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Case Reports
. 2013 Sep 17:11:234.
doi: 10.1186/1477-7819-11-234.

Carcinoma ex pleomorphic adenoma of the upper lip: a case of an unusual malignant component of squamous cell carcinoma

Eiji Mitate  1 , Shintaro Kawano, Tamotsu Kiyoshima, Toshiyuki Kawazu, Toru Chikui, Yuichi Goto, Ryota Matsubara, Seiji Nakamura
Affiliations
Case Reports

Carcinoma ex pleomorphic adenoma of the upper lip: a case of an unusual malignant component of squamous cell carcinoma

Eiji Mitate et al. World J Surg Oncol. .

Abstract

Background: Squamous cell carcinoma (SCC) as the malignant component of carcinoma ex pleomorphic adenoma (CXPA) occurring in upper lip is rare.

Case report: A 55-year-old male patient presented with an asymptomatic mass of the upper lip that had noticed 8 years previously. The mass was clinically suspected to be a benign salivary gland tumor based on palpation and magnetic resonance imaging findings. A needle biopsy was then carried out, and the pathological diagnosis was pleomorphic adenoma. The tumor was removed under general anesthesia. Histopathological examination revealed well-demarcated tumor tissues showing typical histologic features of pleomorphic adenoma. However, SCC tissue with several mitotic figures was found in the central area of the tumor tissue. The tumor was finally diagnosed as CXPA. There was no evidence of recurrence or metastasis 6 years postoperatively.

Conclusion: This is the first report of CXPA of the upper lip with an unusual malignant component of SCC.

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Figures

Figure 1
Figure 1
Intraoral findings and magnetic resonance images. (A) An elastic hard mass is located in the right upper lip. Magnetic resonance images show an apparently circumscribed mass lesion in the right upper lip. (B) T1-weighted image. (C) T2-weighted image.
Figure 2
Figure 2
Resected specimens and histopathological findings (hematoxylin and eosin stain). (A) The specimen obtained by needle biopsy shows typical histopathologic features of pleomorphic adenoma (PA). Bar = 100 μm. (B) The cut surface of the excised tumor is glistening, heterogeneous, and tan. Bar = 10 mm. (C) The loupe image shows that the tumor is completely encapsulated. The malignant component is located in the central area of the tumor. The arrowhead shows the labial mucosa. The dotted lines indicate the squamous cell carcinoma (SCC) component. Bar = 10 mm. (D) The unclear borderline between the PA and SCC components at low magnification. Arrowheads and asterisks show ductal structures and well-differentiated squamous cell component, respectively. Bar = 100 μm. (E) High magnification of Figure 2D. Bar = 50 μm. (F) The PA region. Bar = 100 μm. (G) The SCC region. Arrows show mitotic figure of cancer cells. Bar = 50 μm.
See this image and copyright information in PMC

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