What is Pleomorphic Adenoma?
Pleomorphic adenoma, often referred to as a benign salivary gland tumor, is one of the most common types of non-cancerous growth found in the salivary glands. This tumor primarily affects the parotid glands, which are located near the ears. Though pleomorphic adenomas are non-cancerous, if left untreated, they can cause complications, including growth into surrounding tissues or transformation into malignant tumors in rare cases.
Pleomorphic adenoma is made up of a mixture of glandular (epithelial) and connective tissue. This mixture is what gives it the name "pleomorphic" — which means "many forms" — since it can present itself in various shapes and textures. Though it is benign, its tendency to grow slowly and persist over time can lead to discomfort or functional issues, such as difficulties with eating or talking if it presses on nearby nerves or muscles.
What are the Symptoms of Pleomorphic Adenoma?
The most noticeable symptom of pleomorphic adenoma is usually a painless lump or swelling in the area near the jaw or cheek. The swelling may feel firm or rubbery, and it can vary in size. As the tumor grows, it may cause some discomfort or tenderness, especially if it presses against surrounding structures like nerves.
Other symptoms can include:
Difficulty in opening the mouth
Dry mouth
Numbness or weakness in the face, if the tumor presses on the facial nerve
Swelling that increases in size over time
Most people notice the tumor when it is still small, but it can grow to become noticeable after months or even years. If the lump starts to change shape, or if you experience new symptoms like pain or rapid growth, it may be a sign of a problem that requires medical attention.
What Causes Pleomorphic Adenoma?
The exact cause of pleomorphic adenoma is not well understood, but there are several factors that may contribute to its development. Some of these factors include:
Genetic mutations: Research suggests that changes in certain genes can lead to the formation of these tumors. Specific mutations can cause the abnormal growth of salivary gland cells, leading to the development of pleomorphic adenomas.
Age and gender: Pleomorphic adenomas most commonly occur in adults, especially in those between the ages of 30 and 50. They are more frequent in women than in men.
Radiation exposure: People who have been exposed to radiation, particularly in childhood, may have a higher risk of developing salivary gland tumors, including pleomorphic adenomas.
Though these factors may contribute to the development of pleomorphic adenoma, it is important to note that not all individuals with these risk factors will develop the condition.
How is Pleomorphic Adenoma Diagnosed?
To diagnose pleomorphic adenoma, a healthcare professional will typically start with a physical examination to feel for any lumps or swelling in the salivary glands. However, this is usually followed by more advanced imaging tests to confirm the presence of the tumor and assess its size, location, and structure.
Common diagnostic tools include:
Ultrasound: An ultrasound can provide real-time images of the lump to help determine its size, texture, and whether it is benign.
CT scan or MRI: If the ultrasound is inconclusive, more detailed scans like a CT or MRI can give a clearer picture of the tumor and help doctors plan treatment.
Fine needle aspiration biopsy (FNA): This test involves taking a small sample of the tumor tissue to examine under a microscope. It helps to rule out the possibility of cancer and confirm the diagnosis of pleomorphic adenoma.
What are the Treatment Options for Pleomorphic Adenoma?
The most effective and common treatment for pleomorphic adenoma is surgical removal of the tumor. Surgery is typically recommended because it helps to prevent the tumor from growing larger, causing further complications, or potentially turning cancerous over time.
Surgical Removal of the Tumor
Parotidectomy: In cases where the tumor is located in the parotid gland, a parotidectomy (surgical removal of the parotid gland) may be performed. The goal is to remove the tumor along with a portion of the surrounding tissue to ensure complete removal.
Superficial Parotidectomy: If the tumor is located in the superficial lobe of the parotid gland, this method may be used, where only the outer portion of the gland is removed.
Submandibular or Sublingual Gland Removal: For tumors located in other salivary glands like the submandibular or sublingual glands, removal of the affected gland may be necessary.
The surgery is generally safe, but there are risks involved, including damage to the facial nerve, which could cause facial weakness or drooping. Surgeons take great care to avoid this complication during the procedure.
Post-Surgery Care
After surgery, most patients recover well with few complications. However, it is important to follow the surgeon's post-operative instructions, including:
- Rest and avoid strenuous activity
- Monitor for signs of infection, such as redness, swelling, or fever
- Attend follow-up appointments to ensure the tumor does not recur
Can Pleomorphic Adenoma Return After Treatment?
Though pleomorphic adenomas are generally benign, they have a small chance of recurring after removal, particularly if the tumor was not fully excised. This is why regular follow-up appointments with your doctor are crucial for monitoring the affected area and catching any potential recurrence early.
When to See a Doctor?
If you notice any unusual swelling, lumps, or changes in the mouth, throat, or jaw, it is important to see a healthcare provider promptly. A doctor's early diagnosis can prevent complications and help avoid further growth or potential malignancy of the tumor. Treatment, usually surgical, can be highly effective in managing pleomorphic adenomas and restoring health.
