Polymorphous low-grade adenocarcinoma

Polymorphous low-grade adenocarcinoma
Low magnification micrograph of a polymorphous low-grade adenocarcinoma, showing the typical variation of architectural arrangement. H&E stain.
Specialty	ENT surgery

Polymorphous low-grade adenocarcinoma (PLGA) is a rare, asymptomatic, slow-growing malignant salivary gland tumor. ^[1] It is most commonly found in the palate. ^[2]

The name of the tumor derives from the fact that:

• It has a varied microscopic architectural appearance, i.e. it is polymorphous.
• It is non-aggressive when compared to other oral cavity tumors, i.e. it is a low-grade tumor. ^[1]
• It forms glands, i.e. it is an adenocarcinoma .

It affects the minor salivary glands in the area between the hard and the soft palate. Male to female ratio is 3:1, and the average age is 56 years.

Histology

PLGAs consist of a monomorphous cell population that has a varied histologic morphology.

Microscopically, its histology can be confused with an adenoid cystic carcinoma and a pleomorphic adenoma.

• 
  Polymorphous low-grade adenocarcinoma. H&E stain.
• 
  Micrograph of a polymorphous low-grade adenocarcinoma. H&E stain.

Treatment

PLGAs are treated with wide local surgical excision and long-term follow-up. ^[2] There is a recurrence rate of 14% (Peterson, contemporary of oral and maxillofacial surgery).

References

1. Arathi N, Bage AM (2009). "Polymorphous low-grade adenocarcinoma of parotid gland: a rare occurrence". Indian Journal of Pathology & Microbiology. 52 (1): 103–105. doi: 10.4103/0377-4929.44985 . PMID   19136798.
2. Paleri V, Robinson M, Bradley P (April 2008). "Polymorphous low-grade adenocarcinoma of the head and neck". Current Opinion in Otolaryngology & Head and Neck Surgery. 16 (2): 163–169. doi:10.1097/MOO.0b013e3282f70441. PMID   18327037. S2CID   45814368.