Basal Cell Adenoma of Submandibular Salivary Gland: A Case Report and Literature Review

Abstract

Background: Salivary gland tumours constitute about 3-4 % of all head and neck neoplasms. Approximately 80 % originate in the parotid gland and they are rarely present in the submandibular gland. Basal cell adenoma is a benign epithelial salivary gland tumour that appears to have unique histologic characteristics. The diagnosis of this entity must be established by histological study.

Case report: The literature revealed only four reported cases of basal cell adenoma of submandibular salivary gland. This article presents a rarely occurring basal cell adenoma as a fifth reported case in submandibular salivary gland in a 23 year old female.

Discussion: A rare case of basal cell adenoma of submandibular salivary gland is reported with clinical features, diagnosis, histopathological features and treatment modalities. When there is involvement of submandibular gland with a tumour the histopathological confirmation is mandatory instead of relying on FNAC and it must be differentiated from pleomorphic adenoma, adenoid cystic carcinoma, adenocarcinoma due to its prognostic implications.

Conclusion: Entities like basal cell adenoma can only be established by histopathological examination after excisional biopsy. The treatment done also affects the ultimate prognosis. As such the surgeon has to make his clinical decision based on many factors like history, clinical examination, histopathological examinations, radiological examination and immunohistochemistry study. No single criteria should be relied upon. We recommend to carry out genetic pattern study in a person with basal cell adenoma to rule out pathogenesis and establish a correct diagnosis of it for better understanding and prognosis.

Keywords: Adenoid cystic carcinoma; Basal cell adenoma; Basaloid epithelial cells; Pleomorphic adenoma.

Fig. 1

Clinical photograph showing submandibular swelling

Fig. 2

CT scan showing a well defined solid lesion at the anterior end of right submandibular gland

Fig. 3

Intra-operative appearance of tumor mass

Fig. 4

Excised surgical specimen (2.5 × 3 cm)

Fig. 5

Histopathological appearance of trabecular–tubular type of basal cell adenoma (×10)

Fig. 6

Histopathological appearance of trabecular–tubular type of basal cell adenoma (×100)

Fig. 7

Histopathological appearance of trabecular–tubular type of basal cell adenoma showing intact capsule and basement membrane