Polymorphous Low Grade Adenocarcinoma of the Parotid in a Teenager

Document Type: Case Report

Authors

1 Department of Radiotherapy, Government Medical College and Hospital, Chandigarh, India.

2 Department of Otorhinolaryngology and Head and Neck Surgery, Government Medical College and Hospital, Chandigarh, India.

3 Department of Pathology, Government Medical College and Hospital, Chandigarh, India.

Abstract

Abstract
Introduction:
Polymorphous low grade adenocarcinoma (PLGA) is a rare salivary gland neoplasm with an indolent course. It occurs primarily in the minor salivary glands but can rarely occur in the major salivary glands. It usually occurs in the fifth to seventh decades of life with female preponderance.
 
Case Report:
A 16-year-old male presented with recurrent painless swelling in the right preauricular region and with a history of surgical intervention at the same site in the past. His histopathology report was suggestive of pleomorphic adenoma. The swelling recurred after one year of excision and a superficial parotidectomy was performed. The detailed histopathological examination was suggestive of Polymorphous low grade adenocarcinoma. In view of close margins, the patient was given adjuvant radiotherapy. Thirty-three months post-surgery, he is alive and disease-free. We describe a rare case of PLGA of the parotid gland in a teenager with its clinical characteristics, histopathological features, and treatment.
 
Conclusion:
The occurrence of PLGA in the parotid gland is rare with only a few cases reported in literature. The diagnosis of PLGA is challenging due to morphological diversity.

Keywords

Main Subjects


1.Batsakis JG, Pinkston GR, Luna MA, Byers RM, Sciubba JJ, Tillery GW. Adenocarcinomas of the oral cavity: A clinicopathologic study of terminal duct carcinomas. J LaryngolOtol 1983;97:825‑35.

2.Freedman PD, Lumerman H. Lobular carcinoma of intraoral minor salivary gland origin: report of twelve cases. Oral Surg Oral Med Oral Pathol 1983;56:157-66.

3.Evans HL, Batsakis JG. Polymorphous low-grade adenocarcinoma of minor salivary glands: a study of 14 cases of a distinctive neoplasm. Cancer 1984;53:935-42.

4.Vincent SD, Hammond HL, Finkelstein MW. Clinical and therapeutic features of polymorphous low-grade adenocarcinoma. Oral Surg Oral Med Oral Pathol 1994;77:41-7.

5.Castle JT, Thompson LD, Frommelt RA, Wenig BM, Kessler HP. Polymorphous low grade adenocarcinoma: a clinicopathologic study of 164 cases. Cancer. 1999;86:207-19.

6. Evans HL, Luna MA. Polymorphous low‑grade adenocarcinoma: A study of 40 cases with long‑term follow up and an evaluation of the importance of papillary areas. Am J SurgPathol 2000;24:1319‑28.

7.Nagao TGaffey TAKay PAMinato HSerizawa HLewis JE. Polymorphous low-grade adenocarcinoma of the major salivary glands: report of three cases in an unusual location. Histopathology 2004;44:164-71.

8. Ruiz-Godoy L, Suárez LMosqueda AMeneses A. Polymorphous low-grade adenocarcinoma of the parotid gland. Case report and review of the literature. Med Oral Patol Oral Cir Bucal 2007;12:E30-3.

9.Merchant WJ, Cook MG, Eveson JW. Polymorphous low-grade adenocarcinoma of the parotid gland. Br J Oral Maxillofac Surg 1996; 34:328-30.

10.Luna MA, Wenig BM. Polymorphous low grade adenocarcinoma. In: Barners L, Everson JW, Reichert P, Sidrunsky D, editors. Pathology and genetics. Head and neck tumours. World health organization classification of tumors. Lyon IARC press.2005;223-4.

11.Shukla M, Gaud U, Kumar M, Pandey M. Polymorphous Low-Grade Adenocarcinoma (PLGA) in an 18-year-old male. Indian J Surg 2013;75:153-5.

12. Kumar M, Stivaros N, Barrett AW, Thomas GJ, Bounds G, Newman L. Polymorphous low-grade adenocarcinoma--a rare and aggressive entity in adolescence. Br J Oral Maxillofac Surg 2004; 42:
195-9.

13.Tsang YWTung YChan JK. Polymorphous low grade adenocarcinoma of the palate in a child. J Laryngol Otol 1991;105:309-11.

14.McHugh JBVisscher DWBarnes EL. Update on selected salivary gland neoplasms. Arch Pathol Lab Med 2009;133:1763-74.