Adenoma sebáceo de la glándula parótida

Medicina oral, patologia oral y cirugia bucal (Impact Factor: 1.17). 01/2006;
Source: OAI


Tumors of the salivary glands constitute an important field of oral and maxillofacial pathology. The majority of salivary gland neoplasms are benign, with malignant salivary tumors accounting for 15 to 32 percent. The most common site for salivary gland tumors is the parotid gland, accounting up to 80 percent of all cases. This article reports the pathologic picture in a case of sebaceous adenoma of the parotid gland. The tumor was composed of epithelial cells lining ducts and closely associated with broad areas of sebaceous differentiation. The growth pattern was predominantly cystic, with cavities filled with sebaceous material. Areas of oncocytic metaplasia were also seen. The presence of sebaceous glands in salivary neoplasms is frequent, however, and in spite of this, salivary neoplasms constituted partially or entirely of these cells are rarely observed. To the surgeon and pathologist, the major problem in dealing with sebaceous adenoma is the recognition of this rare entity, avoiding confusing with other more aggressive neoplasms. The treatment involves surgical excision. The addition of the current case to the previously published data brings the total number of parotid sebaceous adenoma to seven. Los tumores de las glándulas salivales constituyen un área importante de la patología oral y maxilofacial. La mayor parte de las neoplasias glandulares salivales son benignas, representando las malignas entre el 15 y el 32% del total. La localización más común de estas entidades es la glándula parótida, en la que asientan hasta el 80% de todos los casos. En este artículo se presenta un caso de adenoma sebáceo salival, de localización parotídea. El tumor, formado por células epiteliales que tapizan conductos, exhibe amplias áreas de diferenciación sebácea y zonas con metaplasia oncocítica. El patrón histológico es predominantemente quístico, observándose cavidades rellenas con material sebáceo. Si bien la presencia de glándulas sebáceas en las glándulas salivales es frecuente, las neoplasias exclusivamente formadas por las mismas son muy infrecuentes. Dada su rareza, este tumor plantea problemas diagnósticos diferenciales con otras entidades benignas y malignas. Su tratamiento implica la extirpación de la lesión, lo que generalmente involucra la eliminación de la glándula en la que ha surgido. El presente caso constituye el séptimo publicado de esta entidad.

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    ABSTRACT: Primary sebaceous tumors of salivary glands are extremely rare, although sebaceous glands are commonly present in parotid and submandibular glands. A review of the files of the Armed Forces Institute of Pathology yielded 21 cases of primary salivary gland sebaceous tumors. Five were sebaceous adenomas, 9 sebaceous lymphadenomas, 5 sebaceous carcinomas and 2 sebaceous lymphadenocarcinomas. Seventeen tumors were located in the parotid gland and one each in the submandibular gland, the minor salivary glands of buccal mucosa and in ectopic salivary gland tissue in a periparotid lymph node. Thirteen tumors occurred in males and six in females. The peak incidence for all the sebaceous tumors, occurred in the sixth and seventh decades. The influence of age, sex, race, clinical symptoms, and pathology on survival is reviewed for each tumor group. Our histopathologic observations strongly suggest that sebaceous lymphadenoma and sebaceous lymphadenocarcinoma arise from sebaceous glandular rests in a lymph node in a fashion similar to that of a Warthin tumor.
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