Polymorphous low grade adenocarcinoma is a malignant epithelial tumour with low metastatic rate and infiltrative growth pattern. Six cases of polymorphous lowgrade adenocarcinoma terminal duct adenocarcinoma of the minor salivary glands are presented. A collection of disease information resources and questions answered by our genetic and rare diseases information specialists for polymorphous low grade adenocarcinoma. To date, this entity has been identified either within the confines of the oral cavity or, rarely, in the nasal cavity. Polymorphous low grade adenocarcinoma plga is a rare tumor of the salivary glands that is limited, to a great extent, to the minor salivary glands and commonly, but not exclusively, localized in the palate of the mouth. Polymorphous lowgrade adenocarcinoma synonyms, polymorphous. As the name implies, polymorphous low grade adenocarcinoma plga is a low grade neoplasm consisting of a uniform population of tumor cells that are arranged in a variety of architectural patterns polymorphous. Polymorphous low grade adenocarcinoma plga is a malignant epithelial tumor characterized by cytologic uniformity, morphologic diversity, an infiltrative growth pattern and low metastatic potential. Polymorphous lowgrade adenocarcinoma plga is a rare tumor that mostly affects minor salivary glands. The tumor mass may grow at a slow rate in the mouth and may present no pain. Polymorphous low grade adenocarcinoma versus pleomorphic adenoma of minor salivary glands. Polymorphous lowgrade adenocarcinoma is a lowgrade and indolent neoplasm, with 1020% risk of local recurrence, and low risk for distant metastasis and death due to plga.
Previously used terms for plga include lobular carcinoma and terminal duct carinoma. The major salivary glands are the parotid glands at the side of the face, below the ears. Atlas of head and neck pathology polymorphous lowgrade adenocarcinoma table of contents previous next polymorphous lowgrade adenocarconoma terminal duct carcinoma first named in 1983, this malignant tumor formerly was variously described as a. The 57 surveys for which it was possible to calculate the percentage of plgas among all malignant minor salivary gland. A collection of disease information resources and questions answered by our genetic and rare diseases information specialists for polymorphous lowgrade adenocarcinoma. This parotid epithelialmyoepithelial carcinoma shows a solid growth pattern with scattered tubules and mostly shows elongated nuclei with open chromatin and delicate nuclear membranes reminiscent of polymorphous low grade adenocarcinoma original magnification. Polymorphous lowgrade adenocarcinoma of salivary gland. Oct 12, 2014 polymorphous low grade adenocarcinoma plga is one such tumor, misunderstood, underdiagnosed, controversial in nomenclature and unpredictable in behavior. Polymorphous lowgrade adenocarcinoma located in the. It is important to differentiate plga from other salivary gland tumors with myoepithelial differentiation such as pleomorphic adenoma and adenoid cystic carcinoma.
Metastasis of polymorphous lowgrade adenocarcinoma journal of. Paranasal sinuses are uncommon venues for polymorphous low grade adenocarcinoma. Polyrnorphous lowgrade adenocarcinoma plga is a distinctive salivary gland neoplasm with a propensity to arise almost exclusive from minor salivary glands. A nonpapillary subtype of polymorphous lowgrade adenocarcinoma. Metastases to locoregional lymph nodes occur in only 610% of cases. Polymorphous low grade adenocarcinoma plga is a rare tumor that mostly affects minor salivary glands.
The cases were retrieved from the files of the oral and. Polymorphous lowgrade adenocarcinoma of maxillary alveolus. In all but one there was a history of a painless intraoral mass of. Polymorphous lowgrade adenocarcinoma definition of. Symptoms of polymorphous low grade adenocarcinoma including 5 medical symptoms and signs of polymorphous low grade adenocarcinoma, alternative diagnoses, misdiagnosis, and correct diagnosis for polymorphous low grade adenocarcinoma signs or polymorphous low grade adenocarcinoma symptoms. Polymorphous low grade adenocarcinoma lester dr thompson. Polymorphous lowgrade adenocarcinoma nord national. Polymorphous low grade adenocarcinoma plga is a recently described, relatively uncommon tumor that arises preferentially in minor salivary glands, favoring the palace. Polymorphous low grade adenocarcinoma plga is an indolent malignant tumor affecting the minor salivary gland almost exclusively. Synonyms for polymorphous low grade adenocarcinoma in free thesaurus. The palate or roof of the mouth, is the most common site for plga.
