Cystadenoma is a rare benign salivary gland tumor that chiefly originates in the minor salivary glands as a cystic growth with papillary projections into the cystic lumen without the lymphoid element.
It is further classified into two histopathological variants that have been recognized by World Health Organization as the papillary and the mucinous forms of cystadenoma. Clinically, it is difficult to differentiate from other benign minor salivary tumors and mucous retention phenomenon. Diagnosis is chiefly based on characteristics histological features. It is believed that the salivary gland tumors are difficult to diagnose and interpret because there are varied patterns of presentation.
The study of salivary gland disorders has increased in leaps and bounds. The authors report a case of mucinous cystadenoma of the minor salivary gland on the hard palate, which is even rarest of the rarely reported cystadenomas of the minor salivary glands.
Tumors of salivary glands constitute a heterogeneous group of lesions of great morphologic variation. Annual incidence of salivary gland tumors around the world is They are more common on hard palate than soft palate, probably because there are greater number of gland aggregate on hard palate than Aden hj and oral soft palate.
Cystadenomas of salivary glands are benign neoplasms, in which the epithelium demonstrates adenomatous proliferation that is characterized by formation of multiple cystic structures.
Several morphological variants of cyst adenoma have been described of which papillary and mucinous cystadenoma are important. World Health Organization WHO described papillary cystadenoma which closely resembles Wartins tumor, but without the lymphoid elements.
If mucous cells predominate in the cell population of the lining epithelial cells, the tumor is termed as mucinous cystadenoma. Cystadenoma is a rare, slowly and painlessly enlarging asymptomatic salivary gland tumor that rarely exceeds 1.
Common sites of occurrence are palate and buccal mucosa, lip and the tonsillar area, but cyst adenomas have also been reported Aden hj and oral occur on the tongue. Cystadenoma is widely distributed among major and minor salivary glands. No large series of cyst adenoma with follow-up information has been reported.
The likelihood of recurrence is low. A conservative surgical procedure ensures complete removal. The use of a carbon dioxide laser has become common in oral and maxillofacial surgery for lesions of the oral mucosa.
Advantages reported for the carbon dioxide laser in oral soft-tissue surgery include, minimal damage to adjacent tissue, good hemostasis, minimal inflammatory reaction, scar formation and precise cutting.
A years-old female reported with an asymptomatic swelling in the right posterior palatal area in the region of missing 15,16 and 17 [ Figure Aden hj and oral ].
The swelling was present since several months and gradually increased to the presenting size. On examination, a well-defined, round mass, approximately 2 cm in diameter was revealed, which was soft to firm in consistency, non-movable, slightly compressible and painless.
No carious tooth was found to be associated and there was no sign of tooth displacement. The mucosa over the swelling appeared normal. A provisional clinical diagnosis of benign minor salivary tumor was given For differential diagnosis, pleomorphic adenoma, a low- grade minor salivary gland malignancy acinar cell adenocarcinoma AcACadenoidcystic carcinoma, mucoepidermoid carcinomaresidual cyst, retention Aden hj and oral, lipoma, neurofibroma and palatal odontogenic keratocyst were considered.
Patient was investigated with a panoramic and a maxillary occlusal radiograph, which showed no bony alteration in the area of the swelling. An intra-oral periapical radiograph was performed to rule out possible odontogenic origin.
Fine needle aspiration cytology of the swelling yield a hemorrhagic aspirate of insignificant volume. H and E stained smear of the aspirate showed presence of mostly red blood cells and some chronic inflammatory cells.
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Routine hematological investigations were advised before the patient was referred to oral surgery for excision of the palatal mass. Primary closure of the overlying mucosa was performed [ Figure 2b ] and the wound healed by primary intention without any intra-or post-operative complications [ Figure 2c ]. Periodontally compromised adjacent maxillary molar was later extracted. Surgical excision by raising a full thickness mucosal flap aPrimary closure of the wound bPost-operative: Healing after 1 month Aden hj and oral.
