Pleomorphic adenoma with extensive squamous metaplasia and keratin pearls

Author(s): Nishi Tandon, Neema Tiwari*, Nirupama Lal, A. N. Srivastava

Abstract

Background: Pleomorphic adenoma is the most common salivary gland tumor, accounting for 54 to 65% of all salivary gland neoplasams.80% of all the benign salivary gland neoplasms is constituted by pleomorphic adenoma. Parotid is the most commonly affected gland followed by submandibular salivary gland and the minor salivary glands. Histo-morphologically a pleomorphic adenoma shows both stromal as well as epithelial components. Case History: Here we present the case of a 22 yr. old male who presented to the ENTOPD with complains of swelling in front of the ear on the left side around the parotid region since 2yrs. A biopsy of the swelling was done and sent to the department of Pathology. A diagnosis of pleomorphic adenoma with squamous metaplasia and keratin pearls formation was given. A superficial parotidectomy was performed under general anesthesia. Discussion: Pleomorphic adenoma is one of the most common salivary gland tumors the mean age of occurrence being 43.6 yrs. Squamous metaplasia in the pleomorphic adenoma results in formation of an extensive keratin-filled cysts lined by squamous epithelium. Many a times excessive squamous metaplasia is mistaken for malignancy, including mucoepidermoid carcinoma and squamous cell carcinoma. Conclusion: The presence of squamous metaplasia in pleomorphic adenoma makes up 25% of the total secondary changes in the tumor. The patient was taken up for surgery & discharged after three days and was on follow-up for one month, after which he recovered completely.

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