Long-Standing Pleomorphic Adenoma on a Female’s Palate: A Case Report
,
Abstract
This case report elucidates the significant oncologic risk associated with long-standing pleomorphic adenoma (PA), wherein the cumulative risk of malignant transformation to carcinoma ex pleomorphic adenoma (CXPA) escalates over time. It details the management of a 46-year-old female with a 25-year history of a palatal mass, which exhibited recent rapid growth—a key clinical warning sign. Diagnosis was confirmed via incisional biopsy following clinical and cone-beam computed tomography assessment, which revealed bony erosion. The patient was successfully treated with complete surgical excision, with final histopathology confirming a benign PA. The case underscores a critical clinical dilemma: delayed intervention for PA inadvertently heightens malignancy risk and complicates management. Consequently, this report strongly advocates for prompt diagnosis and definitive surgical excision upon initial detection of PA to preempt transformation and mitigate the profound prognostic implications of CXPA. Keywords: Pleomorphic adenoma; Carcinoma ex pleomorphic adenoma; Palatal neoplasms.
1. Witt RL, Iacob CE, Ozer E. Benign salivary gland tumors. In: Witt RL, editor. Salivary Gland Diseases and Disorders: Diagnosis and Management. 1st Ed. New York: Thieme; 2022. p. 127-46.
2. Aro K, Leivo I, Mäkite AA. Update on diagnostics and treatment of minor salivary gland carcinomas. Curr Opin Otolaryngol Head Neck Surg. 2021 Apr; 29(2):91-8. doi: 10.1097/MOO.0000000000000693.
3. Valstar MH, de Ridder M, van den Broek EC, Stuiver MM, van Dijk BAC, van Velthuysen MLF, et al. Salivary gland pleomorphic adenoma in the Netherlands: a nationwide epidemiological study. Head Neck. 2020 Dec; 42(12):3546-56. doi: 10.1002/hed.26404.
4. Andreasen S, Therkildsen MH, Bjørndal K. The molecular landscape of pleomorphic adenoma and carcinoma ex pleomorphic adenoma. Oral Dis. 2023 Apr; 29(3):1083-92. doi: 10.1111/odi.14022.
5. Zbären P, Stauffer E. Carcinoma ex pleomorphic adenoma: a diagnostic challenge. Curr Opin Otolaryngol Head Neck Surg. 2020 Apr; 28(2):125-9. doi: 10.1097/MOO.0000000000000615.
6. Antony J, Gopalan V, Smith RA, Lam AK. Carcinoma ex pleomorphic adenoma: a comprehensive review of clinical, pathological and molecular data. Head Neck Pathol. 2022 Mar; 16(1):236-49. doi: 10.1007/s12105-021-01398-2.
7. Ferrari M, Taboni S, Carobbio A, Lombardi D. Molecular pathways in carcinoma ex pleomorphic adenoma: From benign to malignant transformation. Oral Oncol. 2023 Dec; 147:106588. doi: 10.1016/j.oraloncology.2023.106588.
8. Zhao Y, Liu S, Li J. Genomic alterations and signaling pathways in the malignant transformation of pleomorphic adenoma. Cancer Genet. 2024 Jan; 282-283:39-47. doi: 10.1016/j.cancergen.2024.01.061.
9. Nisa L, Aygenc E, Celik N. Management and outcomes of recurrent pleomorphic adenoma of the parotid gland: A single-institution experience. Eur Arch Otorhinolaryngol. 2023 Apr; 280(4):1921-9. doi: 10.1007/s00405-022-07750-w.
2. Aro K, Leivo I, Mäkite AA. Update on diagnostics and treatment of minor salivary gland carcinomas. Curr Opin Otolaryngol Head Neck Surg. 2021 Apr; 29(2):91-8. doi: 10.1097/MOO.0000000000000693.
3. Valstar MH, de Ridder M, van den Broek EC, Stuiver MM, van Dijk BAC, van Velthuysen MLF, et al. Salivary gland pleomorphic adenoma in the Netherlands: a nationwide epidemiological study. Head Neck. 2020 Dec; 42(12):3546-56. doi: 10.1002/hed.26404.
4. Andreasen S, Therkildsen MH, Bjørndal K. The molecular landscape of pleomorphic adenoma and carcinoma ex pleomorphic adenoma. Oral Dis. 2023 Apr; 29(3):1083-92. doi: 10.1111/odi.14022.
5. Zbären P, Stauffer E. Carcinoma ex pleomorphic adenoma: a diagnostic challenge. Curr Opin Otolaryngol Head Neck Surg. 2020 Apr; 28(2):125-9. doi: 10.1097/MOO.0000000000000615.
6. Antony J, Gopalan V, Smith RA, Lam AK. Carcinoma ex pleomorphic adenoma: a comprehensive review of clinical, pathological and molecular data. Head Neck Pathol. 2022 Mar; 16(1):236-49. doi: 10.1007/s12105-021-01398-2.
7. Ferrari M, Taboni S, Carobbio A, Lombardi D. Molecular pathways in carcinoma ex pleomorphic adenoma: From benign to malignant transformation. Oral Oncol. 2023 Dec; 147:106588. doi: 10.1016/j.oraloncology.2023.106588.
8. Zhao Y, Liu S, Li J. Genomic alterations and signaling pathways in the malignant transformation of pleomorphic adenoma. Cancer Genet. 2024 Jan; 282-283:39-47. doi: 10.1016/j.cancergen.2024.01.061.
9. Nisa L, Aygenc E, Celik N. Management and outcomes of recurrent pleomorphic adenoma of the parotid gland: A single-institution experience. Eur Arch Otorhinolaryngol. 2023 Apr; 280(4):1921-9. doi: 10.1007/s00405-022-07750-w.
| Files | ||
| Issue | Vol 12, No 4 (Autumn 2025) | |
| Section | Case Report(s) | |
| Keywords | ||
| Pleomorphic adenoma; Carcinoma ex pleomorphic adenoma; Palatal neoplasms. | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Sarabi Kia H, Esmaeili A, Fattahi B, Sarkhosh S. Long-Standing Pleomorphic Adenoma on a Female’s Palate: A Case Report. J Craniomaxillofac Res. 2026;12(4):288-291.
