Pleomorphic adenoma (PA) is considered the most common benign salivary gland tumor [11]. Willis [12] created the name Pleomorphic adenoma. The World Health Organization (WHO) categorized PA in 1972 as “a circumscribed tumor characterized by clearly visible epithelial tissue interspersed with the tissue of mucoid, myxoid, or chondroid appearance” [13]. It strikes during the third and sixth decades of life, with a minor proclivity for females with a female-to-male ratio of 2:1 [14]. The term “mixed tumor” is deceptive [12], despite the fact that it is made up of mesenchymal and epithelial cells [15]. The parotid gland is frequently affected, particularly the lower pole of the superficial lobe. The minor salivary glands of the mouth are involved in 8% of PAs. Sixty to 65% of the salivary glands in the mouth [12] and 5.5% in the minor salivary glands of the cheek [16] are involved.
The clinical features of the lesion are consistent with those described in the literature, including an asymptomatic, slow-growing nodular lesion of firm consistency with normal intact mucosa [8,9,10]. Based on the characteristics of the mass as being superficial and easily accessible by excisional biopsy, we did not recommend Fine Needle Aspiration Cytology (FNAC) of the lesion preoperatively. However, FNAC is still a precise and helpful tool for distinguishing benign from malignant tumors and establishing the ideal treatment strategy.
The histopathological report of the case described the interaction of epithelial components clustered in duct-like structures with myoepithelial cells in the stroma with various patterns such as mucoid, myxoid, cartilaginous, or hyaline. These findings coincide with PA's microscopic features [8, 15].
The tumor under inquiry has a wide range of histological features that reflect the polymorphic pattern seen in salivary gland neoplasms. The histology of these malignancies, which is linked to the type of cell, handles a wide range of histomorphology [16, 17]. PA’s histogenesis is linked to the intercalated duct’s reserve cells. The ability of reserve cells to develop into multiple subtypes points out the morphological variability seen in salivary gland neoplasms, which can even differ within the same tumor [17].
Soft-tissue neoplasms, like neurilemoma [8, 10] neurofibroma, lipoma [8, 14] neoplasms of minor salivary glands, may also be considered for the differential diagnosis [18], in addition to inflammatory and reactive lesions [8,9,10].
Finally, while developing diagnostic hypotheses is critical, the significance of making definitive scrutiny is emphasized. Whereas the comprehensive look at a lesion can imply a variety of theories, the anatomopathological investigation is the only way to figure out the definitive findings. The recommended treatment for PA is surgical excision with preservation of the capsule and a perimeter of normal tissue around it [8,9,10, 14, 15, 19,20,21]. PA should be diagnosed as soon as feasible because, despite its rarity [19, 22, 23], later malignant change to carcinoma ex pleomorphic adenoma might occur [7, 11, 21,22,23]. Consequently, in our study, we followed up the case for 5 years with no recurrence.
