1/9. A minor salivary gland tumour presenting with dysphagia.A case is reviewed of a giant benign myoepithelioma of the soft palate presenting in an elderly female patient. Due to the large size of the lesion and its mass effect the patient developed dysphagia with subsequent significant weight loss. The clinico-pathological features of this rare tumour are described and the literature reviewed.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/9. Extramedullary plasmacytoma of the parotid gland. Report of a case with extensive amyloid deposition masking the cytologic and histopathologic picture.BACKGROUND: Extramedullary plasmacytomas are uncommon. Although approximately 90% occur in the head and neck region, parotid gland localization is extremely rare. CASE: This report describes fine needle aspiration and histopathologic findings in an extramedullary plasmacytoma arising in the left parotid gland of a 62-year-old man. Aspiration smears showed multiple amorphous clumps of material admixed with ductal epithelial cells, multinucleated giant cells and inflammatory cells rich in plasma cells, suggestive of pleomorphic adenoma. In surgical material, excessive amyloid deposition was observed. Six months later the tumor recurred, and in the second surgical specimen clusters of atypical plasma cells among amyloid deposits was noted. Clinical and laboratory examination excluded multiple myeloma. After local recurrence, radiotherapy was applied. Ten months later the patient was well and without systemic involvement. CONCLUSION: Two points are important. First, in the salivary gland region, because of the focal metachromasia of amyloid with Giemsa stain, amyloid can be confused with the chondromyxoid matrix of pleomorphic adenoma. Second, although localized forms of amyloid tumor exist, one should keep in mind that amyloid may be so abundant that it may mask an underlying plasma cell neoplasm, as in our case.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
3/9. Combined transcervical transmastoid approach to giant parotid pleomorphic adenoma: a case report.Although rare, giant major salivary gland pleomorphic adenomas are among the most astonishing patient presentations. patients may ignore these slow-growing, benign lesions until significant functional impairment occurs. Complete tumor excision and facial nerve preservation in these cases are challenging requirements and are greatly aided by combined transcervical and transmastoid approaches to these lesions. In the presented case, facial nerve monitoring accurately identified the collateralization between the upper and lower divisions of the facial nerve and allowed the required sacrifice of the lower division without the need for facial nerve grafting or reconstruction. The patient recovered full function of all branches.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
4/9. Giant neck neoplasm. Case report.Giant latero-cervical neoplasias usually originate in the parotid gland, as slow-growing adenomas, in subjects who take little care of their personal health. Giant adenomas of submandibular gland are very rare. These neoplasias involve prevalently male sex (male/female ratio: 2/1) and usually occur between 20 and 40 years of age. Signs of malignant transformation may be observed in the adenomatous epithelial component in a percentage ranging from 1% to 10% of cases. The case is reported of a giant malignant latero-cervical neoplasia originating from a pleomorph adenoma of the submandibular gland. The diagnostic work-up and treatment protocol are described.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
5/9. Giant pleomorphic adenoma of the parotid gland with malignant transformation.A 72-year-old female is described who was admitted to the hospital with a giant mixed tumor of the left parotid gland that had grown to a weight of 6051 g within 20 years and ultimately underwent resection of the mass. Histopathological examination revealed adenocarcinoma cells with hyperchromatic nuclei and mitotic figures proliferated in pleomorphic adenoma. Many authors have reported giant tumors weighing more than a few kilograms of the parotid glands, and most were benign. The present tumor was the sixth largest among all the parotid tumors, including both benign and malignant, which were reported. Furthermore, our case was the largest one confirmed as malignant recorded in the world literature. The tumor was successfully resected with no marked facial nerve paralysis.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
6/9. Malignant myoepithelial carcinoma (myoepithelioma) arising in a pleomorphic adenoma of the parotid gland. An immunohistochemical study and review of the literature.A 66-year-old woman presented with a giant tumor of the parotid gland, which under a light microscope had a sarcomatous appearance with spindle-shaped myoepithelial cells (malignant myoepithelioma). Histochemical examination showed longitudinal fibrils in the cytoplasm of the myoepithelial cells. Immunohistochemical studies showed positive staining for S-100 protein, vimentin, and actin in the myoepithelial cells. Cytokeratin was seen in the ductular epithelial cells and in the periductular myoepithelial cells, but it was absent from malignant myoepithelial cells. Ultrastructurally, these cells contained several longitudinally oriented slender structures resembling myofilaments without dense bodies. A review of the literature confirms the rarity of malignant myoepithelial carcinoma (myoepithelioma) arising in the parotid gland, and we therefore add another case.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
7/9. Giant mitochondria in a pleomorphic adenoma of the submandibular gland.A benign pleomorphic adenoma of the submandibular gland was examined by electron microscopy. In some areas, the epithelial cells comprising the tumor formed ductlike structures surrounding a lumen filled with membrane vesicles. The cells actually abutting the lumens had giant mitochondria measuring up to 8 micrometers in diameter; such enlarged organelles were absent from immediately subjacent cells. The giant mitochondria exhibited a variety of cristal arrangements, the most common being a quasireticulate one. They often contained expanded cristae that enclosed a number of helical filaments. Bundles of 14-nm tubules with faintly discernible axial periodicity were frequently present in the matrix compartment, as were amorphous dense inclusions. The basis for the occurrence of giant mitochondria only in duct cells may reside in microenvironmental factors rather than in altered nuclear or mitochondrial genomes.- - - - - - - - - - ranking = 3keywords = giant (Clic here for more details about this article) |
8/9. Giant cell tumor of major salivary glands: report of three cases, one occurring in association with a malignant mixed tumor.Three cases of a heterofore undescribed neoplasm of major salivary glands morphologically similar to giant cell tumor of bone are presented. All tumors were located in the parotid gland of adult individuals, and all patients are alive and well following surgical excision. One of the three cases was associated intimately with a malignant mixed tumor (carcinoma in pleomorphic adenoma). Ultrastructural and immunohistochemical studies failed to provide conclusive evidence about the specific nature of the tumor cells. The major salivary glands should be added to the long list of organs in which extraskeletal giant cell tumors have been observed, whether alone or in association with an epithelial malignancy.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
9/9. Giant pleomorphic adenoma of the parotid gland: case report and review of the literature.Pleomorphic adenomas account for the majority of parotid masses, typically arising in the tail of the gland and enlarging slowly over time. The vast majority are 2 to 6 cm in size when resected. We report resection of the largest benign mixed tumor recorded in the modern English language literature. An 85-year-old reclusive woman had a 20-year history of an enlarging right periauricular mass that had begun bleeding several days prior to admission. The patient ultimately underwent resection of the mass, which measured 26 cm in diameter, weighed 6.85 kg, and proved on pathologic examination to be a benign mixed tumor without malignant degeneration. The implications of this unusual case for the management of mixed tumors are discussed, and a review of the world literature on giant pleomorphic adenomas is presented.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |