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Review
. 2015 Oct;35(4):293-6.

Giant pleomorphic adenoma of the parotid gland: an unusual case presentation and literature review

A Tarsitano  1 , A Pizzigallo  1 , F Giorgini  1 , C Marchetti  1
Affiliations
Review

Giant pleomorphic adenoma of the parotid gland: an unusual case presentation and literature review

A Tarsitano et al. Acta Otorhinolaryngol Ital. 2015 Oct.

Abstract
in English, Italian

Pleomorphic adenoma is the most common type of all salivary gland tumours. Although uncommon, cases of giant pleomorphic adenomas have been described in the medical literature, the majority involving the parotid gland. This paper describes an unusual case of a giant adenoma arising in the parotid gland. The patient underwent surgical resection of the giant tumour, which was one of the largest pleomorphic adenoma reported in recent literature. This case has prompted us to evaluate the behaviour of those benign tumours, which suggested that aesthetic and social morbidity is sufficient to justify, when possible, early tumour excision, despite the relatively low risk of malignant transformation. Management of this unusual tumour is discussed, and the literature on giant parotid tumours is reviewed.

L'adenoma pleomorfo rappresenta il più comune istotipo tumorale interessante le ghiandole salivari. Quantunque non siano comuni, la letteratura medica internazionale ha descritto alcuni rari casi di adenoma pleomorfo gigante. La maggior parte di essi era di origine parotidea. Questo articolo vuole descrivere un inusuale caso di adenoma gigante di origine parotidea. La crescita abnorme che la massa tumorale ha avuto in questo caso, ne ha determinato la discesa per gravità verso il torace del paziente. Il paziente è stato sottoposto ad exeresi chirurgica del tumore, che è apparso essere uno dei più voluminosi adenomi pleomorfi riportati nella letteratura recente. Questo atipico caso ci ha portato a riflettere in merito al comportamento clinico di siffatte forme tumorali benigne. È evidente come le morbidità estetiche e sociali siano sufficienti a giustificare, quando possibile, una precoce asportazione del tumore, malgrado il relativamente basso rischio di trasformazione maligna. Di seguito discuteremo la gestione clinica e chirurgica di questo raro caso. Forniremo inoltre una revisione della letteratura in merito.

Keywords: Giant pleomorphic adenoma; Neck mass; Parotid tumours.

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Figures

Fig. 1.
Fig. 1.
The patient at initial examination, showing a large, multinodular left neck mass extending from the parotid region onto the chest.
Fig. 2.
Fig. 2.
Pre-operative imaging evaluation. MRI showing the giant mass. The outline of the heterogeneous lesion is clearly demarcated, and tissue planes preserved.
Fig. 3.
Fig. 3.
Pre-operative CT scan showing the tumour pedicle (arrow) arising from facial artery. It measured about 15 cm in length, and demonstrated numerous feeding vessels.
Fig. 4.
Fig. 4.
Intra-operative image showing the multinodular tumour and the main vascular pedicle (arrow).
Fig. 5.
Fig. 5.
Post-operative image showing clinical aspect after giant tumour removal with facial nerve preservation.
See this image and copyright information in PMC

References

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