Expression of hormonal receptor in patients with metastasizing pleomorphic adenoma of the major salivary gland; a clinicopathological report of three cases

Department of Pathology, Faculty ofMedicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 09/2009; 92(9):1250-5.
Source: PubMed


Metastasizing pleomorphic adenoma is an uncommon malignant tumor of the salivary gland demonstrating benign epithelial and modified myoepithelial elements intermingling with tissue of mucoid, myxoid, or chondroid appearance that inexplicably manifests local or distant metastasis.
To determine the expression of hormonal receptor in the patients with metastasizing pleomorphic adenoma of the major salivary gland.
Medical records, clinical and pathologic findings of three patients who were diagnosed as metastasizing pleomorphic adenoma were reviewed. The immunohistochemical stains for estrogen receptor, progesterone receptor, and Ki-67 were performed.
Three cases of metastasizing pleomorphic adenoma, clinically presenting as painless, gradually enlarged cervical lymph nodes were reported. The pathologic examinations of the cervical lymph nodes are morphologically and immunohistologically identical to the sialoadenectomy specimen. Immunohistochemical stains show positive reactivity to progesterone receptor but negative reactivity to estrogen receptor in both mesenchymal and epithelial components of pleomorphic adenoma.
These are the first reported cases of metastasizing pleomorphic adenoma of the major salivary glands associated with expression of progesterone receptor in both specimens of sialoadenectomy and lymph node biopsy. This finding supports the pathogenesis of benign metastasis of tumor. However, the role of hormonal receptor in the pathogenesis and treatment of salivary metastasizing pleomorphic adenoma should be further investigated.

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    ABSTRACT: We report a case highlighting the multidisciplinary management of a giant pleomorphic adenoma of the parotid gland that showed rapid growth in the third trimester of pregnancy. A 43-year-old Caucasian woman presented in her 32nd week of gestation with a tumor of the parotid gland. Ultrasonography of her neck showed a parotid lesion of 40 × 30 × 27.5 mm. A follow-up magnetic resonance imaging scan of the neck four weeks later revealed that the tumor had grown to 70 × 60 × 60 mm, reaching the parapharyngeal space with marked obstruction of the oropharynx of about 50%. After discussing the case with our multidisciplinary tumor board and the gynecologists it was decided to deliver the baby by caesarean section in the 38th week of gestation, and then to perform a surgical resection of the tumor. Indications for early surgical intervention of similar cases should be discussed on an individual patient basis in a multidisciplinary setting.
    Journal of Medical Case Reports 04/2011; 5(1):141. DOI:10.1186/1752-1947-5-141

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