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Pleomorphic adenoma of the salivary glands: prospective clinicopathologic and flow cytometric study
L Junquera1, D Alonso, A Sampedro
1Department of Oral and Maxillofacial Surgery, University of Oviedo, Hospital Central de Asturias, Oviedo, Spain.
Background:
Primary surgery is the appropriate treatment for most pleomorphic adenomas of the salivary glands. However, no reliable criteria have been established to predict tumors with aggressive features.
Methods:
In 44 patients treated for salivary pleomorphic adenoma, clinicopathologic features and flow cytometric findings were recorded. S-phase fractions were classified as low (0%-1%), intermediate (1.1%-5%), and high (>5%). The relationship between clinicopathologic parameters and flow cytometric DNA analysis was assessed with the Pearson's correlation coefficient.
Results:
The mean tumor size was 24.4 mm. Microscopically, myxoid structures predominated in 61.4% of cases. Only five specimens showed high S-phase fractions. All samples were DNA diploid (mean coefficient of variation 3.2%). S-phase fraction and tumor size correlated significantly (r = 0.73, P = 0.003). Two patients with recurrent tumors had high S-phase fractions both on the first resected specimens and at the time of the second operation.
Conclusions:
The S-phase fraction may be a valuable predictor of aggressive behavior in salivary pleomorphic adenomas. High S-phase fractions were associated with higher tumor size and a greater tendency to recur.