, que na maioria das vezes é indolor. Todos os casos foram tratados por excisão total, com exceção de um relatório de radioterapia adjuvante. Entre as estratégias terapêuticas encontradas, a ressecção total do tumor, preservando a pseudocápsula tumoral intacta, parece ser um consenso. Alternativamente, a biópsia por aspiração de agulha fina incluindo a avaliação de alterações genéticas pode representar uma ferramenta valiosa nos casos diagnósticos desafiadores. Uma biópsia incisional antes da cirurgia não é recomendada, pois a ruptura da pseudocápsula aumenta consideravelmente a recorrência do adenoma, permitindo até mesmo sua malignização. Com relação à genética, estudos atuais indicam que as aberrações moleculares envolvidas no adenoma são semelhantes às da patogênese do tumor da glândula salivar. Para casos de recorrência, a patologia torna-se difícil de tratar e múltiplas cirurgias podem ser necessárias, às vezes levando a um tratamento cirúrgico radical.

Pleomorphic Adenoma of the Hard Palate: A Multidisciplinary Approach

Pleomorphic adenoma is the most common salivary gland tumor accounting for 80% of all major salivary gland tumors. It is a benign salivary gland neoplasm that constitutes 3% to 10% of the neoplasms in the head and neck region.1 Salivary gland neoplasms represents less than 1% of all tumors. This article is being showcased as a special case due to the fact it was done at a Taluk Hospital and also because ENT and oromaxillofacial surgeons were involved during the surgery.

Clinical and radiologic outcomes of pleomorphic adenoma and adenoid cystic carcinoma of the lacrimal gland / Desfechos clínicos e radiológicos do adenoma pleomórfico e do carcinoma adenoide cístico da glândula lacrimal

ABSTRACT Purpose: To compare the radiologic and clinical features of primary lacrimal gland pleomorphic adenoma and adenoid cystic carcinoma. Methods: This study retrospectively reviewed imaging findings and medical records of lacrimal gland pleomorphic adenoma and adenoid cystic carcinoma. Results: Eleven patients with pleomorphic adenoma and 16 patients with adenoid cystic carcinoma were evaluated. There were no statistically significant differences between groups regarding age or sex. Proptosis was the most common presenting symptom in both groups. Adenoid cystic carcinomas were more likely to present with a palpable mass, diplopia, pain, and sensory loss than pleomorphic adenomas, although the differences were not statistically significant between groups. Furthermore, there were no significant differences in terms of homogeneity and globe indentation between lacrimal gland pleomorphic adenoma and adenoid cystic carcinoma on computed tomography (CT)(all p>0.05). The rates of bone invasion, tumor calcification, and wedge sign were significantly higher in adenoid cystic carcinomas, and bone remodeling was statistically significantly higher in pleomorphic adenomas, on CT(all p<0.05). Pleomorphic adenomas were significantly more likely to show well-defined margins, lobulated contours, heterogeneous contrast enhancement, and hyperintensity on T2-weighted magnetic resonance images (all p<0.05). Conclusion: When differentiating between lacrimal gland pleomorphic adenoma and adenoid cystic carcinoma, evaluation of radiologic features along with clinical features is of great importance. Lobulated contours may be a significant distinguishing radiologic feature suggesting pleomorphic adenoma.

RESUMO Objetivo: Comparar as características radiológicas e clínicas do adenoma pleomórfico primário e do carcinoma adenoide cístico da glândula lacrimal. Métodos: Este estudo revisou retrospectivamente os achados de imagem e os prontuários médicos de casos de adenoma pleomórfico e carcinoma adenoide cístico da glândula lacrimal. Resultados: Foram avaliados 11 pacientes com adenoma pleomórfico e 16 pacientes com carcinoma adenoide cístico. Não houve diferenças estatisticamente significativas em relação à idade e sexo. Proptose foi o sintoma de apresentação mais comum em ambos os grupos. Os carcinomas adenoides císticos foram mais propensos que os adenomas pleomórficos a apresentarem massas palpáveis, diplopia, dor e perda sensorial, mas essa diferença entre os grupos não foi estatisticamente significativa. Não houve diferenças estatísticas em termos de homogeneidade e indentação do globo ocular entre os dois tipos de tumores em imagens de tomografia computadorizada (p>0,05). Também à tomografia computadorizada, a invasão óssea, a calcificação do tumor e o sinal em cunha foram mais frequentes nos carcinomas adenoides císticos, enquanto a remodelação óssea foi mais frequente nos adenomas pleomórficos, com significância estatística para todas essas manifestações (p<0,05). À ressonância magnética, os adenomas pleomórficos foram significativamente mais propensos a terem margens bem definidas, contornos lobulados, realce heterogêneo pelo contraste e hiperintensidade na ressonância magnética ponderada em T2 (p<0,05). Conclusão: Ao se diferenciar o adenoma pleomórfico e o carcinoma adenoide cístico da glândula lacrimal, é muito importante avaliar as características radiológicas juntamente com as características clínicas. Os contornos lobulados podem ser uma característica radiológica significativamente distinta em favor do adenoma pleomórfico.

