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{{SI}}                                                                 
{{Pleomorphic adenoma}}
{{CMG}} {{AE}} {{MV}}
'''For patient information, click [[Pleomorphic adenoma (patient information)|here]]'''
{{SK}} Pleomorphic adenoma of the salivary glands; BMT; Benign mixed tumors of the salivary gland
==Overview==


'''Pleomorphic adenoma''' (also known as "Benign mixed tumor of the salivary gland") is a benign neoplastic tumor of the [[salivary gland]]s. Pleomorphic adenoma is the most common type of salivary gland tumor and the most common tumor of the [[parotid gland]].<ref name="radiographics">Ewa J. Bialek, Wieslaw Jakubowski, Piotr Zajkowski, Kazimierz T. Szopinski, and Antoni Osmolski. [http://radiographics.rsnajnls.org/cgi/content/abstract/26/3/745 US of the Major Salivary Glands: Anatomy and Spatial Relationships, Pathologic Conditions, and Pitfalls.] RadioGraphics 2006 26: 745-763. </ref>
{{CMG}}; {{AE}} {{M.N}}


==Historical Perspective==
{{SK}}


*Pleomorphic adenoma was first discovered by Beahrs  in in 1957.
==[[Pleomorphic adenoma overview|Overview]]==


==[[Pleomorphic adenoma historical perspective|Historical Perspective]]==
==Classification==
*Pleomorphic adenoma may be classified according to [classification method] into [number] subtypes/groups:
:*[group1]
:*[group2]
:*[group3]
*Other variants of pleomorphic adenoma include [disease subtype 1], [disease subtype 2], and [disease subtype 3].
==Pathophysiology==
*The pathogenesis of pleomorphic adenoma is characterized by [feature1], [feature2], and [feature3].
*The [gene name] gene/Mutation in [gene name] has been associated with the development of pleomorphic adenoma, involving the [molecular pathway] pathway.
*On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of pleomorphic adenoma.
*On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of pleomorphic adenoma.
==Causes==
*Common causes of pleomorphic adenoma, include:


==[[Pleomorphic adenoma classification|Classification]]==
==Differentiating Pleomorphic Adenoma from Other Diseases==
*Pleomorphic adenoma must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as:
:*[Differential dx1]
:*[Differential dx2]
:*[Differential dx3]
==Epidemiology and Demographics==
* The prevalence of pleomorphic adenoma is approximately [number or range] per 100,000 individuals worldwide.
* In [year], the incidence of pleomorphic adenoma was estimated to be [number or range] cases per 100,000 individuals in [location].
===Age===


==[[Pleomorphic adenoma pathophysiology|Pathophysiology]]==
*Pleomorphic adenoma is more commonly observed among patients aged [age range] years old.
*Pleomorphic adenoma is more commonly observed among [elderly patients/young patients/children].
===Gender===
*Pleomorphic adenoma affects men and women equally.
*[Gender 1] are more commonly affected with pleomorphic adenoma than [gender 2].
* The [gender 1] to [Gender 2] ratio is approximately [number > 1] to 1.
===Race===
*There is no racial predilection for pleomorphic adenoma.
==Risk Factors==
*Common risk factors in the development of pleomorphic adenoma, include:
== Natural History, Complications and Prognosis==


*The majority of patients with pleomorphic adenoma remain asymptomatic for [duration/years].
==[[Pleomorphic adenoma causes|Causes]]==
*Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
*If left untreated, the majority of patients with pleomorphic adenoma may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
*Common complications of pleomorphic adenoma include [complication 1], [complication 2], and [complication 3].
*Prognosis is generally [excellent/good/poor], and the [1/5/10­year mortality/survival rate] of patients with pleomorphic adenoma is approximately [#%].
== Diagnosis ==
===Diagnostic Criteria===
*The diagnosis of pleomorphic adenoma is made when at least [number] of the following [number] diagnostic criteria are met:
:*[criterion 1]
:*[criterion 2]
:*[criterion 3]
:*[criterion 4]
=== Symptoms ===
*Pleomorphic adenoma is usually asymptomatic.
*Symptoms of pleomorphic adenoma may include the following:
:*[symptom 1]
:*[symptom 2]
:*[symptom 3]
:*[symptom 4]
:*[symptom 5]
:*[symptom 6]
=== Physical Examination ===
*Patients with pleomorphic adenoma usually appear [general appearance].
*Physical examination may be remarkable for:
:*[finding 1]
:*[finding 2]
:*[finding 3]
:*[finding 4]


==[[Pleomorphic adenoma differential diagnosis|Differentiating Pleomorphic Adenoma from other Diseases]]==
=== Laboratory Findings ===
*There are no specific laboratory findings associated with pleomorphic adenoma.


