A Case of Pleomorphic Adenoma Metastasising to Contralateral Supraclavicular Lymph Node

Esmail Abdulahi Ahmed*, Kamil Akdag, Onur Üstün, Ayça Başkadem Yılmazer, Pınar Özay Nayır, Zeynep Aydodu and Yavuz Uyar

A Case of Pleomorphic Adenoma Metastasising to Contralateral Supraclavicular Lymph Node.

Pleomorphic adenomas are the most common benign parotid tumours in all populations. Management always consists of a curative superficial parotidectomy. However, rare cases described, in which these histological benign tumors metastasize to distant sites. We present an example of a recurrent parotid pleomorphic adenoma with a contralateral supraclavicular lymph node metastasis after several surgical interventions.

In this case, we reported reported a case of 29-years male with extensive metastasis in submandibular, submental and also very rarely seen contralateral supraclavicular lymph node metastasis. Parotidectomy with preservation of facial nerve and radiotherapy was given to the patient since the lesions were very aggressive.

The patient had several surgical interventions, so it is essential to do meticulous resection in the first surgery to prevent local recurrence and distant metastasis. Pleomorphic adenoma is a benign tumour that has elements of both epithelial and mesenchymal tissues. Pleomorphic adenoma is a tumour of variable capsulation characterized microscopically by architectural rather than cellular pleomorphism, most commonly with a tissue of mucoid, myxoid or chondroid appearance which consists of the salivary glands.

It consists of approximately 3% of all head and neck tumours and about 70-80% of these neoplasms occur in the major salivary glands. The tumour most commonly found in the parotid or submandibular glands.

Incidence of pleomorphic adenoma varies from 2 to 3.5% with a female preponderance, 3rd and 6th
decades are peak ages for pleomorphic adenoma. Neck irradiation is a very strong predisposing factor while the link between the development of pleomorphic adenoma and a simian virus is not clear

Although pleomorphic adenoma is a benign tumour sometimes it shows recurrence and also transformation to malign
tumour with an incidence of 2 to 7%.

Otolaryngol Open J. 2019; 5(2): 34-38. doi: 10.17140/OTLOJ-5-158