Peritoneal sarcomatosis due to undifferentiated pleomorphic sarcoma: A case report and review of the literature

Undifferentiated pleomorphic sarcoma (UPS), which was previously known as malignant fibrous histiocytoma (MFH), rarely presents in the abdomen, and sarcomatosis due to UPS has not yet been reported in the literature. Here, we present a 62-year-old man who had abdominal sarcomatosis due to UPS with a poor prognosis.

Analysis of Various Histopathological Patterns in Pleomorphic Adenoma - An Institutional Case Study

Introduction: Pleomorphic adenoma, the most common benign mixed salivary gland tumor which accounts for 70-80%, is a biphasic tumor with dual origin from epithelial and myoepithelial elements. It shows a malignant transformation rate of 6%. Microscopically, pleomorphic adenoma characteristically displays vast morphologic diversity. This present study is done to analyze prevalence rates and histomorphological variations to better elucidate the pattern of occurrence, diagnosis and treat- ment plan of pleomorphic adenoma. Materials and Methods: This are a retrospective study which was conducted in a private institution, Chennai. Based on the proportion of parenchymal and stromal tumor components, the cases were classified into four subtypes as proposed by Foote and Frazell. Morphological patterns, cellular patterns, capsular alterations and Stromal components were analyzed and statisti- cally evaluated. Results: Our analysis showed an overall 0.87% of pleomorphic adenoma cases being reported were associated with minor salivary glands followed buccal mucosa and palate. All the reported cases showed Type II pattern with histological cellular pat- tern of spindle cells and ductal morphological pattern. Conclusion: We observed the great diversity of morphological aspects of the stroma in pleomorphic adenoma, in which many cases showed variation in morphology and cellularity associated with tumor location.

Effect of tumor-stromal fibroblasts on the biological behavior of salivary gland pleomorphic adenoma cells in vitro / 华西口腔医学杂志

OBJECTIVES@#This study aims to investigate the effects of tumor-stromal fibroblasts (TSFs) on the proliferation, invasion, and migration of salivary gland pleomorphic adenoma (SPA) cells in vitro.@*METHODS@#Salivary gland pleomorphic adenoma cells (SPACs), TSFs, and peri-tumorous normal fibroblasts (NFs) were obtained by tissue primary culture and identified by immunocytochemical staining. The conditioned medium was obtained from TSF and NF in logarithmic phase. SPACs were cultured by conditioned medium and treated by TSF (group TSF-SPAC) and NF (group NF-SPAC). SPACs were used as the control group. The proliferation, invasion, and migration of the three groups of cells were detected by MTT, transwell, and scratch assays, respectively. The expression of vascular endothelial growth factor (VEGF) in the three groups was tested by enzyme linked immunosorbent assay (ELISA).@*RESULTS@#Immunocytochemical staining showed positive vimentin expression in NF and TSF. Results also indicated the weak positive expression of α-smooth muscle actin (SMA) and fibroblast activation protein (FAP) in TSFs and the negative expression of α-SMA and FAP in NFs. MTT assay showed that cell proliferation in the TSF-SPAC group was significantly different from that in the NF-SPAC and SPAC groups (P<0.05). Cell proliferation was not different between the NF-SPAC and SPAC groups (P>0.05). Transwell and scratch assays showed no difference in cell invasion and migration among the groups (P>0.05). ELISA showed that no significant difference in VEGF expression among the three groups (P>0.05).@*CONCLUSIONS@#TSFs may be involved in SPA biological behavior by promoting the proliferation of SPACs but has no effect on the invasion and migration of SPACs in vitro. Hence, TSF may be a new therapeutic target in SPA treatment.

