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Mixed tumor (Pleomorphic adenoma), salivaryglandspleomorphicadenomaxu13 -…
Mixed tumor (Pleomorphic adenoma)
Examination
Biopsy : Incisional biopsy เพื่อดูลักษณะทาง Histology
CT scan : ดูขอบเขตของรอยโรคที่เป็นเนื้อเยื่ออ่อน
Palpation : คลำดูต่อมน้ำลายว่ามีอาการเจ็บหรือไม่
คลำ Lymph node ว่ามีการบวมไหม
Inspection : มองดูใบหน้าว่ามีการบวมขึ้นมาหรือไม่
Histology
Epithelial cells proliferating as ducts or tubules.
Eosinophilic secretions can be seen in duct.
Myxoid stroma
Chondroid stroma
osseous metaplasia
Adipose metaplasia
Epidemiology
females > males (2:1 ratio)
Most commonly in 30 - 60 years
Affects patients of all ages
common in the parotid gland
In oral most common at palate
Predisposing factors
exposure to radiation
oncogenic simian virus (SV40)
Differential diagnosis
Parotid nodal metastasis
Facial nerve schwannomas
Warthin tumor
Myoepitheliomas
Mucoepidermoid
Adenoid cystic carcinoma
Basal cell adenoma
Treatment
Surgical treatment
Parotid gland
Total parotidectomy
Superficial parotidectomy
Submandibular gland
Simple excision with preserve of mandibular branch of facial nerve, hypoglossal nerve, and lingual nerve
Minor salivary gland
Simple excision with preserve of mandibular branch of facial nerve, hypoglossal nerve, and lingual nerve
Chemotherapy
Doxorubicin
Platinum-based agent
Cisplatinum
Adriamycin
5-fluorouracill
Epirubicin
Radiation therapy
Neutron therapy
Pathophysiology
Proliferation of polygonal epithelial and spindle-shaped myoepithelial cells
May be arranged to form duct-like structures
The tumor is surrounded by a fibrous pseudo capsule.
The tumor extends through normal glandular parenchyma in the form of finger-like pseudopodia.
Clinal features
Vary in size
Painless swelling
Usually on ulcer
Usually smooth surface
Slow growing
Palpate >> firm
