Carcinoma ex pleomorphic adenoma: diagnostic difficulty and outcome.
OBJECTIVE
To analyze a series of carcinoma ex pleomorphic adenoma (CXPA) and to assess the diagnostic difficulties.


METHODS
The clinical presentation of 24 CXPAs was compared with 300 pleomorphic adenomas (PAs). Furthermore, pathohistological findings and follow-up results of CXPAs were evaluated.


RESULTS
Eight of 24 (33%) CXPAs versus 41 of 300 (14%) PAs were localized in the deep lobe (P < 0.05). Forty-two percent of CXPAs versus 6 percent of PAs, respectively, were greater than 4 cm (P < 0.05). The sensitivity in detecting CXPA by fine-needle aspiration cytology (FNAC) was 47 percent. The tumor was known to be malignant preoperatively in 10 (42%) patients. Six of 24 (25%) patients with CXPA developed a tumor recurrence. The overall 5-year survival rate of CXPA was 76 percent.


CONCLUSIONS
CXPAs are difficult to identify preoperatively. FNAC has a low accuracy and sensitivity. CXPAs versus PAs are significantly more frequently localized in the deep lobe and are significantly greater in size.
Zbären
Peter
P
Department of Otorhinolaryngology, Head, and Neck Surgery, University Hospital, Berne, Switzerland. peter.zbaeren@insel.ch
Zbären
Sibylle
S
Caversaccio
Marco D
MD
Stauffer
Edouard
E
D008949:Adenoma, Pleomorphic / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000473:pathology*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010307:Parotid Neoplasms / Q000473:pathology*