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Sialadenoma Papilliferum with Inverted Pattern in a Young Patient: A Case Report.

Reis de Sá Silva e Costa FE, Vizcaíno Vázquez JR - Am J Case Rep (2015)

Bottom Line: However, unlike the classical SP, both epithelia grew under the mucosal surface.As a result, it did not manifest as an exophytic proliferation, but as a nodule.We excluded squamous papilloma, inverted ductal papilloma, intraductal papilloma and mucoepidermoid carcinoma, the principal entities in the differential diagnosis of SP, and concluded it was an SP with inverted pattern.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Hospital de Santo António - Centro Hospitalar do Porto, Porto, Portugal.

ABSTRACT

Background: Sialadenoma papilliferum (SP) is a rare, benign neoplasm of salivary gland origin which manifests as an exophytic papillary excrescence of the mucosa. Indeed, SP is both an exophytic proliferation of papillary stratified squamous epithelium above the mucosal surface and an endophytic salivary ductal proliferation beneath the mucosa. It arises predominantly in minor salivary glands and usually affects patients in the age range of 32-87 years, with reports in young patients being exceedingly rare.

Case report: We report the case of a previously healthy 20-year-old man diagnosed with a nodular mass in the upper lip buccal mucosa. The tumor was excised and submitted for microscopic examination. Histologic examination revealed a biphasic proliferation of papillary stratified squamous and salivary ductal epithelia, both underneath the mucosal surface.

Conclusions: In this unique case, as the classical SP, the tumor had a biphasic proliferation of squamous and ductal epithelia. However, unlike the classical SP, both epithelia grew under the mucosal surface. As a result, it did not manifest as an exophytic proliferation, but as a nodule. We excluded squamous papilloma, inverted ductal papilloma, intraductal papilloma and mucoepidermoid carcinoma, the principal entities in the differential diagnosis of SP, and concluded it was an SP with inverted pattern.

No MeSH data available.


Related in: MedlinePlus

Sialadenoma papilliferum with inverted pattern. There was a well-defined, pseudo-capsulated lesion below the mucosal surface (arrowhead). Slide view, H&E.
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f1-amjcaserep-16-663: Sialadenoma papilliferum with inverted pattern. There was a well-defined, pseudo-capsulated lesion below the mucosal surface (arrowhead). Slide view, H&E.

Mentions: Microscopically, there was a well-defined pseudo-capsulated lesion which grew in an endophytic way, creating a submucosal cystic space (Figure 1). The luminal cavity was filled with papillary projections and folds of keratinizing stratified squamous epithelium supported by fibrovascular cores containing an infiltrate of lymphocytes and plasma cells (Figure 2), beneath which there was a proliferation of small and ectatic ducts (Figure 3). The ducts were lined with a double layer of cells: a basal layer composed of cuboidal cells and a luminal lining layer of columnar cells (Figure 4).


Sialadenoma Papilliferum with Inverted Pattern in a Young Patient: A Case Report.

Reis de Sá Silva e Costa FE, Vizcaíno Vázquez JR - Am J Case Rep (2015)

Sialadenoma papilliferum with inverted pattern. There was a well-defined, pseudo-capsulated lesion below the mucosal surface (arrowhead). Slide view, H&E.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4590578&req=5

f1-amjcaserep-16-663: Sialadenoma papilliferum with inverted pattern. There was a well-defined, pseudo-capsulated lesion below the mucosal surface (arrowhead). Slide view, H&E.
Mentions: Microscopically, there was a well-defined pseudo-capsulated lesion which grew in an endophytic way, creating a submucosal cystic space (Figure 1). The luminal cavity was filled with papillary projections and folds of keratinizing stratified squamous epithelium supported by fibrovascular cores containing an infiltrate of lymphocytes and plasma cells (Figure 2), beneath which there was a proliferation of small and ectatic ducts (Figure 3). The ducts were lined with a double layer of cells: a basal layer composed of cuboidal cells and a luminal lining layer of columnar cells (Figure 4).

Bottom Line: However, unlike the classical SP, both epithelia grew under the mucosal surface.As a result, it did not manifest as an exophytic proliferation, but as a nodule.We excluded squamous papilloma, inverted ductal papilloma, intraductal papilloma and mucoepidermoid carcinoma, the principal entities in the differential diagnosis of SP, and concluded it was an SP with inverted pattern.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Hospital de Santo António - Centro Hospitalar do Porto, Porto, Portugal.

ABSTRACT

Background: Sialadenoma papilliferum (SP) is a rare, benign neoplasm of salivary gland origin which manifests as an exophytic papillary excrescence of the mucosa. Indeed, SP is both an exophytic proliferation of papillary stratified squamous epithelium above the mucosal surface and an endophytic salivary ductal proliferation beneath the mucosa. It arises predominantly in minor salivary glands and usually affects patients in the age range of 32-87 years, with reports in young patients being exceedingly rare.

Case report: We report the case of a previously healthy 20-year-old man diagnosed with a nodular mass in the upper lip buccal mucosa. The tumor was excised and submitted for microscopic examination. Histologic examination revealed a biphasic proliferation of papillary stratified squamous and salivary ductal epithelia, both underneath the mucosal surface.

Conclusions: In this unique case, as the classical SP, the tumor had a biphasic proliferation of squamous and ductal epithelia. However, unlike the classical SP, both epithelia grew under the mucosal surface. As a result, it did not manifest as an exophytic proliferation, but as a nodule. We excluded squamous papilloma, inverted ductal papilloma, intraductal papilloma and mucoepidermoid carcinoma, the principal entities in the differential diagnosis of SP, and concluded it was an SP with inverted pattern.

No MeSH data available.


Related in: MedlinePlus