Publication:

Secondaries in the neck-submandibular gland carcinoma pleomorphic adenoma with salivary gland

Carcinoma ex pleomorphic adenoma (CA-ex-PA) represents a highly uncommon form of malignancy within the minor salivary glands of the oral cavity. CA-ex-PA is characterized as a carcinomatous transformation, occurring either as primary lesion or as recurrence of PA. PA can develop into different forms of malignancies like CA-ex-PA, carcinosarcoma or metastasizing PA. This particular type of tumor is predominantly prevalent among women aged between 30 and 60 years. A 55-year-old woman presented with symptoms including swelling on the right side of neck below the jaw, which is suspected to have metastasized from an unknown origin. Intraoperatively submandibular gland excision and right radical neck dissection along with internal jugular vein (IJV) was done to ensure definitive diagnosis. Histopathological results revealed that she was affected with CA-ex-PA stage pT3N2a. After the surgery patient was sent for radiotherapy as a part of her treatment plan and made an uneventful recovery. On the follow-up, the patient has shown no signs of recurrence and has no adverse or anticipated events. CA-ex-PA is a rare, aggressive cancer that can lead to death. Preoperative diagnosis of submandibular gland tumors requires comprehensive clinical history, suspicion of malignancy and radiographic analysis. In order to manage CA-ex-PA and prolong survival rates, prompt diagnosis, a multidisciplinary approach, surgical resection and radiation therapy are essential. Consistent follow-up is also crucial.