Benign Mixed Tumor

(Pleomorphic Adenoma)

Clinical Features
Pleomorphic

adenoma is benign tumor that is

derived from a mixture of ductal epithelial cells
and myoepithelial cells --- show both epithelial and
mesenchymal differentiation.
The most common neoplasm of salivary glands.
Location: 60% of tumors in the parotid, less
common in the submandibular glands, & relatively
rare in the minor salivary glands. In parotid gland,
most tumor arise within the superficial lobe.
Sex & Age: frequent in women in the 4th decade of
life. But it can be occurred in children & in elderly
persons of either sex.

 Symptoms:

painless, slow growing, mobile

discrete mass within the parotid or
submadibular areas or in the buccal cavity.
Treatment: parotidectomy.
Recurrence: 4% (parotidectomy) 25%
(enucleation).

Macroscopic
Rounded

and well demarcated mass.

Encapsulated (but sometimes the capsule is
not fully developed producing a tongue-like
protrusions into the surrounding gland)
Cut Section: solid, gray white in color,
consistency depends on the relative amount
of epithelial cells and stroma.

Microscopic
Tumor

composed of two components

(biphasic appearance):
Epithelial component
Forming

duct structures / acini / irregular tubules /

sheets of cells.
Foci of squamous metaplasia are common.

Mesenchymal component
Loose

myxoid tissue (contained stellate cells)

Cartilagenous or osseus differentiation are usually
found