Multiple bilateral malar mucinous cystadenomas in the minor salivary glands

Abstract

Mucinous cystadenoma, one of the subtypes of cystadenomas, is a rare benign salivary gland tumor. Most of the cases reported tumors presenting as asymptomatic, slow growing, single masses, primarily occurring in the parotid glands, buccal mucosa, and hard palate. This report describes a case of multiple mucinous cystadenomas that presented as subcutaneous swellings in both cheeks, which were mistaken for a benign subcutaneous tumor. A complete surgical excision was performed through an intraoral incision. There were no recurrences or complications. A diagnosis of mucinous cystadenoma was made by histopathological examination. Mucinous cystadenomas are differentiated from other salivary gland tumors based on the pathological findings. A malignant transformation is also possible. Preoperative imaging cannot identify mucinous cystadenomas because of their small size and atypical features, and needle biopsy has its limitations in such salivary gland tumors. Therefore, accurate diagnosis and treatment through surgical excision become important.

Keywords: Cheek; Minor salivary gland; Mucinous cystadenoma.

Fig. 1.

Preoperative ultrasonography. (A) Two 0.5 cm-sized masses seen in the subcutaneous layer of the left cheek. (B) A mass measuring 0.3 cm in the left cheek. (C) Two subcutaneous masses measuring 0.5 and 0.8 cm in the right cheek. According to ultrasonography reports, well-defined oval hypoechoic lesions in the subcutaneous layer were observed, possibly representing benign tumors.

Fig. 2.

Intraoperative photographs. (A) The masses were approached through an incision in the upper gingivobuccal sulcus. (B) Yellowish nodular masses were identified in the subcutaneous layer and complete excision was performed with primary closure.

Fig. 3.

Gross and histopathological images of the tumors. (A) Gross image of the 0.8 cm wide whole mass, which was one of the largest ones. (B) Histopathological image (H&E, ×40). (C) Histopathological assessment revealed a layer of epithelial cells lining a cystic cavity with mucous secretions (H&E, ×100).