Adenome pleomorphe des glandes salivaires accessoires

Abstract

Objective : Pleomorphic adenoma (PA) is the most common benign neoplasm of the minor salivary glands. Clinical behavior,
diagnosis, treatment modalities and evolution of nine cases of pleomorphic adenoma were discussed.
Materials and methods : This is a descriptive and retrospective study about 9 cases of pleomorphic adenoma conducted
over a period of 20 years (1990 à 2009) at the ENT department of Sousse (Tunisia).
Results : There were 5 men and 4 women having a mean age of 40 years. The main site of this adenoma was the hard palate. The others 3 tumors were seen in the nasal cavity, in the parapharyngeal space and in cervical soft tissues. Clinical examination showed a swelling at the level of the interested region. Computed tomography (CT) was made in 5 cases,
associated to the magnetic resonance imaging (MRI) in 2 cases. The treatment was based in surgical excision of the tumors. Histologically, the tumor showed features of a benign PA in 8 cases and of malignant PA in 1 case. Two patients had a documented local recurrence. The evolution was good for the first patient after secondary excision of the tumor.
The patient presenting a carcinoma ex pleomorphic adenoma developed quickly pulmonary and cerebral metastases.
Conclusion : Pleomorphic adenoma of minor salivary gland is generally known to be a slow-growing tumour. They must be evoked before all painless swelling in the upper aerodigestive tract developed under a healthy mucosa. The surgical management is basically total resection of the tumor with a safety margin of 5 mm. Longer follow-up was needed due to the possibility of recurrences and malignancy transformation.

Keywords : Pleomorphic adenoma, Minor salivary gland, Imaging.