A giant pleomorphic adenoma of the submandibular salivary gland: a case report

Abstract

The most common benign salivary gland tumor is the pleomorphic adenoma (PA). They can attain grotesque proportions and weigh several kilograms. They can cause facial disfigurement and, if untreated, could lead to airway compromise. We report a case of a large PA arising from the left submandibular salivary gland in a 20-year-old black female. The lesion measured ∼16 × 15 × 12 cm.

Keywords: adenoma; carcinoma ex pleomorphic; facial deformity; giant pleomorphic adenoma; mixed tumor; submandibular tumor.

Figure 1

(A, B) Clinical presentation, front and profile views of tumor mass. (C, D) Orthopantomograph and posteroanterior views showing intact bony structures.

Figure 2

(A) Computed tomography scan showing the superior, inferior, and mesial extent of the tumor mass with scattered calcifications within the lesion (arrows). (B) Micrograph showing the myxochondroid and cellular nature of the tumor. (C) Arrow indicates area of sacrificed skin with ulceration (site of previous biopsy). (D) Planned marked incision line.

Figure 3

(A to D) Sequential surgical excision of the tumor mass.

Figure 4

(A) Specimen after removal. (B) Return to almost complete aesthetic normalcy with no skin contouring being done. This demonstrates the tremendous elasticity of the skin, which had shrunk. (C, D) Wound closure and postoperative view of the patient.

Figure 5

A sketch diagram showing the anterior view of the tumor mass and the superoanterior extent of the facial vein and artery as well as the possible region of the terminal branches of the marginal mandibular branch of the facial nerve.