Giant Pleomorphic Adenoma of Parotid Gland: A Rare Cytological Diagnosis
Senior Resident, Department of Pathology, AIIMS, Phulwari Sharif, Patna, Bihar, India.
Pleomorphic adenoma is the most common salivary gland neoplasm, which affects both major and minor salivary glands. It is also the most common neoplasm arising in the parotid. In minor salivary glands, it most commonly involves the palate and rarely involves the lips, cheek and gingiva. It is also called Benign Mixed Tumour (BMT), since it is composed of a variable amount of epithelial and mesenchymal elements. Diagnostic modalities include Ultrasonography (USG), Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). MRI provided the most precise structural information of the tumour as well as surrounding structures. A 60-year-old female presented with a massive right-sided infra-auricular swelling, since 20 years. On Contrast Enhanced Computed Tomography (CECT), a huge lobular exophytic lesion with thin enhancing septation and few calcific foci was visualised in the right parotid region. The Fine Needle Aspiration Cytology (FNAC) yielded the diagnosis of Pleomorphic Adenoma (PA). Giant PA with an indolent course is a rare entity in itself. This is a case of giant PA of the parotid gland growing insidiously over a period of 20 years.