scholarly journals Clinical analysis of 109 cases of lacrimal gland pleomorphic adenoma

2021 ◽  
Vol 14 (12) ◽  
pp. 1852-1857
Author(s):  
Rui Liu ◽  
◽  
Hong Zhang ◽  
Xin Ge ◽  
Jian-Min Ma ◽  
...  
Keyword(s):  
Pleomorphic Adenoma ◽  
Malignant Transformation ◽  
Lacrimal Gland ◽  
Histopathological Examination ◽  
Case Series ◽  
Bone Destruction ◽  
Clinical Analysis ◽  
Ki 67 ◽  
Initial Surgery ◽  
Clinical Records

AIM: To monitor the prognosis of patients with lacrimal gland pleomorphic adenoma (LGPA) following surgical resection within the past 10y. The factors affecting patient prognosis are analyzed and the experience of surgical treatment is summarized. METHODS: In this retrospective, comparative case series, clinical records from 109 cases of LGPA treated chiefly at the same institution between November 2009 and May 2019 were reviewed. All 109 patients underwent surgery, histopathological examination, and imaging examination. For patients who underwent surgery for the first time, LGPA could be resected completely, including tumor and capsule tissues, using a surgical approach via the eyebrow arch or double eyelid crease. RESULTS: The ratio of males to females was 1:1.60, the ages ranged from 19 to 74 years old with a mean age of 43.64±13.07 years old, and the ratio of left to right eyes was 1:1.37. A total of 109 patients underwent surgical excision and five of these received radiotherapy after malignant transformation. Of these patients, 15 were lost to follow up within the April 1, 2020 deadline and 1 was diagnosed as a recurring pathology. The 5-year recurrence rate for 86 patients who underwent initial surgery was 7.27%. Single factor analysis revealed that the course of disease, bone destruction, invasion of surrounding tissues, tumor size, capsule integrity, and expression of Ki-67 were statistically significant (P<0.05). Binomial Logistic regression analysis showed that capsule integrity was a risk factor influencing recurrence (P=0.008). CONCLUSION: LGPA has a risk of recurrence and potential for malignant transformation. Complete removal of the tumor and capsule in the initial surgery is a key factor in preventing recurrence.

scholarly journals Retears of the Rotator Cuff: An Ultrasonographic Assessment During the First Postoperative Year

2019 ◽  
Vol 7 (12) ◽  
pp. 232596711988904 ◽  
Author(s):  
Giussepe Aguado ◽  
Daniel Vernaza Obando ◽  
Gilberto A. Herrera ◽  
Alejandro Ramirez ◽  
Paulo J. Llinás
Keyword(s):  
Rotator Cuff ◽  
Surgical Repair ◽  
Statistical Significance ◽  
Case Series ◽  
Level Of Evidence ◽  
Double Row ◽  
Initial Surgery ◽  
The Difference ◽  
Clinical Records ◽  
Massive Tears

Background: Surgical repair of rotator cuff (RC) tears is an effective treatment option. However, the prevalence of recurrent ruptures is high. Hypothesis: Recurrent tears are a frequent complication of surgical repair of RC tears. Their incidence might be influenced by factors such as the patient’s age and size of the initial tear. Study Design: Case series; Level of evidence, 4. Methods: Data from 90 adult patients who underwent arthroscopic RC repair between 2014 and 2017 and underwent an ultrasound examination 6 to 12 months after surgery were analyzed retrospectively. Massive tears were repaired using a double-row technique, and nonmassive tears were repaired with a single-row technique. Clinical records were reviewed for demographic information. Results: All patients (57.8% women; 42.2% men) were older than 18 years (mean, 58.9 years). Of these patients, 30.0% (27/90) had massive tears, which were primarily found in patients ≥60 years (74.1%; 20/27). Complete healing was seen in 74.5% of all repairs during follow-up. A total of 23 patients (25.5%) had retears (13 complete; 10 partial), which were diagnosed by ultrasound imaging 6 to 12 months after the initial surgery. The occurrence of retears was more prevalent in patients with massive tears than in patients with nonmassive tears (40.7% vs 19.0%, respectively); the difference was statistically significant ( P = .03). Reruptures occurred in 50.0% of patients older than 60 years with massive tears. Although patients older than 60 years had more recurrent tears (32.6%) compared with younger patients (18.2%), the difference was not statistically significant ( P = .12). Conclusion: One-quarter of the patients who had undergone surgical repair of an RC tear had recurrent ruptures. There was a statistically significant association between the initial massive tear and a retear. Patients older than 60 years showed a higher recurrence rate, but this difference lacked statistical significance. Reruptures occurred in 50.0% of patients older than 60 years with massive tears.