Antonyms for polymorphous low grade adenocarcinoma. Pdf polymorphous low grade adenocarcinoma james castle. Polymorphous adenocarcinoma pac is an uncommon tumour and mostly related to minor salivary glands. Here, we report a polymorphous low grade adenocarcinoma case of the maxillary sinus, a very rare.
Polymorphous lowgrade adenocarcinoma plga has been known as a comparatively less aggressive malignant tumor that predominantly occurs in the minor. Karyotypic variability and evolutionary characteristics of a polymorphous low grade adenocarcinoma in the parotid gland. Recently, two cases of plga with microscopically confirmed distant metastases have been reported. It is associated with a slow growth and indolent biology. Polymorphous lowgrade adenocarcinoma of the parotid gland. Polymorphous low grade adenocarcinoma plga is a rare, asymptomatic, slowgrowing malignant salivary gland tumor. Polymorphous lowgrade adenocarcinoma versus pleomorphic.
Nonencapsulated but often well circumscribed tumor with diverse polymorphous growth patterns cribriform, fascicular, microcystic, mixed, papillary focal, pseudoadenoid cystic without true lumens, single file, solid, strandlike, tubular am j surg pathol 1984. Polymorphous lowgrade adenocarcinoma plga is a rare tumor of the salivary glands that is limited, to a great extent, to the minor salivary glands and commonly, but not exclusively, localized in the palate of the mouth. Always seek professional medical advice about any treatment or change in treatment plans. Treatments for polymorphous lowgrade adenocarcinoma. Polymorphous lowgrade adenocarcinoma is a distinct neoplasm of the salivary gland composed of luminal and nonluminal tumor cells. Women are affected twice as frequently as men, and generally present in the fifth to sixth decade of life with a painless ihaoral mass. Its occurrence in the tongue is rare with very few cases reported in the literature. Polymorphous lowgrade adenocarcinoma should be thought of as distinct from adenoid cystic carcinoma, a common differential diagnostic. The purpose of this study is to report six new cases followedup during a long period.
A case report in a male 48 he had history of foul smelling discharge from the mouth, dysphagia, odynophagia, bleeding, weight loss. Polymorphous low grade adenocarcinomas plga are minor salivary gland neoplasms with a predilection for intraoral sites. These surveys included studies from different researchers, countries and continents. Polymorphous lowgrade adenocarcinoma plga is a lowgrade malignant neoplasm usually arising in the minor salivary glands. Original article polymorphous lowgrade adenocarcinoma. Polymorphous low grade adenocarcinoma plga is a minor salivary gland neoplasm that is characterized by morphologic variability, cytologic uniformity, and an infiltrating growth pattern. Jun 27, 2014 polymorphous low grade adenocarcinoma plga is a tumor of minor salivary glands that exhibits considerable morphologic overlap with adenoid cystic carcinoma and cellular pleomorphic adenoma, especially in small biopsy specimens. The patients included men and 27 women age 22 to 71 years median age, 54 years. A, nasopharyngeal plga demonstrating bone invasion original magnification 40. Polymorphous lowgrade adenocarcinoma has only rarely been reported in britain, but we believe it deserves wider recognition as a distinct clinicopathological entity and, in particular, separation.
Polymorphous low grade adenocarcinoma, salivary gland tumors. Polymorphous low grade adenocarcinoma with distant metastases. Polymorphous lowgrade adenocarcinoma libre pathology. The tumors were all intraoral, and the palate was the most common site n 24. It is a malignant neoplasm with low aggressiveness and it is thus important to identify and treat it accordingly. Plga is predominantly found in females in their sixth to seventh decade, and it most commonly arises in the minor salivary glands, with more than half of cases involving the palate. Polymorphous low grade adenocarcinoma has a consistent p63. Minor salivary gland malignant neoplasms account for 2 4% of head. We report a case of a 55 year old male who presented with an asymptomatic swelling on the hard palate. Common tumor of palate with infiltrative growth, multiple architectural growth patterns and cellular uniformity, first described in 1983 oral surg oral med oral pathol 1983. Polymorphous lowgrade adenocarcinoma december 5 th, 2008.
