CASE REPORT
Year : 2004  |  Volume : 8  |  Issue : 2  |  Page : 94-95

Juvenile pleomorphic adenoma

Vindhya Savithri, S Sudha, PM Shameena, Varughese V Ipe
Department of Oral and Maxillofacial Pathology, Government Dental College, Calicut, India

Correspondence Address:
Vindhya Savithri
Department Of Oral Pathology, Government Dental College, Calicut -673008
India

Source of Support: None, Conflict of Interest: None

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Abstract

Pleomorphic aderoma is a benign mixed salivary gland tumour seen most commonly in the parotid gland and is usually found in 4th and 6th decade of life. This is a case report of an unusual occurrence in a child in a rare intro-oral site, It was clinically diagnosed as fibronia and later histopathological examination revealed it to be a pleomorphic adenoma.

Keywords: Labialsulcus.Salivarygland.

Introduction

is 43%. ^[3] It is characterized by histomorphologic heterogeneity. i.e.. it is composed of glandular& stromal elements in differing proportions. The stroma may be mucoid, myxoid or chondroid. Most tumours occur between the 4 ^th to 6 ^th decades and there is a slight female predominance ^[2] .

Case Report

A male patient aged 13 years reported to Govt. Dental College. Calicut with the complaint of a growth in the tipper labial sulcus of three months duration [Figure 1]. During this time, the growth was seen to be slowly enlarging insize.

General examination of the patient was done and revealed no abnormal findings. the family history and medical history were non-contributory Infra orally the oral hygiene of the patient was good and a growth of approximately 1.5*1sq. cm in size was seen in the labial sulcus in relation to the upper left premolars region. The growth was non-tender and non-fluctuant. It had a smooth surface and was mobile. There were no associated carious teeth and palpable lymph nodes in the cervical region. Radiologic examination also revealed no findings and a provisional diagnosis of fibrurna was made

All routine laboratory investigations were done and revealed no abnormally. The mass was then enucleated by blunt dissection and it appeared to be encapsulated. The specimen was then sent for histopathologic examination- The tissue section revealed the presence of a fibrous capsule. Epidielium was seen proliferating in a duct-like pattern [Figure 2]. Proliferating epithelium was seen forming duct-like structures and some of these duct ­like structures contained eosinophilic coagulum [Figure 2] Abundant mucus cells were also seen. Myxoid areas were observed in stroma. These features lead to the diagnosis of pleomorphic adenoma.

Discussion

Pleomorphic adenoma may be derived from dutal and or myoepithelial elements. A remarkable microscopic diversity can exist from one tumor to the next. as well as in different areas of the same tumour. Minor salivary glands are the 2nd most common site for salivary gland neoplasm (9% to 23%). Intra orally the palate(60%) is the most common site os coccurence followed by the upper lip(20%) and buccal mucosa(10%).This case involved the labial sulcus, which is a very unusal site,On scanning the available literature, we found that no cases have been reported to occur in the labial sulcus.

Ribeiro et al ^[4] reported that epithelial neoplasms of salivary gland origin are relatively uncummon in children and adolescents and the mean age of occurence was 1 1.8 years. Kessler et al ^[5] and Ogata H et al ^[6] in different studies concluded that all the benign salivary neoplasms in children were pleomorphic adenoma. Hentandcz et al ^[2] reported an incidence of 1.4% for pleomorphic adenoma in children.

Jorge et al ^[8] reported a study on cases of juvenile infra oral pleomorpiuc adenoma of which 80% patients were female. 40% of the cases affected the palate amid another 40% occurred in the upper lip while 20% were seen in tongue. The pleomorphic adenoma youngsters seems to have similar biological characteristics to its counter pare seen in adults. But long-term follow-up is necessary to rule out a recurrence [Figure 3].

 

References

1.	Colour atlas & text of salivary gland Diseases disorders & surgery (1995): John E. D B N.Mark MG, 197-206).
2.	A textbook of Oral Pathology (4 th ed) Shafer. Hine, Lety(Pg 230-235).
3.	Oral and Maxillotacial Pathology (2 nd ed) Neville,Damm, Allen Bouquot(Pg 406-413)
4.	Rebeiro Kdc G, Kowalski LP, Saha L M, de Laniargo B, Epithelial Salivary glands neoplasnia in children and adolescents a forty four year experience is Med Pedials Oncol 2002 Dec: 39(6):594-600.
5.	Kessler A Handler SB, Salivary gland neoplasma in children: 1 to 10 year survey at the childrens Hospital of Philadelphia. Int J Pediatr Otorhinilaryngol 1994 Jane: 29 (3)'. 195-202.
6.	Ogata H, Fbihara S. Mukai K. Salivary gland neoplasma in children. Jpn J Clin Oncol 1994 Apr: 24I (2 ): 88-93.
7.	Hernandez MVM. toranzo FJM, Juaz GJJ Pelomorphic adenoma of the parotid gland in the pediatric children. A case report and literature review Rev ADM 1996: 53 (4). 201 -203.
8.	Jorge .J, Pries FR, Alves FA. Perez DL. Kowalske LP. Lopes MA. Almoila OP. Juvenile intra-oral pleomorphicc adenoma, report of five cases and review of literature Int J Deal Maxillofac Surg 2002 June: 31 (3): 273-5.

Figures

  [Figure 1], [Figure 2], [Figure 3]