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Volume-12 Number-1, 2025 / Case Report

Carcinoma Ex-Pleomorphic Adenoma: A Silent Transformation with Aggressive Potential

Author:
Farheen Khan
Department of Pathology, Era's Lucknow Medical College and Hospital, Era University, Lucknow, U.P., Indi
Nishi Tandon
Department of Pathology, Era's Lucknow Medical College and Hospital, Era University, Lucknow, U.P., India
Andleeb Zehra
Department of Pathology, Era's Lucknow Medical College and Hospital, Era University, Lucknow, U.P., India
Sidrah Fatima
Department of Pathology, Era's Lucknow Medical College and Hospital, Era University, Lucknow, U.P., India
Nirupma Lal
Department of Pathology, Era's Lucknow Medical College and Hospital, Era University, Lucknow, U.P., India
Abstract:
Introduction: Pleomorphic adenoma represents majorly encountered tumor of the salivary glands which is benign, predominantly involving the parotid region. Despite its indolent presentation, it possesses a latent possibility of being malignant which is known as “carcinoma ex pleomorphic adenoma”, emphasizing the necessity of timely identification and definitive surgical treatment.
Case Scenario: A 52-year-old man was admitted with a slowly enlarging painless lump in the left parotid region which had been present 6 months. Ultrasound and MRI imaging studies showed a well-defined heterogeneous mass compatible with pleomorphic adenoma. The lesion was surgically removed. Histologic appearance of a biphasic lesion composed of epithelial/myoepithelial components set in a chondromyxoid stroma was seen. There were areas of nuclear atypia and pleomorphism, but no definite signs of malignancy.
Discussion: Although pleomorphic adenomas are usually benign, they should be carefully examined as can develop into malignant tumors over time. Accurate diagnosis and treatment planning requires an accurate approach to diagnosis including clinical examination and microscopic analysis, and imaging techniques. Treatment mainly consists of surgical removal, and particularly if histology reveals atypical features. In such cases, it is advised to have long term monitoring to find early indications of recurrence or malignant change.
Conclusion: The importance of early diagnosis and complete evaluation of salivary gland tumors is emphasized in this case. Surgical excision as frequently as possible and guided by a pathologic diagnosis is effective in its ability to prevent malignant transformation and to improve patient outcome. 
Keywords:
Histopathology, Malignant transformation, Pleomorphic adenoma, Parotid neoplasm, Salivary gland tumor.

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Download PDF View in DOI 10.24041/ejmr.2025.13