A large and invasive pleomorphic adenoma of nasal cavity: a rare case report and review of literatures

Background Pleomorphic adenomas are common tumors of major salivary glands. However, the localization in nasal cavity originating from the lateral wall is exceptional. This work is a presentation of a very rare case that presents the diagnostic challenge, considering the multitude of malignant and benign differential diagnosis. A discussion of surgical approach, and the possible complications associated with it. Case presentation This is the case of an invasive nasal pleomorphic adenoma in a 48-year-old patient; the patient underwent complete excision through combined left lateral rhinotomy and functional endoscopic sinus surgery. Conclusion Pleomorphic adenoma is a very rare benign tumor of the nasal cavity. Clinical diagnosis is generally difficult regarding the multitude of differential diagnosis. Confirmation is established upon histological aspect. This is a case of a very rare large pleomorphic adenoma of nasal cavity originating from the lateral wall, associated with differential diagnosis, and surgical approaches, as well as perceivable complications. The strength of this work is to point out the importance of complete surgical extirpation and thorough follow-up to prevent recurrences and malignant transformation.

Integrated weighted gene coexpression network analysis identifies Frizzled 2 (FZD2) as a key gene in invasive malignant pleomorphic adenoma

Background Invasive malignant pleomorphic adenoma (IMPA) is a highly malignant neoplasm of the oral salivary glands with a poor prognosis and a considerable risk of recurrence. Many disease-causing genes of IMPA have been identified in recent decades (e.g., P53, PCNA and HMGA2), but many of these genes remain to be explored. Weighted gene coexpression network analysis (WGCNA) is a newly emerged algorithm that can cluster genes and form modules based on similar gene expression patterns. This study constructed a gene coexpression network of IMPA via WGCNA and then carried out multifaceted analysis to identify novel disease-causing genes. Methods RNA sequencing (RNA-seq) was performed for 10 pairs of IMPA and normal tissues to acquire the gene expression profiles. Differentially expressed genes (DEGs) were screened out with the cutoff criteria of |log2 Fold change (FC)|> 1 and adjusted p value < 0.05. Then, WGCNA was applied to systematically identify the hidden diagnostic hub genes of IMPA. Results In this research, a total of 1970 DEGs were screened out in IMPA tissues, including 1056 upregulated DEGs and 914 downregulated DEGs. Functional enrichment analysis was performed for identified DEGs and revealed an enrichment of tumor-associated GO terms and KEGG pathways. We used WGCNA to identify gene module most relevant with the histological grade of IMPA. The gene FZD2 was then recognized as the hub gene of the selected module with the highest module membership (MM) value and intramodule connectivity in protein–protein interaction (PPI) network. According to immunohistochemistry (IHC) staining, the expression level of FZD2 was higher in low-grade IMPA than in high-grade IMPA. Conclusion FZD2 shows an expression dynamic that is negatively correlated with the clinical malignancy of IMPA and it plays a central role in the transcription network of IMPA. Thus, FZD2 serves as a promising histological indicator for the precise prediction of IMPA histological stages.

Identification of 19-bp indel of the Pleomorphic Adenoma Gene 1 in Bali cattle population

Pleomorphic adenoma gene 1 (PLAG1) is a zinc finger transcription factor gene located on bovine chromosome 14 (BTA14) affecting body size and reproduction traits in cattle. The objective of this study was to identify 19-bp indel of the PLAG1 gene in Bali cattle population. A total of 96 blood samples of Bali Cattle were collected from Balai Pembibitan Ternak Unggul dan Hijauan Pakan Ternak (BPTU-HPT) Denpasar. Genomic DNA was extracted from blood samples and used to detect 19-bp indel of the PLAG1 gene using following primer pair 5’-TCCGAACAACAGGTGAGGGAGAAAT-3’ and 5’-CCACTTCAGG-GGTGCTCTAGGTTTG-3’. The polymerase chain reaction (PCR) products using DNA pool samples were sequenced to validate the PCR product and to find out novel polymorphism in Bali cattle population. The result showed that there was no variation found in Bali cattle population based on 19-bp indel of the PLAG1 gene, which is indicated by 123 bp DNA band. However, sequence analysis of the PLAG1 gene resulted in a novel single nucleotide polymorphism (SNP) at nucleotide number 32235 of the PLAG1 gene that changed guanine (G) to adenine (A). This novel SNP could be furthermore genotyped and it might be a potential candidate marker for body size and reproduction traits in Bali cattle.

Pleomorphic Adenoma of Neck: Case Report

Pleomorphic adenomas are benign tumour of the salivary glands that mostly affect the parotid gland. The tumor's "pleomorphic" form can be explained by its epithelial and connective tissue origins. Females between the ages of 30 and 50 are more likely to get the tumour. The tumour usually presents as asymptomatic swelling that progresses slowly. The majority of treatment is surgical removal of the tumour mass, with special attention paid to preserving the facial nerve. This is a case report of a 42-year-old female patient who had a pleomorphic adenoma of the submandibular gland. On the right side of the face, the patient had a slowly growing asymptomatic swelling. Pleomorphic adenoma is the commonest salivary gland tumor characterized by diverse histomorphological features. Early diagnosis and treatment plan entails thorough history taking, clinical examination, coupled with radiographic and histopathological findings.

Clinical analysis of 109 cases of lacrimal gland pleomorphic adenoma

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.