scholarly journals Pleomorphic Adenoma of Lacrimal Gland: A Rare Entity

2021 ◽  
Vol 8 (7) ◽  
pp. C100-104
Author(s):  
Kirti Chadha Kazi ◽  
Vivek Choodamani Parameshwar ◽  
Vikas S Kavishwar ◽  
Prithesh Bhaskar Shetty
Keyword(s):  
Pleomorphic Adenoma ◽  
Lacrimal Gland ◽  
Histopathological Examination ◽  
Mass Effect ◽  
Final Diagnosis ◽  
Myoepithelial Cells ◽  
Significant Loss ◽  
Excision Biopsy ◽  
Post Surgery ◽  
Rare Tumours

Among the various tumours affecting the lacrimal gland, pleomorphic adenomas though most common can present clinically and radiologically as worrisome tumours. Histopathologic diagnosis hence is very critical for these tumours. We present a case of pleomorphic adenoma of the lacrimal gland which we encountered at our institutes. The patient was a 46-year-old male who came with complaints of a gradually progressing swelling in the right eye not associated with much pain or significant loss of vision. MRI revealed a large lobulated extrachoanal mass causing mass effect and scalloping of the adjacent bony structures. An excision biopsy was done and sent for histopathological examination. Histologically the tumour showed a biphasic morphology comprising of epithelial (ductal and myoepithelial) and chondromyxoid stromal components. Immunohistochemistry showed positivity for pan CK and CK 7 in ductal epithelial cells, p63 and S100 in myoepithelial cells and a low Ki67 index. On the basis of immunohistochemistry profile along with clinicoradiological correlation a final diagnosis of pleomorphic adenoma of the lacrimal gland was made. The patient post-surgery was doing well but was lost to follow up. It can thus be seen that is it absolutely necessary to accurately diagnose these benign but clinically misconceiving rare tumours of the lacrimal gland for appropriate management of such patients.

Malignant transformation of a lacrimal gland pleomorphic adenoma with pulmonary metastases

2015 ◽  
Vol 43 (6) ◽  
pp. 591-592
Author(s):  
Emil D Kurniawan ◽  
Garry Davis ◽  
Penelope McKelvie ◽  
Thomas G Hardy
Keyword(s):  
Pleomorphic Adenoma ◽  
Malignant Transformation ◽  
Lacrimal Gland ◽  
Pulmonary Metastases

Malignant transformation of grade II ganglioglioma to glioblastoma: A case report

2012 ◽  
Vol 3 (2) ◽  
Author(s):  
Hrvoje Čupić ◽  
Tomislav Sajko ◽  
Nikolina Sesar ◽  
Mihovil Ivica ◽  
Leo Pažanin
Keyword(s):  
Malignant Transformation ◽  
Ganglion Cells ◽  
Histopathological Examination ◽  
World Health ◽  
Proliferation Index ◽  
Surgical Removal ◽  
Ki 67 ◽  
Grade Ii ◽  
Health Organization ◽  
P53 Immunoreactivity

AbstractGangliogliomas are well differentiated and slowly growing neuroepithelial tumors composed of neoplastic ganglion cells and neoplastic glial cells corresponding mostly to the World Health Organization grade I tumors. However, some of these tumors disclose histologically more malignant glial component and correspond to grade II or grade III tumors. We report a case of left temporal lobe tumor in a 42-year-old woman fulfilling the diagnostic criteria for atypical (grade II) ganglioglioma with high Ki-67 proliferation index and p53 immunoreactive tumor cells. In spite of gross total removal of the tumor, it recurred eight months after surgery. Histopathological examination of the recurrent tumor revealed that it had undergone malignant transformation into a glioblastoma. This case indicates that gangliogliomas with high Ki-67 proliferating index and p53 immunoreactivity should be carefully monitored for recurrence and malignant progression regardless of their morphological grading and seemingly total surgical removal.

