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Massive ossifying pleomorphic adenoma of the maxillary antrum: A rare presentation.

Ray D, Mazumder D, Ray J, Bhattacharya S - Contemp Clin Dent (2015 Jan-Mar)

Bottom Line: Though parotid is the most common site of origin, it has been reported to arise from various unusual locations.Incidence of its origin in the respiratory tract is extremely rare, and the occurrence is even lower in the maxillary sinus.Histological findings showed extensive ossification and hyalinization of the stroma as a striking feature.

View Article: PubMed Central - PubMed

Affiliation: Department of Dentistry, Medical College, Kolkata, West Bengal, India.

ABSTRACT
Pleomorphic adenoma is the most common benign neoplasm of salivary gland origin involving both major and minor glands. Though parotid is the most common site of origin, it has been reported to arise from various unusual locations. Incidence of its origin in the respiratory tract is extremely rare, and the occurrence is even lower in the maxillary sinus. We report a case of a huge antral pleomorphic adenoma in a 33-year-old male patient presented as a swelling in the maxilla which was mistaken of odontogenic origin. Histological findings showed extensive ossification and hyalinization of the stroma as a striking feature. The patient has undergone hemimaxillectomy and is in 8 months follow-up without any sign and symptom of recurrence.

No MeSH data available.


Related in: MedlinePlus

Photomicrograph of H and E stained section (×100) showing glandular elements intermixed with osteoid islands and myxoid areas
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Figure 5: Photomicrograph of H and E stained section (×100) showing glandular elements intermixed with osteoid islands and myxoid areas

Mentions: In our case though marked myoepithelial cell proliferation was noted in some sections of the excisional sample, absence of cellular pleomorphism, mitotic activity, perineural invasion or squamous metaplasia, ruled out the possibility of the malignant counterpart [Figure 4]. The numerous mature osteoid islands abutting the intact peripheral fibrous capsule with intermixed myxoid areas further suggested that of a benign entity [Figure 5]. It is presumed that the myoepithelial cells undergo metaplasia to produce osteoid areas. The preponderance of osteoid tissue may produce confusion with fibro-osseous lesions arising in the maxilla. The presence of glandular elements in such instance is the key factor for diagnosis. Myxoid areas were inconspicuous as ill-defined fine basophilic regions produced by glycosaminoglycan-rich matrix.[10] Though the extensive ossification dominated the histological picture, the connective tissue stroma also showed extreme hyalinization producing cribriform-like patterns.


Massive ossifying pleomorphic adenoma of the maxillary antrum: A rare presentation.

Ray D, Mazumder D, Ray J, Bhattacharya S - Contemp Clin Dent (2015 Jan-Mar)

Photomicrograph of H and E stained section (×100) showing glandular elements intermixed with osteoid islands and myxoid areas
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4319336&req=5

Figure 5: Photomicrograph of H and E stained section (×100) showing glandular elements intermixed with osteoid islands and myxoid areas
Mentions: In our case though marked myoepithelial cell proliferation was noted in some sections of the excisional sample, absence of cellular pleomorphism, mitotic activity, perineural invasion or squamous metaplasia, ruled out the possibility of the malignant counterpart [Figure 4]. The numerous mature osteoid islands abutting the intact peripheral fibrous capsule with intermixed myxoid areas further suggested that of a benign entity [Figure 5]. It is presumed that the myoepithelial cells undergo metaplasia to produce osteoid areas. The preponderance of osteoid tissue may produce confusion with fibro-osseous lesions arising in the maxilla. The presence of glandular elements in such instance is the key factor for diagnosis. Myxoid areas were inconspicuous as ill-defined fine basophilic regions produced by glycosaminoglycan-rich matrix.[10] Though the extensive ossification dominated the histological picture, the connective tissue stroma also showed extreme hyalinization producing cribriform-like patterns.

Bottom Line: Though parotid is the most common site of origin, it has been reported to arise from various unusual locations.Incidence of its origin in the respiratory tract is extremely rare, and the occurrence is even lower in the maxillary sinus.Histological findings showed extensive ossification and hyalinization of the stroma as a striking feature.

View Article: PubMed Central - PubMed

Affiliation: Department of Dentistry, Medical College, Kolkata, West Bengal, India.

ABSTRACT
Pleomorphic adenoma is the most common benign neoplasm of salivary gland origin involving both major and minor glands. Though parotid is the most common site of origin, it has been reported to arise from various unusual locations. Incidence of its origin in the respiratory tract is extremely rare, and the occurrence is even lower in the maxillary sinus. We report a case of a huge antral pleomorphic adenoma in a 33-year-old male patient presented as a swelling in the maxilla which was mistaken of odontogenic origin. Histological findings showed extensive ossification and hyalinization of the stroma as a striking feature. The patient has undergone hemimaxillectomy and is in 8 months follow-up without any sign and symptom of recurrence.

No MeSH data available.


Related in: MedlinePlus