Juvenile cellular pleomorphic adenoma

Abstract

Salivary gland tumours are rare in children and when they do arise, they preferentially affect major salivary glands with sporadic incidence in minor salivary glands. The mucosa of the cheek is an uncommon site of occurrence for intraoral pleomorphic adenoma and most of these cases have been reported in adults. Histologically, it shows a highly variable morphology because of interplay between epithelial and mesenchymal (myxoid, hyaline, chondroid, osseous) elements which arise from same cell clone, which may be a myoepithelial or ductal reserve cell. Here we report a rare case of juvenile pleomorphic adenoma of the cheek in a 12-year-old girl with a predominant epithelial component histologically. Relevant studies are discussed with a focus on its cytology and cytogenetics.

Figure 1

Preoperative intraoral photograph of left buccal mucosa.

Figure 2

Well-circumscribed round mass on left buccal mucosa during surgical excision.

Figure 3

Excised specimen.

Figure 4

Periphery of the lesion with capsule surrounding sheets of loosely cohesive cells with foci of mucous goblet cells.

Figure 5

Periodic acid Schiff staining demonstrating mucous pools.

Figure 6

Ductal structures containing eosinophilic material surrounded by myoepithelial cells.

Figure 7

Plasmacytoid areas (round cells with eccentric nucleus and eosinophilic cytoplasm) with foci of squamous metaplasia.

Figure 8

Eosinophilic hyaline material form bands separating the epithelial cells.