POLYMORPHOUS LOW-GRADE ADENOCARCINOMA: About two cases

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Vol. 87 No. 6 (2009): Issue Jun 2009

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Lobna Ayadi
Salma Chaâbouni
Laboratoire d'Anatomie et de Cytologie Pathologiques
Houria Dhouib
Service d'Oto-rhino-laryngologie
Karima Abbès
Laboratoire d'Anatomie et de Cytologie Pathologiques
Morched Dhouib
Service de Chirurgie Maxillo-faciale
Saloua Makni
Laboratoire d'Anatomie et de Cytologie Pathologiques
Mohamed Abdelmoula
Service de Chirurgie Maxillo-faciale
Abdelmonem Ghorbel
Service d'Oto-rhino-laryngologie
Abdelmajid Khabir
Laboratoire d'Anatomie et de CytologiePathologiques CHU. Habib Bourguiba Sfax-Tunisie
Tahya Boudawara
Laboratoire d'Anatomie et de Cytologie Pathologiques

Abstract

Background : Polymorphous low-grade adenocarcinoma (APBG) is a variant of malignant tumour of minor salivary glands usually arising in the palate.
Aim : Our aim is to discuss morphology, evolution and differential diagnosis of this rare tumour.
Case reports: The first case interested a 65-year-old-woman admitted for a two- months-history of a right submaxillary swelling. Examination found a tumour of the right side of the palate. A biopsy concluded to a pleomorphic adenoma. Giving that the mass enlarged, a surgical resection carrying off the thyroid with a bilateral neck dissection was performed. Diagnosis was an APBG partially resected with lymph node metastasis. The patient received adjuvant radiotherapy. Local recurrence appeared 28 months after treatment. The second case interested a 57-year-old-woman who consulted for a 12-year-history of a swelling of the  lower lip. Clinical examination showed a painless nodule measuring 2 cm located in the mucosal side of the lower lip. An excisional biopsy was performed. Pathologic examination  concluded to an APBG completely resected. The patient had no evidence of disease with a follow-up of 54 months.
Conclusion: APBG is characterised by a morphologic diversity and a cytologic uniformity that may cause a diagnostic dilemma especially with adenoid cystic carcinoma and pleomorphic adenoma. Its aggressiveness is assessed by its local infiltrative growth pattern requiring a wide surgical excision.

Keywords:

Polymorphous low-grade adenocarcinoma, minor salivary glands, prognosis, surgery

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