The histopathological examination revealed numerous large and small cystic spaces interspersed in a fibrous connective tissue stroma [ Figure 4 ]. The cystic lumens were lined by cell layer thick epitheliums, which varied from flattened to cuboidal Aden hj and oral tall columnar Aden hj and oral [ Figure 5 ].
The stroma exhibited multiple hemorrhagic areas and focal aggregates of chronic inflammatory cells along with few mucous cells. Normal appearing mucous acini could also be appreciated in the deeper sections [ Figure 6 ]. Cellular atypia and mitosis were absent. A diagnosis of mucinous cyst adenoma was made.
Patient is under follow-up for identification of any recurrence. Photo micrograph depicting cystic lumen with flat a and cuboidal b epithelial lining black arrows.
Cyst adenoma is a rare benign neoplasm of epithelial origin found chiefly affecting the minor salivary glands. Although cases involving the major salivary glands have been reported.
Bauer and Bauer suggested that the cyst adenoma arises principally from the undifferentiated epithelium of the intercalated ducts of the salivary gland. The papillary variety of cyst adenoma exhibits papillary proliferations that project into the cystic lumens and may closely resemble the Warthin's tumor with the absence of the lymphoid element. Cyst adenoma has been reported to occur in patients between 17 years and 86 years of age with a mean age of about 61years.
Male ratio being 3: The most common site of occurrence is the palate, as Aden hj and oral in our case, followed by the buccal mucosa and the tongue.
As such, cystadenoma presents no distinct clinical features and may be impossible to differentiate clinically from other benign salivary gland tumors, mucous retention or extra vasations phenomena and low-grade minor salivary gland malignancies such as papillary cystic variant PCV of ACC, adenoid cystic carcinoma and muco epidermoid carcinoma.
Papillary folds are seen interspersed with cystic spaces, which may be small or large with well-defined papillary growths and glandular epithelial masses stranded Aden hj and oral cords of fibro vascular tissue. Further, ACC-PCV is reported to occur in younger patients years ,[ 15 ] contrary to our case of a year-old female.
Diagnosis of cystadenoma is strictly histopathological.
The histopathological features described in our case were characteristic and in general agreement with what has been reported in the literature for cystadenoma.
Since salivary gland tumors show great histomorphological diversity, differential diagnosis of cystadenoma must include intra ductal papilloma, cystadeno carcinoma, low-grade mucoepidermoid carcinoma and Aden hj and oral Tumor. Most cases of cystadenomas, including our case, are treated by simple surgical excision. The aim of this Aden hj and oral report is to document the rarely reported mucinous cystadenoma and may be the first reported mucinous cystadenoma in the oral cavity among the Indian population.
National Center for Biotechnology InformationU. Dent Res J Isfahan. Author information Article notes Copyright and License information Disclaimer. Received May; Accepted May. This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3. This article has been cited by other articles in PMC.
Abstract Cystadenoma is a rare benign salivary gland tumor that chiefly originates in the minor salivary glands as a cystic growth with papillary projections into the cystic lumen without the lymphoid element.
Benign neoplasm, hard palate, minor salivary gland tumor, mucinous cystadenoma. Open in a separate window.
Masterclass aden hj and oral naked 18+ gallery
Soft-tissue bit sent for histopathology approx. Footnotes Source of Support: Textbook of Oral Pathology. WB Saunders, Philadelphia, Elsevier; Tumors of salivary glands; Aden hj and oral. A rare tumor originated in minor salivary gland. J Bras Patol Med Lab. Clinical analysis of salivary gland tumor cases in West China in past 50 years.
Seifert G, Sobin LH. The World Health Organization's histological classification of salivary gland tumors: A commentary on the second edition. Alexis JB, Dembrow V. Papillary cystadenoma of a minor salivary gland. J Oral Maxillofac Surg. Tumors of the intraoral minor salivary glands: A demographic and histologic study of cases.