Lacrimal gland pleomorphic adenoma and malignant epithelial tumours: clinical and imaging differences

2018 ◽  
Vol 103 (2) ◽  
pp. 264-268 ◽  
Author(s):  
Stephanie Ming Young ◽  
Yoon-Duck Kim ◽  
Hyun Jin Shin ◽  
Yukihiro Imagawa ◽  
Stephanie S Lang ◽  
...  
Keyword(s):  
Pleomorphic Adenoma ◽  
Lacrimal Gland ◽  
Medical Records ◽  
Case Series ◽  
Surgical Excision ◽  
Symptom Duration ◽  
Imaging Features ◽  
Tertiary Institution ◽  
Significant Difference ◽  
Epithelial Tumours

AimsTo investigate the clinical and imaging features of primary and recurrent lacrimal gland pleomorphic adenoma (LGPA), as well as lacrimal gland malignant epithelial tumours (LGMET).MethodsRetrospective comparative case series from September 2000 to September 2016 in a single tertiary institution. Medical records of cases with histopathologically proven primary LGPA (PLGPA), recurrent LGPA (RLGPA) and LGMET were reviewed.ResultsSixty-four patients with LGPA (55 primary and nine recurrent) and 36 patients with LGMET underwent surgical excision in the study period. There was no significant difference in terms of age, gender or laterality. In terms of symptom duration, that of LGMET (7.1 months) was significantly shorter than PLGPA (23.9 months), which in turn was significantly shorter than RLGPA (127.1 months). Proptosis was the most common presenting symptom among all three groups. On CT, LGMET and RLGPA were significantly more likely to have ill-defined margins (p<0.001) and be heterogeneous (p<0.001) than PLGPA. RLGPAs (56%) were significantly more likely to have calcification than LGMET (34%), which in turn was more likely to have calcification than PLGPA (13%); LGMET (40%) and RLGPA (33%) were significantly more likely to have bony invasion than PLGPA (2.2%). On MRI, LGMETs (55%) were significantly more likely to have a tail or wedge sign indicating infiltration into the posterior orbit than PLGPA (0%) or RLGPA (0%).ConclusionOur study adds important information regarding differentiating clinical and radiological features between malignant and benign epithelial lacrimal gland tumours that would aid in their management.

scholarly journals Carcinoma Ex Pleomorphic Adenoma of the Uvula - Case Report

2021 ◽  
Vol 2 (7) ◽  
pp. 543-547
Author(s):  
Joana Borges da Costa ◽  
Ana Isabel Goncalves ◽  
Andre Carcao ◽  
Joana Santos ◽  
Delfim Duarte ◽  
...  
Keyword(s):  
Case Report ◽  
Pleomorphic Adenoma ◽  
Malignant Transformation ◽  
Benign Tumor ◽  
Histopathological Examination ◽  
Carcinoma Ex Pleomorphic Adenoma ◽  
Surgical Specimen ◽  
Common Location ◽  
Cervical Ganglion ◽  
Progressive Growth

Introduction: Carcinoma Ex Pleomorphic Adenoma (CEPA) results from the malignant transformation of a benign tumor of the Salivary Glands (SG), the Pleomorphic Adenoma (PA). PA is considered the most common salivary tumor with a 5% risk of malignant transformation and its excision is recommended. CEPA is a rare tumor, corresponding to 3.6% of all salivary tumors and 11.6% of all GS carcinomas. About 18% of CEPAs affect minor SG, with the palate being the most common location. The present work serves to describe a case of a CEPA of the Uvula Minor SG (UMSG). Case Report: We present a case report of a 57-year-old patient, with no relevant medical history, referred to the ENT consultation due to the appearance and progressive growth of a painless uvula lesion. The objective ENT examination showed a 15 mm ulcerative-vegetating lesion with apparent origin on the posterior face of the uvula. The lesion was biopsied and histopathological examination identified the presence of a neoplasm of the minor SG, probably NOS adenocarcinoma. The patient underwent Computed Tomography (CT) scan that showed an irregularity of the uvula, with no signs of invasion of the remaining soft palate, without other significant pharyngo-laryngeal changes. The patient underwent partial pharyngectomy and bilateral selective cervical ganglion dissection, and the histopathology of the surgical specimen confirmed that it was an invasive CEPA, the malignant component of the tumor corresponding to a NOS adenocarcinoma of the UMSG. The patient has been followed up in the ENT consultation, with no signs so far of loco-regional recurrence. Discussion/Conclusion: In the presented case, the patient probably developed an undiagnosed PA that had become malignant over time. Given that it is a poor prognosis neoplasm, it’s essential that the ENT specialists are aware of this disease, in order to facilitate and anticipate the diagnosis and treatment as much as possible.

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