Pleomorphic Adenoma – Summary
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Just a few words more about Pleomorphic adenomas.
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As you can see, the majority of Pleomorphic adenomas,
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we usually say about 80%, occur in the parotid gland.
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Of all the pleomorphic adenomas,
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about 8% occur in the submandibular gland,
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about six and a half percent in the minor salivary gland.
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And we just saw one of those in the hard palate, and then a
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smaller proportion in the sublingual gland. In the
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parotid gland, most are in the superficial lobe.
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They may occur in about 1% to 5%,
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and they may be multicentric in about 0.5%.
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Now, the thing about Pleomorphic adenomas is that it should
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be taken out in its entirety with its capsule.
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If that capsule is violated at the time of surgery,
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there is the possibility of seeding of the operative
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bed with pleomorphic adenoma tissue.
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That becomes a disaster because you got lots of little
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pleomorphic adenomas that start growing along those seeds.
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And it's very difficult to eradicate the tumor completely
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once that has occurred. As I said,
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because of the risk of carcinoma ex pleomorphic adenoma,
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a malignant degeneration, if you will,
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of pleomorphic adenomas.
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These are treated aggressively with surgery.
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Rather than being left in the parotid gland
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as a benign tumor,
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they want to take these out because they worry about,
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over the course of time, malignant degeneration.
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Now, if you wait 20-25 years,
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that rate of malignant degeneration gets as high as 20%.
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Usually we don't see that.
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We see them being discovered, taken out,
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and being cured of the disease.
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But that is the risk of Pleomorphic adenomas.
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So what I'd like to do now is to show you a few more cases
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of different appearances of Pleomorphic adenomas.
David M Yousem, MD, MBA
Professor of Radiology, Vice Chairman and Associate Dean
Johns Hopkins University
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