Value of MRI multi-parameter imaging in differential diagnosis of benign parotid tumors / 实用放射学杂志

Objective To investigate the value of multi-parameter features based on MRI in the differential diagnosis of benign parotid tumors.Methods Retrospective analysis was conducted on the MRI data of 144 lesions in 123 patients.According to the pathological results,all cases were divided into pleomorphic adenoma(PA)group(n=90)and non-PA group(n=33).The gender,location,MRI signal and dynamic enhancement types of the two groups were compared and analyzed.Results There were all significant differences in age,gender,cystic degeneration,T1WI,T2WI signals,types of time-signal intensity curve(TIC),lesion location,edge and apparent diffusion coefficient(ADC)values between PA and non-PA groups(P＜0.05).Gender(female),T2 high signal and ADC values were in good agreement with the pathological results in PA(Kappa value was 0.62,0.62,0.78,respectively,P＜0.05).The receiver operating characteristic(ROC)curve showed that ADC value and Tpeak had good differential diagnostic value.Area under the curve(AUC)(AUCADC and AUCTpeak)were 0.97[95％confidence interval(CI)0.92-1.00]and 0.76(95％CI 0.52-0.97),respectively.Cut-off value of ADC was 1.03×10-3 mm2/s,and sensitivity and specificity was 85.71％and 100.00％,respectively.Cut-off value of Tpeak was 102 s,and sensitivity and specificity was 71.43％and 75.00％,respectively.When the two parameters were combined for differential diagnosis,the AUC was 0.92(95％CI 0.92-1.00),and the sensitivity and specificity was 92.86％and 87.50％,respectively.Conclusion The comprehensive analysis of multi-parameter imaging features based on MRI can improve the accuracy of differential diagnosis of benign parotid tumors and help to formulate individualized treatment plans.

Comparative study on the curative effect of ultrasound-guided radiofrequency ablation and surgical excision in the treatment of salivary gland mixed tumor / 中华超声影像学杂志

Objective:To compare the therapeutic effects of ultrasound-guided radiofrequency ablation (RFA) and surgical resection on salivary gland mixed tumor with diameter ≤3 cm, and to analyze the feasibility and clinical value of RFA in the treatment of salivary gland mixed tumor.Methods:A retrospective study was conducted on 43 patients with salivary gland mixed tumor whose diameter ≤3 cm were treated in the First Affiliated Hospital of Zhengzhou University from March 2020 to March 2022.According to the treatment method, they were divided into an ablation group of 20 cases and a resection group of 23 cases. The complete ablation rate of the ablation group was evaluated, the postoperative absorption of ablation foci in the ablation group was recorded, and the perioperative indexes and the incidence of postoperative complications of the two groups were compared. The long-term prognosis of the two groups was followed up, and the incidence of recurrence, malignant metastasis and appearance recovery were evaluated.Results:In the ablation group, the complete ablation rate was 100.00% (20/20). The lesion volume reduction rates at 1, 3, 6 and 12 months after operation were -(39.60±16.18)%, (8.61±8.10)%, (31.87±14.68)% and (58.64±14.82)%, respectively. The operation time, recovery feeding time, postoperative hospital stay and intraoperative bleeding in the ablation group were less than those in the resection group, and the differences were statistically significant (all P<0.001). Postoperative complications occurred in 2 cases in the ablation group and 9 cases in the resection group. There was significant difference in the total incidence of postoperative complications between the two groups(χ 2=4.768, P=0.029). There was 1 case of recurrence in the ablation group, and no facial depression or protuberance occurred 1 year after operation. There was no recurrence in the resection group, one year after operation, the incidence of facial depression and facial protuberance was 13.04%(3/23) and 0, respectively.There was no malignant metastasis in both groups. Conclusions:Ultrasound-guided RFA is safe and effective in the treatment of mixed tumors of salivary gland with diameter ≤3 cm, and the therapeutic effect is not significantly different from that of surgery. With minimal trauma and good cosmetic effect, it has a great application prospect.

