Carcinoma ex Pleomorphic Adenoma in the Parapharyngeal Space

• Main Authors: Sudipta Pal, Sampurna Pati, Somnath Saha, Vedula Padmini Saha
• Format: Article
• Language: English
• Published: Philippine Society of Otolaryngology-Head and Neck Surgery, Inc. 2013-06-01
• Series: Philippine Journal of Otolaryngology Head and Neck Surgery
• Subjects: carcinoma ex pleomorphic adenoma, pleomorphic adenoma, carcinoma, parapharyngeal space, malignant transformation, minor salivary gland tumor, mandibular swing
• Online Access: https://pjohns.pso-hns.org/index.php/pjohns/article/view/499

Objective: To present a case of carcinoma ex pleomorphic adenoma in the parapharyngeal space and discuss its management.   Methods: Design:            Case Report Setting:           Tertiary Government Teaching Hospital Subjects:         One   Results:  A 40-year-old male patient with dysphagia for three months and a left-sided mucosa-covered oropharyngeal mass was found to have a prestyloid parapharyngeal lesion on CT Scans. Fine Needle Aspiration Cytology (FNAC) revealed a pleomorphic adenoma. With a past history of parapharyngeal pleomorphic adenoma excised transorally three years before, the present mass was excised by mandibular swing approach. Post-operative recovery was uneventful, but the final histopathological report was carcinoma ex pleomorphic adenoma.   Conclusion: Malignant transformation should be suspected in recurrent salivary tumors in the parapharyngeal space. Provided there was truly no pre-existing malignant focus in the originally-excised tumor, and that early recurrence was not due to inadequate initial excision, this patient had a rare condition where the same tumor underwent malignant transformation within 3 years only. To the best of our knowledge, such an early transformation to malignancy of a minor salivary gland tumor of the parapharyngeal space has not been reported in the English literature.   Keywords: carcinoma ex pleomorphic adenoma, pleomorphic adenoma, carcinoma,  parapharyngeal space, malignant, transformation, minor salivary gland tumor,  mandibular swing