==[[Pleomorphic adenoma epidemiology and demographics|Epidemiology and Demographics]]==
===Imaging Findings===
*MRI is the imaging modality of choice for pleomorphic adenoma.
*On CT, characteristic findings of pleomorphic adenoma, include:
:*Smooth, and well-marginated tumors
:*The attenuation values of the mass are usually homogeneous and higher than that of the surrounding gland
:*Tumor enhancement is variable and can result in a missed diagnosis if delayed images are not acquired
:*Pleomorphic adenomas are poorly enhancing in the early phase of contrast enhancement, though the amount of enhancement increases over time).


*On MRI, characteristic findings of pleomorphic adenoma, include:
==[[Xyz risk factors|Risk Factors]]==
:*Pleomorphic adenomas are usually well-circumscribed
:*Homogeneous masses with low intensity on T1-weighted images and high intensity on T2-weighted images.
:*They commonly have a rim of decreased signal intensity on T2-weighted images.
:*After gadolinium enhancement, the tumors are homogeneously enhancing unless they are large.
====Gallery====


<gallery perRow="3">
==[[Pleomorphic adenoma screening|Screening]]==
Image:Pleomorphic adenoma MRI 101.jpg|MRI: A right parotid pleomorphic adenoma [http://www.radswiki.net Images courtesy of RadsWiki]
Image:Pleomorphic adenoma MRI 102.jpg|MRI: A right parotid pleomorphic adenoma [http://www.radswiki.net Images courtesy of RadsWiki]
Image:Pleomorphic adenoma MRI 103.jpg|MRI: A right parotid pleomorphic adenoma [http://www.radswiki.net Images courtesy of RadsWiki]
Image:Pleomorphic adenoma MRI 104.jpg|MRI: A right parotid pleomorphic adenoma [http://www.radswiki.net Images courtesy of RadsWiki]
Image:Pleomorphic adenoma MRI 105.jpg|MRI: A right parotid pleomorphic adenoma [http://www.radswiki.net Images courtesy of RadsWiki]
Image:Pleomorphic adenoma PET 106.jpg|PET: A right parotid pleomorphic adenoma [http://www.radswiki.net Images courtesy of RadsWiki]
</gallery>


=== Other Diagnostic Studies ===
==[[Pleomorphic adenoma natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
*Pleomorphic adenoma may also be diagnosed using [[fine needle aspiration]] (FNA) and core needle biopsy.
*Findings on [[fine needle aspiration]] (FNA) and core needle biopsy, include:
:*
:*
:*
== Treatment ==
=== Medical Therapy ===
*There is no treatment for pleomorphic adenoma; the mainstay of therapy is surgery.
*In some cases, patients with pleomorphic adenoma can receive medications to stimulate saliva production, such as:
:*Pilocarpine
:*Cevimeline


=== Surgery ===
==Diagnosis==
*Surgery is the mainstay of therapy for pleomorphic adenoma.
[[Pleomorphic adenoma diagnostic study of choice|Diagnostic study of choice]] | [[Pleomorphic adenoma history and symptoms|History and Symptoms]] | [[Pleomorphic adenoma physical examination|Physical Examination]] | [[Pleomorphic adenoma laboratory findings|Laboratory Findings]] | [[Pleomorphic adenoma electrocardiogram|Electrocardiogram]] | [[Pleomorphic adenoma x ray|X-Ray Findings]] | [[Pleomorphic adenoma echocardiography and ultrasound|Echocardiography and Ultrasound]] | [[Pleomorphic adenoma CT scan|CT-Scan Findings]] | [[Pleomorphic adenoma MRI|MRI Findings]] | [[Pleomorphic adenoma other imaging findings|Other Imaging Findings]] | [[Pleomorphic adenoma other diagnostic studies|Other Diagnostic Studies]]
*Surgical excision in conjunction with pre-surgical biopsy is the most common approach to the treatment of pleomorphic adenoma.


=== Prevention ===
==Treatment==
*There are no primary preventive measures available for pleomorphic adenoma.
[[Pleomorphic adenoma medical therapy|Medical Therapy]] | [[Pleomorphic adenoma surgery|Surgery]] | [[Pleomorphic adenoma primary prevention|Primary Prevention]] | [[Pleomorphic adenoma secondary prevention|Secondary Prevention]] | [[Pleomorphic adenoma cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Pleomorphic adenoma future or investigational therapies|Future or Investigational Therapies]]
*Once diagnosed and successfully treated, patients with pleomorphic adenoma are followed-up every 6 or 12 months.
*Follow-up testing includes [test 1], [test 2], and [test 3].


 
==Case Studies==
==References==
[[Pleomorphic adenoma case study one|Case #1]]
{{Reflist|2}}
[[Category:Disease]]
[[Category:Oral pathology]]
[[Category:Oncology]]

Latest revision as of 14:46, 12 February 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Maneesha Nandimandalam, M.B.B.S.[2]

Synonyms and keywords:

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Pleomorphic Adenoma from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic study of choice | History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | X-Ray Findings | Echocardiography and Ultrasound | CT-Scan Findings | MRI Findings | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

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Case #1