Diagnosis of a Primary Pleomorphic Liposarcoma in a Tree Shrew（Tupaia belangeri subsp. yaoshanensis） / 实验动物与比较医学

A large spontaneous mass on the dorsal abdomen near the hip joint was found in an aged female Tupaia belangeri subsp. yaoshanensis after 5 years of routine feeding. The tumor in the diseased tree shrew was huge, with an intact surface and no ulceration; however, it caused inconvenience in movement while maintaining a good mental state. After inhalation anesthesia with isoflurane (2%-4%), the tree shrew was euthanized after the tree shrew entered deep anesthesia. Anatomical dissection of the tumor, the tumor boundary was unclear and infiltrated into surrounding tissues. HE staining showed that small focal pleomorphism and large areas of adipocytes were seen in the tumor tissue. The pleomorphic sarcoma area was mainly composed of atypical epithelioid cells with easily visible nuclear divisions. The size of the adipocytes was significantly different, and more pleomorphic adipocytes were seen. The cell volume was large, the nucleus was deeply stained and deformed, the edge was impressed, and the cytoplasm was seen with multiple vesicular lipid droplets. Immunohistochemical results showed that the tumor cells were positive for Vimentin, the small focal polymorphic adipocyte nucleus was positive for S-100, and Ki-67 exhibited a higher proportion of positivity. Combined with HE staining and immunohistochemical results, the spontaneous tumor in this tree shrew was comprehensively diagnosed as pleomorphic liposarcoma.

Oral rehabilitation after partial maxilectomy for removal of pleomorphic adenoma: case report / Reabilitação oral após maxilectomia parcial para remoção de adenoma pleomórfico: relato de caso

ABSTRACT Salivary gland tumors account for only 3%-5% of all tumors in the head and neck, 10%-15% of which originate from minor salivary glands. Pleomorphic adenoma is a benign lesion of the salivary gland, most commonly occurring in the region of the hard and soft palates. The treatment of choice for pleomorphic adenomas is with the partial or total function of the extension of the lesion, and placing palatal obturators are one method of reestablishing masticatory function and facial esthetics. This study aimed to rehabilitate a patient using a palatal implant following partial maxillectomy for the removal of a pleomorphic adenoma. A young patient with pleomorphic adenoma of the hard palate underwent a partial right-sided maxillectomy procedure which removed the hard palate and alveolar regions of the molars. Prior to surgery, the patient was assessed to make a surgical guide for resection of the tumor, as well as a provisional obturator plate using orthodontic wire clasps. After healing, the patient was rehabilitated using a palatal obturator which had been incorporated into a removable partial denture. The clinical sequence used to fabricate the final prosthesis was as follows: initial molding after surgery, prosthesis design, preparation of the mouth, work molding, structure testing and orientation planning, teeth testing and installation, and periodic maintenance. Thus, we can conclude that the palatal obturator is an excellent means of restoring a patient's oral function, facial esthetics, and overall quality of life.

RESUMO Os tumores de glândulas salivares representam apenas 3%-5% de todos os tumores em região de cabeça e pescoço, dentre eles 10%-15% se originam de glândulas salivares menores. O adenoma pleomórfico é uma lesão benigna de glândula salivar, tendo uma maior prevalência em região de palato. O tratamento dessas lesões se dá por método excisional ou maxilectomia dependendo da extensão da lesão e, uma das formas de reestabelecimento da estética e função do paciente é com um obturador palatino. O objetivo deste trabalho foi relatar uma reabilitação oral através da utilização de um obturador palatino em um paciente submetido a maxilectomia parcial para remoção de adenoma pleomórfico. Paciente de 22 anos, com adenoma pleomórfico em região de palato, foi submetido a maxilectomia parcial, removendo região de palato duro e região alveolar dos molares do lado direito. Foi realizada moldagem da maxila previamente a cirurgia para confecção de um guia cirúrgico, o guia foi utilizado na ressecção do tumor e, serviu também, para confecção de uma placa obturadora provisória associada a fios ortodônticos. Após cicatrização completa, foi acordado que a reabilitação do paciente seria com uma prótese parcial removível do tipo obturador palatino. A sequência clínica para a realização da prótese foi: moldagem inicial após a cirurgia, delineamento, preparo de boca, moldagem de trabalho, prova da infraestrutura e plano de orientação, prova dos dentes, instalação e manutenções periódicas. Com isso, podemos concluir que o obturador palatino é um excelente meio de reestabelecer função e estética do paciente, melhorando sua qualidade de vida.

MANAGEMENT OF A HUGE PARAPHARYNGEAL MASS : A SURGICAL NOVELTY

Parapharyngeal space(PPS) tumors are very uncommon. Though majority of these tumors are of benign origin, the most common among them is a pleomorphic adenoma. Surgical removal is mainstay for the treatment of these tumors for which a strategic preoperative evaluation of each patient and knowledge of different surgical approaches to PPS are essential. Here we report a rare but typical case of a 35 years old female presented to OPD with a mass in right the parapharyngeal space. The mass was excised successfully using mandibular swing approach and the post operative histopathology report suggested it to be “pleomorphic adenoma”

Lipossarcoma Pleomórfico de Mama em Paciente Jovem ­ Relato de Caso / Pleomorphic Breast Liposarcoma in a Young Patient ­ Case Report

O Sarcoma de partes moles é um tumor maligno raro, correspondendo a aproximadamente 1% dos tumores malignos em adultos. Objetivamos descrever um raro caso de Lipossarcoma pleomórfico em paciente jovem, sem história familiar, que representa 0,3% dos sarcomas da mama. Relatamos o caso de uma paciente do sexo feminino, 39 anos, com nodulação em prolongamento axilar de mama esquerda, cujas mamografia e ecografia caracterizaram nodulação regular, de limites definidos, sem fluxo central ou periférico e ecotextura heterogênea. A Core-Biopsy diagnosticou neoplasia maligna fusocelular. Realizada ressecção segmentar, cujos laudos histopatológico e de imuno-histoquímica concluíram como sendo Lipossarcoma pleomórfico de alto grau. O sarcoma pleomórfico é um subtipo raro e agressivo entre os lipossarcomas. O seu tratamento, assim como dos sarcomas de mama, é a ressecção cirúrgica com margens de segurança; a terapia adjuvante com radioterapia é indicada devido à taxa de recorrência deste tumor. A quimioterapia ainda tem papel indefinido nesses tipos de tumores. Concluímos que, por ser o Lipossarcoma pleomórfico uma neoplasia maligna rara, o diagnóstico e a conduta adequados se fazem necessários para prover terapêutica precisa e conter metastatização e recidiva local.

Soft tissue sarcoma is a rare malignant tumor, accounting for approximately 1% of malignant tumors in adults. We aim to describe a rare case of pleomorphic liposarcoma in a young patient with no family history, representing 0.3% of breast of breast sarcomas. We report the case of a 39-year-old female patient with nodulation in the axillary extension of the left breast, whose mammogram and ultrasonography characterized a regular nodulation, with defined limits, without central or peripheral flow, and heterogeneous echotexture. The Core-Biopsy diagnosed malignant fusocellular neoplasm. Segmental resection was performed. The histopathological and immunohistochemistry reports concluded that it was a high grade pleomorphic liposarcoma. Pleomorphic sarcoma is a rare and aggressive subtype among the liposarcomas. Its treatment, as with breast sarcomas, is surgical resection with safety margins; adjuvant therapy with radiotherapy is indicated due to the recurrence rate of this tumor. Chemotherapy still has an undefined role in these types of tumors. We conclude that, because pleomorphic liposarcoma is a rare malignant neoplasm, the diagnosis and management are necessary to provide an accurate therapy and contain metastasis and local recurrence.

Histopathological study of salivary gland tumors: a tertiary care hospital-based study

Introduction: Salivary gland tumors (SGTs) are relatively uncommon and show a wide variety of morphological heterogeneities. The incidence of SGTs is said to be affected by geographical and racial factors. Histopathological diagnosis plays a major role in the diagnosis of these neoplasms. Objectives: This study investigated the incidence of SGTs and histopathological features of various SGTs, aimed at knowing the epidemiological pattern of these tumors and comparing the results of our study with other studies of SGTs in the literature. Materials and Methods: A retrospective study was conducted on SGTs at the Pathology Department of the Government Medical College and Hospital for a period of 5 years. Clinical and demographic data were documented and analyzed concerning histopathologic type. Results: A total of 86 SGTs were identified, 65.12% of which were classified as benign and 34.88% as malignant. Most tumors occurred in the parotid gland (59.14%). Pleomorphic adenoma (PA) was the most common tumor (56.98%), followed by mucoepidermoid carcinoma (MEC) (17.44%). The tumors occurred more often in men (51.16%) than in women (48.84%). Conclusion: SGTs exhibit broad morphological heterogeneity and these tumors are rare. The parotid gland is the most common location, and PA is the most frequent benign tumor. MEC followed by adenoid cystic carcinoma is the most common malignancy of the salivary gland.

