| Cellular Pleomorphic Adenoma in the Salivary Gland: Diagnostic and Therapeutic Approaches |
Subi Oh1
, Ji Min Na2
, Junhun Cho3
, Han-Sin Jeong1
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1Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
2Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
3Department of Pathology, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Korea |
| 침샘에서 발생한 세포성 다형선종에 대한 진단 및 치료 분석 |
| 오수비1
, 나지민2
, 조준훈3
, 정한신1
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1성균관대학교 의과대학 삼성서울병원 이비인후과학교실
2성균관대학교 의과대학 삼성서울병원 병리학교실
3중앙대학교 광명병원 병리과 |
Received: 30 April 2025; Accepted: 30 May 2025. Published online: 6 August 2025.
*Subi Oh and Ji Min Na contributed equally to this work. |
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| ABSTRACT |
Background and Objectives
Cellular pleomorphic adenoma (PA) is a histological subtype of PA characterized by a predominance of epithelial and/or myoepithelial cells with minimal stromal components. This cellularity complicates preoperative differentiation from malignant salivary gland tumors. The present study aimed to evaluate the clinicopathological features of cellular PA and propose optimal diagnostic and therapeutic strategies.
Subjects and Method
We conducted a retrospective review of 31 cases of cellular PA diagnosed between 2000 and 2024 at a single tertiary institution. Inclusion criteria required surgical pathology reports confirming cellular PA. Clinical characteristics, diagnostic methods, surgical approaches, and outcomes were analyzed. Detailed histopathological review was performed in 18 cases.
Results
Among 31 patients (22 females, 9 males; mean age, 56 years), 80.6% of tumors were located in the parotid gland. In the reviewed specimens, 94.4% (17 of 18) demonstrated >70% tumor cell density. All tumors were well-circumscribed without invasion, cytologic atypia, or frequent mitosis. Fine needle aspiration yielded low diagnostic accuracy (40%), and core needle biopsy was similarly limited. Imaging studies suggested benign features in only 55% of cases. Surgical excision was performed in all cases, with negative margins in 74.2%. Recurrence was observed in 3 cases (9.7%) during the long-term follow-up (69.5-223.1 months).
Conclusion
Cellular PA presents a diagnostic challenge due to its high cellularity and lack of stromal components, often mimicking malignancy in preoperative evaluations. Given its diagnostic ambiguity, complete surgical resection with an adequate margin is recommended to ensure definitive diagnosis and minimize recurrence. |
| Keywords:
Diagnosisㆍ Pleomorphic adenomaㆍ Salivary gland neoplasmsㆍ Surgeryㆍ Treatment outcome |
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