Pleomorphic Adenoma

Question 1

What is the most common salivary tumour?

Where do they occur?

Answer 1

Pleomorphic adenomas

These most commonly occur in the parotid gland.

Question 2

Are pleomorphic adenomas benign or malignant?

Answer 2

Benign

Question 3

Are most parotid tumours benign or malignant?

Answer 3

Benign

Question 4

Clinical features of a pleomorphic adenoma?

Answer 4

1) Slow-growing

2) Painless, firm mass in parotid gland (palpable in the pre-auricular area)

3) Lesion moves freely on examination

Question 5

Do pleomorphic adenomas carry a risk of undergoing malignant transformation?

Answer 5

YES

Question 6

Can the facial nerve be invaded in a pleomorphic adenoma?

Answer 6

No - facial nerve weakness or paralysis suggests malignancy

Question 7

1st line investigation in a pleomorphic adenoma?

Answer 7

US guided fine needle aspiration/core needle biopsy

Question 8

What is the most common reason for a persistent unexplained lump in the parotid?

Answer 8

Pleomorphic adenoma

Question 9

Referral for persistent unexplained lumps in the parotid or submandibular glands?

Answer 9

An urgent referral (within 2 weeks) should be made for persistent unexplained lumps in the parotid or submandibular glands.

Question 10

What is the mainstay of mx of a pleomorphic adenoma?

Answer 10

Surgical –> they are removed due to their risk of malignant transformation

Question 11

What is the main complication of a pleomorphic adenoma?

Answer 11

Malignant transformation (may be indicated by sudden enlargement)