Carcinoma ex Pleomorphic Adenoma: A Case Series and Literature Review

MethodsThis was a single-center retrospective case series. The patients were included from November 2018 to December 2024. All confirmed cases of CXPA that were diagnosed and managed with complete clinical data were included in this study.

Cases with incomplete data were excluded.ResultsSix patients were included, with ages ranging from 45 to 88 years (mean±SD: 64±15.36; median: 62). Most were male (66.7%), with an even distribution of occupations. All presented with preauricular swelling lasting 2 to 10 years, and three had left-sided tumors.

Fine needle aspiration identified 33.3% as benign and 16.7% as malignant. Ultrasound examination showed solid tumors in four cases, three of which were well-defined. Three (50%) underwent total parotidectomy, and three (50%) underwent superficial parotidectomy.

Histopathological examination revealed adenocarcinoma ex pleomorphic adenoma in 50% and squamous cell carcinoma ex pleomorphic adenoma in 16.7%. Tumor sizes ranged from 3.5 to 6 cm (mean: 4.73±1.24 cm). Capsular invasion was present in all cases, with lymph node involvement in 33.3%, lympho-vascular invasion in 16.7%, and perineural invasion in 50%.

Adjuvant therapy included radiotherapy or chemoradiotherapy.ConclusionAlthough CXPA is very rare, it is a serious condition; surgical approach with or without adjuvant therapy may result in preferable outcomes.