Acta oto-laryngologica · 2025
Differential diagnosis between pleomorphic adenoma and carcinoma ex pleomorphic adenoma: focus on clinical and MR findings.
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Sato Asuka, Tachibana Tomoyasu, Kanie Yuichiro, Kakiuchi Minami, Kariya Akifumi, Furukawa Chieko, Naoi Yuto, Sato Yasuharu, Ando Mizuo
Аннотация
BACKGROUND: In parotid tumors, preoperative differential diagnosis between pleomorphic adenoma (PA) and carcinoma ex pleomorphic adenoma (CXPA) remains challenging.
OBJECTIVES: The present study aimed to evaluate the clinical characteristics of CXPA and PA and to identify factors associated with the differential diagnosis of these conditions.
MATERIAL AND METHODS: We reviewed the medical records of 6 CXPA and 127 PA patients treated surgically at our institution between 2008 and 2024.
RESULT: Univariate analysis revealed significant differences in spontaneous pain (p = .044), facial nerve palsy (p = .045), and subjective enlargement (p < .01) between the CXPA and PA patients. Magnetic resonance imaging (MRI) revealed that the proportions of masses with ill-defined margins, localization in the deep lobe, and low apparent diffusion coefficient (ADC) were significantly higher in patients with CXPA than in those with PA (p < .01, p = .048, and p < .01, respectively). Multivariate analysis identified that spontaneous pain and masses with ill-defined margins were associated with CXPA (p = .047 and p = .013, respectively).
CONCLUSION: Spontaneous pain and masses with ill-defined margins could be suggestive of CXPA rather than PA. Low ADC levels indicate the possibility of CXPA.
OBJECTIVES: The present study aimed to evaluate the clinical characteristics of CXPA and PA and to identify factors associated with the differential diagnosis of these conditions.
MATERIAL AND METHODS: We reviewed the medical records of 6 CXPA and 127 PA patients treated surgically at our institution between 2008 and 2024.
RESULT: Univariate analysis revealed significant differences in spontaneous pain (p = .044), facial nerve palsy (p = .045), and subjective enlargement (p < .01) between the CXPA and PA patients. Magnetic resonance imaging (MRI) revealed that the proportions of masses with ill-defined margins, localization in the deep lobe, and low apparent diffusion coefficient (ADC) were significantly higher in patients with CXPA than in those with PA (p < .01, p = .048, and p < .01, respectively). Multivariate analysis identified that spontaneous pain and masses with ill-defined margins were associated with CXPA (p = .047 and p = .013, respectively).
CONCLUSION: Spontaneous pain and masses with ill-defined margins could be suggestive of CXPA rather than PA. Low ADC levels indicate the possibility of CXPA.