Pleomorpic Adenoma of Infratemporal Fossa Co- Existing with Actinomycosis: A Rare Case Report with Review of Literature

Introduction: Salivary gland tumors account for about 3% of head and neck tumors and the majority are benign in nature. Among these, the most common pathological type is pleomorphic adenoma also called the mixed tumor. It is a kind of tumor containing glandular tissue, myxoid and cartilage-like tissue. As the structure of the tissue is diverse, it is called a “mixed tumor.” Actinomycosis is a chronic suppurative bacterial infection caused by Actinomyces israelii. In this case report, we are presenting a rare co-existence of pleomorphic adenoma and Actinomycosis in the infratemporal fossa. Case description: A 40-year-old female patient complains of pain over the upper left back tooth region for the past 6months. The patient had a past history of a small lesion in 28 region which resulted in constant irritation. The patient had consulted the dentist for the same and underwent extraction of 28 and 38 three years back, which was thought to be the cause of the swell- ing. Conclusion: The case highlights the importance of proper history taking, clinical examination, and histopathological examina- tion in arriving at a precise diagnosis of a lesion irrespective of size and clinical presentation.

Circumscribed astrocytic gliomas: Contribution of molecular analyses to histopathology diagnosis in the WHO CNS5 classification

The newest revision of the WHO classification of tumors of the central nervous system, also known as WHO 5th edition, introduces substantial changes, especially within the glial tumor category and separates adult-type and pediatric-type glial tumors into different categories for the first time. In addition, another category of glial tumors, “Circumscribed Astrocytic Gliomas” were also created. This group includes pilocytic astrocytoma, pleomorphic xanthoastrocytoma, subependymal giant cell astrocytoma, chordoid glioma, astroblastoma, and the highly nebulous novel entity high-grade astrocytoma with piloid features. We present a brief and critical review of the pathological and molecular characteristics of these often well-demarcated tumors that can occur in adults as well as in the pediatric population.

Presentación inusual del adenoma pleomorfo congénito de fosa nasal en neonato

RESUMEN Introducción: El adenoma pleomorfo es la neoplasia benigna más frecuente en las glándulas salivales, su localización en vías aéreas superiores es poco frecuente. Objetivo: Describir la inusual presentación de un adenoma pleomorfo congénito nasal, no descrito con anterioridad en Cuba. Presentación del caso: se presenta un caso raro de recién nacido con datos clínicos de obstrucción nasal horas después de su nacimiento. Previos estudios y resultado de biopsia del tumor intranasal determinaron adenoma pleomorfo congénito. Se realizó exéresis de tumor por cirugía endoscópica nasal. Conclusiones: El adenoma pleomorfo debe ser considerado un diagnóstico diferencial en todas las edades; sospechar ante un paciente con síntomas de obstrucción unilateral o epistaxis. Un diagnóstico temprano permite un tratamiento oportuno con abordaje quirúrgico endoscópico menos invasivo y una menor tasa de recidiva. Este tumor se destaca por su potencial recurrencia o transformación maligna por lo que es importante mantener vigilancia endoscópica e imagenológica.

ABSTRACT Introduction: Pleomorphic adenoma is the most frequent benign neoplasm in the salivary glands; its location in the upper airways is rare. Objective: Describe the unusual presentation of a nasal congenital pleomorphic adenoma, not previously described in Cuba. Case Presentation: A rare case of a newborn with clinical data of nasal obstruction hours after birth is presented. Previous studies and biopsy result of the intranasal tumor determined congenital pleomorphic adenoma. Tumor excision was performed by endoscopic nasal surgery. Conclusions: Pleomorphic adenoma should be considered a differential diagnosis at all ages. Suspecting should be normal when a patient has symptoms of unilateral obstruction or epistaxis. Early diagnosis allows timely treatment with a less invasive endoscopic surgical approach and a lower rate of recurrence. This tumor stands out for its potential recurrence or malignant transformation, so it is important to maintain endoscopic and imaging surveillance.