Its resemblance to lobular carcinoma of the breast had led to its earlier nomenclature of terminal duct carcinoma. Dec 17, 2018 what are the signs and symptoms of polymorphous low grade adenocarcinoma of salivary gland. Nonencapsulated uniform plump columnar cells with bland nuclei with diverse growth patterns tubular, cribriform, papillary, solid, fascicular, microcystic, single file, pseudoadenoid cystic without true lumens, strandlike, mixed. Polymorphous low grade adenocarcinoma plga originating mostly in the minor salivary glands of the posterior hard and soft palate is characterised by its indolent growth and a slower rate of metastasis. Polymorphous lowgrade adenocarcinoma of seromucous glands of. Polymorphous lowgrade adenocarcinoma genetic and rare. Polymorphous low grade adenocarcinoma plga is a slowgrowing salivary gland malignancy with a nonaggressive behaviour. Diagnostic dilemma of polymorphous low grade adenocarcinoma. Polymorphous lowgrade adenocarcinoma of the tongue. Polymorphous lowgrade adenocarcinoma negative for gfap original magnification. Polymorphous lowgrade adenocarcinoma lester dr thompson.
A soft tissue enlargement is present at the junction of the left hard and soft palate. Polymorphous low grade adenocarcinoma of salivary gland signs and symptoms may include the following. Seldom does the plga present an aggressive behaviour and demonstrate distant metastasis, as in the present case where a 73yearold female patient with a swelling in the maxillary alveolus was. Polymorphous low grade adenocarcinoma is a welldefined entity in the minor salivary glands. Immunohistochemical pattern of pleomorphic adenoma. Treatment list for polymorphous low grade adenocarcinoma the list of treatments mentioned in various sources for polymorphous low grade adenocarcinoma includes the following list. Polymorphous low grade adenocarcinomas are minor salivary gland neoplasms with a predilection for intraoral sites. Epidemiology represents 2 nd or 3 rd most common minor salivary gland malignancy 1726% 1st. Polymorphous low grade adenocarcinoma has only rarely been reported in britain, but we believe it deserves wider recognition as a distinct clinicopathological entity and, in particular, separation. Mar 16, 2020 as the name implies, polymorphous low grade adenocarcinoma plga is a low grade neoplasm consisting of a uniform population of tumor cells that are arranged in a variety of architectural patterns polymorphous. The major salivary glands are the parotid glands at the side of the face. Most patients present with an asymptomatic mass in the hard palate.
Jan 15, 20 this study is an analysis of the prevalence of polymorphous low grade adenocarcinoma plga in epidemiological surveys of salivary tumors published in the english language from 1992 to 2012. A carcinoma commonly misclassified as polymorphous low grade adenocarcinoma hematoxylineosin staining used in both parts of figure. Polymorphous lowgrade adenocarcinoma plga was recognized as a distinct entity in 1983 by batsakis et al. Polymorphous low grade adenocarcinomas plgas are thought to be indolent tumours that are localised preferentially to the palate and affect the minor salivary glands almost exclusively. In such cases, it is critical to make a definite diagnosis as each of these tumors has an entirely different treatment protocol. Polymorphous low grade adenocarcinoma of the salivary glands with transformation to high grade carcinoma. Polymorphous lowgrade adenocarcinoma plga is a rare malignant tumor, commonly found in minor salivary glands of the hard or soft palate. Forms of invasion seen in polymorphous low grade adenocarcinoma plga hematoxylineosin staining used in all parts of figure.
Oral surg oral med oral pathol oral radiol endod 91 2. It has a varied microscopic architectural appearance, i. We report a case of plga arising from the parotid gland. Pdf polymorphous low grade adenocarcinoma researchgate. It has previously been known as terminal duct carcinoma, lobular carcinoma, and low grade papillary adenocarcinoma. Histopathological spectrum of polymorphous lowgrade. Polymorphous low grade adenocarcinoma of the hard palate.
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