Accelerated growth of pleomorphic adenoma in a pregnant woman undergoing in vitro fertilization: A case report.

RATIONALE

Pleomorphic adenoma of the parotid gland usually demonstrates indolent growth; however, its behavior during pregnancy or hormone therapy remains poorly characterized. This case aims to explore the potential impact of in vitro fertilization (IVF) on the rapid tumor progression and its unusual chondrosarcoma-like pathology, raising clinical awareness of possible IVF-associated glandular changes.

PATIENT CONCERNS

A 37-year-old female undergoing IVF complained of a left parotid mass that increased in size from undetectable to 6 cm (egg-sized) over 2 weeks. She was anxious about the tumor growth rate.

DIAGNOSES

Imaging showed a parotid tumor measuring 6 cm × 5 cm × 4 cm. Histopathology revealed chondrosarcoma-like appearance with scattered clusters of glandular epithelial cells. Immunohistochemistry confirmed its salivary origin (CK7 and P63 demonstrated positivity in epithelial cells; S-100 demonstrated positivity in chondroid matrix), combined with other pathological performance, malignancy was excluded. Histopathological examination revealed extensive parotid fat degeneration.

INTERVENTIONS

The patient underwent tumor resection and superficial parotidectomy 2 months after delivery. Hormonal investigations during IVF and perioperative periods were normal except for relatively reduced testosterone.

OUTCOMES

Postoperative recovery was uneventful. No recurrence or salivary dysfunction occurred during the 4-year follow-up.

LESSONS

This case suggests that pleomorphic adenoma might have active stromal growth (rather than cellular increase) on IVF, mimicking chondrosarcoma. Sex hormone levels were not directly connected with tumor growth, indicating other mechanisms may exist. Further studies are warranted to investigate the underlying mechanisms linking IVF to stromal alterations in salivary gland tumors.