What is carcinoma ex pleomorphic adenoma?

What is carcinoma ex pleomorphic adenoma?

Carcinoma ex pleomorphic adenoma (CXPA) is a carcinoma arising from a primary or recurrent benign pleomorphic adenoma. It often poses a diagnostic challenge to clinicians and pathologists. The entity is difficult to diagnose preoperatively. Pathological assessment is the gold standard for making the diagnosis.

What causes carcinoma ex pleomorphic adenoma?

Carcinoma ex pleomorphic adenoma arises from pleomorphic adenoma in a multistep process with genetic alterations of, for example, PLAG1, HMGA2, or mdm2. The prognosis of this group of carcinomas is highly variable, ranging from 30% to 95%, depending on malignant histology and extent of tumor invasion.

What is parotid adenoma?

Pleomorphic adenomas are benign salivary gland tumors, which predominantly affect the superficial lobe of the parotid gland. The “pleomorphic” nature of the tumor can be explained on the basis of its epithelial and connective tissue origin. The tumor has a female predilection between 30–50 years of age.

What percentage of pleomorphic adenomas become malignant?

Pleomorphic adenomas harbor a small risk of malignant transformation. The malignant potential is proportional to the time the lesion is in situ (1.5% in the first five years, 9.5% after 15 years).

Does a pleomorphic adenoma have to be removed?

Conclusions: Almost all pleomorphic adenomas can be effectively treated by formal parotidectomy, but the procedure is not mandatory. Extracapsular dissection is a minimal margin surgery; therefore, in the hands of a novice or occasional parotid surgeon, it may result in higher rates of recurrence.

How is pleomorphic adenoma treated?

The treatment of choice for pleomorphic adenomas is surgery, although there is the risk of damaging the nerve and causing a facial paresis. For surgically non resectable tumours, radiation therapy is widely used, which is also an effective adjuvant therapy.

Is pleomorphic adenoma locally invasive?

It is more invasive but is more accurate compared to FNA with diagnostic accuracy greater than 97%. Furthermore, core needle biopsy allows more accurate histological typing of the tumor. In terms of imaging studies, ultrasound can determine and characterize superficial parotid tumors.

What is an adenoma?

Listen to pronunciation. (A-deh-NOH-muh) A tumor that is not cancer. It starts in gland-like cells of the epithelial tissue (thin layer of tissue that covers organs, glands, and other structures within the body).

How serious is pleomorphic adenoma?

Although it is classified as benign, a pleomorphic adenoma can undergo a malignant transformation, with a tendency to recur. In 5% of cases, in fact, if it is not surgically removed, a pleomorphic adenoma can degenerate into a carcinoma (taking the name of Carcinoma ex Pleomorphic Adenoma).

How fast do pleomorphic adenomas grow?

Conclusions: The median growth rate for enlarging tumors is estimated at 10.2% per year. Due to variability, tumor growth rate should be estimated on an individual patient basis.

Are pleomorphic adenomas painful?

Pleomorphic adenoma typically presents as a slow-growing, painless, firm mass and is only occasionally associated with facial palsy or pain.

Does a pleomorphic adenoma cause pain?