Expression of Hormonal Receptor in Patients with Metastasizing Pleomorphic Adenoma of the Major Salivary Gland; A Clinicopathological Report of Three Cases
Noppadol Larbcharoensub MD*,**, Patcharee Karnsombut Cert, MLT*, Jumroon Tungkeeratichai MD***, Supawadee Prakunhungsit MD***, Ladawan Narkwong MD****, Juvady Leopairut MD*
Affiliation : * Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand ** Department of Anatomy, Faculty of Science, Mahidol University, Bangkok, Thailand *** Department of Otolaryngology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand **** Department of Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Background : Metastasizing pleomorphic adenoma is an uncommon malignant tumor of the salivary gland
demonstrating benign epithelial and modified myoepithelial elements intermingling with tissue of mucoid,
myxoid, or chondroid appearance that inexplicably manifests local or distant metastasis.
Objective : To determine the expression of hormonal receptor in the patients with metastasizing pleomorphic
adenoma of the major salivary gland.
Material and Method: Medical records, clinical and pathologic findings of three patients who were
diagnosed as metastasizing pleomorphic adenoma were reviewed. The immunohistochemical stains for
estrogen receptor, progesterone receptor, and Ki-67 were performed.
Results : Three cases of metastasizing pleomorphic adenoma, clinically presenting as painless, gradually
enlarged cervical lymph nodes were reported. The pathologic examinations of the cervical lymph nodes are
morphologically and immunohistologically identical to the sialoadenectomy specimen. Immunohistochemical
stains show positive reactivity to progesterone receptor, but negative reactivity to estrogen receptor in both
mesenchymal and epithelial components of pleomorphic adenoma.
Conclusion : These are the first reported cases of metastasizing pleomorphic adenoma of the major salivary
glands associated with expression of progesterone receptor in both specimens of sialoadenectomy and lymph
node biopsy. This finding supports the pathogenesis of benign metastasis of tumor. However, the role of
hormonal receptor in the pathogenesis and treatment of salivary metastasizing pleomorphic adenoma should
be further investigated.
Keywords : Adenoma, Pleomorphic, Immunohistochemistry, Neoplasm metastasis, Receptors, Progesterone, Salivary gland neoplasms
