Kalwaniya Dheer S, Meena Reena, Kumar Devender, Tolat Aditya, Arya Satya V
General Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND.
Cureus. 2023 Jul 22;15(7):e42311. doi: 10.7759/cureus.42311. eCollection 2023 Jul.
Pleomorphic adenomas (PA) are the most common benign salivary gland tumors. They arise from the major salivary glands, as well as the minor salivary glands. They may arise rarely from the palate, oral cavity, neck, and nasal cavity also. Yet, the fourth, fifth, and sixth decades of life are the most common for them to manifest. Forty percent of them occur in males and 60% in females. It is a benign mixed tumor, which has three components: an epithelial component, a myoepithelial cell component, and a mesenchymal component. A fibrous capsule separates these cells from the surrounding tissues. It generally presents as a slowly progressing painless swelling, which is well-delineated, nonsymptomatic, and not involving the facial nerve. Salivary gland tumors can be accurately diagnosed before surgery using fine-needle aspiration (FNA), ultrasonography (USG), and computed tomography (CT) scan. Calponin, cluster of differentiation 9 (CD9), glial fibrillary acidic protein (GFAP), Mcl-2, metastasis suppressor gene (NM23), p63, S-100, smooth muscle actin (SMA), and SRY-box transcription factor 10 (SOX10) exhibit the majority of the positive reactions in pleomorphic adenomas. The diagnostic marker pleomorphic adenoma gene 1 (PLAG1) is frequently employed since it is specific for pleomorphic adenoma. Although benign, these epithelial tumors have a propensity to recur and undergo malignant transformation if incompletely excised, leading to increased morbidity in these patients. A review of the consensus guidelines and literature was conducted, and the online literature on the subject from 2002 was included. This article is not a complete review of all the available literature; rather, it is a comprehensive review of the topic.
多形性腺瘤(PA)是最常见的涎腺良性肿瘤。它们起源于大涎腺以及小涎腺。它们也可能很少起源于腭部、口腔、颈部和鼻腔。然而,40至60岁是其最常见的发病年龄段。其中40%发生于男性,60%发生于女性。它是一种良性混合瘤,有三个组成部分:上皮成分、肌上皮细胞成分和间叶成分。一层纤维包膜将这些细胞与周围组织分隔开。它通常表现为缓慢进展的无痛性肿胀,边界清晰,无症状,且不涉及面神经。涎腺肿瘤在手术前可通过细针穿刺抽吸(FNA)、超声检查(USG)和计算机断层扫描(CT)进行准确诊断。钙调蛋白、分化簇9(CD9)、胶质纤维酸性蛋白(GFAP)、髓细胞白血病-2(Mcl-2)、转移抑制基因(NM23)、p63、S-100、平滑肌肌动蛋白(SMA)和SRY盒转录因子10(SOX10)在多形性腺瘤中表现出大多数阳性反应。诊断标志物多形性腺瘤基因1(PLAG1)因其对多形性腺瘤具有特异性而经常被使用。尽管这些上皮性肿瘤是良性的,但如果切除不完全,它们有复发和发生恶性转化的倾向,导致这些患者的发病率增加。我们对共识指南和文献进行了回顾,并纳入了2002年以来关于该主题的在线文献。本文并非对所有现有文献的完整综述;相反,它是对该主题的全面综述。