Unusual Metastases from a Pleomorphic Adenoma of the Parotid Gland: A Case and Literature’s Review

Giuditta Mannelli, Lucio Rucci, Oreste Gallo

First Clinic of Otorhinolaryngology-Head and Neck Surgery, University of Florence, Florence, Italy.

DOI: 10.4236/ijohns.2013.26048                

Abstract

Background: Pleomorphic adenoma constitutes the most common benign parotid gland tumor. Local recurrence after surgery has been described in 1%-5% of cases, and malignant evolution in 2%-9% of cases. Metastasizing pleomorphic adenomas has rarely been reported. No histologic or molecular parameters exist at the present time that could predict the development of metastasis in these neoplasms. Methods and Results: A 54-year-old woman had a superficial left parotidectomy with facial nerve preservation for pleomorphic adenoma. She developed two recurrences in 2000 and 2001, but 25 years later the first operation she presented a metastasis in her right gluteal region with evidence of local recurrence. Conclusion: Metastatizing pleomorphic adenoma is a rare pathologic situation but, in case of swelling or lump appearance in patients with pleomorphic adenoma history, it should be taken in mind.

Keywords

Salivary Gland Tumors; Pleomorphic Adenoma; Metastases; Surgery; Gluteal Region

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	B. M. Wenig, C. L. Hitchcok, G. L. Ellis and D. R. Gnepp, “Metastasizing Mixed Tumor of Salivary Gland: A Clinicopathologic and Flow Cytometric Analysis,” American Journal of Surgical Pathology, Vol. 16, No. 9, 1992, pp. 845-858. http://dx.doi.org/10.1097/00000478-199209000-00003
[2]	G. L. Ellis and P. L. Auclair, “Malignant Epithelial Tumors,” In: G. L. Ellis and P. L. Auclair, Eds., Tumors of the Salivary Glands, Armed Forces Institute of Pathology, Washington DC, 1996, pp. 39-136.
[3]	V. Manucha and O. B. Ioffe, “Metastasizing Pleomorphic Adenoma of Salivary Gland,” Archives of Pathology & Laboratory Medicine, Vol. 132, No. 9, 2008, pp. 1445-1447.
[4]	G. R. Youngs and P. J. Scheuer, “Histologically Benign Mixed Parotid Tumor with Hepatic Metastasis,” Journal of Pathology, Vol. 109, No. 2, 1973, pp. 171-173. http://dx.doi.org/10.1002/path.1711090211
[5]	V. Raja, C. China, K. H. Masaki and G. Nakano, “Benign Metastasizing Pleomorphic Adenoma,” Journal of Clinical Oncology, Vol. 20, No. 9, 2002, pp. 2400-2403.
[6]	F. W. Foote Jr. and L. E. Frazell, “Tumors of the Major Salivary Glands,” Cancer, Vol. 6, 1953, pp. 1065-1133. http://dx.doi.org/10.1002/1097-0142(195311)6:6<1065::AID-CNCR2820060602>3.0.CO;2-0
[7]	S. A. R. Nouraei, M. S. Ferguson, P. M. Clarke, A. Sandison, G. S. Sandhu, L. Michaels and P. Rhys-Evans, “Metastasizing Pleomorphic Salivary Adenoma,” Archives of Otolaryngology—Head and Neck Surgery, Vol. 132, No. 7, 2006, pp. 788-793. http://dx.doi.org/10.1001/archotol.132.7.788
[8]	A. El-Naggar, J. G. Batsakis and S. Kessler, “Benign Metastatic Mixed Tumours or Unrecognised Salivary Gland Carcinomas?” Journal of Laryngology & Otology, Vol. 102, No. 9, 1988, pp. 810-812. http://dx.doi.org/10.1017/S0022215100106528
[9]	Y. Jin, C. Jin, K. Arheden, et al., “Unbalanced Chromosomal Rearrangements in a Metastasizing Salivary Gland Tumour with Benign Histology,” Cancer Genetics and Cytogenetics, Vol. 102, No. 1, 1998, pp. 59-64. http://dx.doi.org/10.1016/S0165-4608(97)00301-4
[10]	J. Klijanienko, A. El-Naggar, V. Servois, J. Rodriguez, P. Validire and P. Vielh, “Clinically Aggressive Metastasizing Pleomorphic Adenoma: Report of Two Cases,” Head and Neck, Vol. 19, No. 7, 1997, pp. 629-633. http://dx.doi.org/10.1002/(SICI)1097-0347(199710)19:7<629::AID-HED11>3.0.CO;2-Y
[11]	J. Paris, F. Facon, M. A. Chrestian, A. Giovanni and M. Zanaret, “Recurrence of Pleomorphic Adenomas of the Parotid: Changing Attitudes,” Revue de LaryngologieOtologie-Rhinologie, Vol. 124, No. 4, 2003, pp. 229-234.
[12]	A. S. Glas, H. Hollema, R. E. Nap and J. T. Plukker, “Expression of Estrogen Receptor, Progesterone Receptor, and Insulin-Like Growth Factor Receptor-1 and of MIB-1 in Patients with Recurrent Pleomorphic Adenoma of the Parotid Gland,” Cancer, Vol. 94, No. 8, 2002, pp. 2211-2216. http://dx.doi.org/10.1002/cncr.10445