Pleomorphic adenoma of the epiglottis: A systematic review

Pleomorphic adenoma (PA) predominantly occurs in major salivary glands, with epiglottic involvement being exceptionally rare. This study systematically reviews the epidemiological characteristics, clinical manifestations, diagnostic approaches, therapeutic interventions, and prognostic outcomes of PA of the epiglottis.

Two independent investigators screened the literature and extracted data, including the following databases: PubMed, Web of Science, CAS SciFindern, EMBASE, Scopus, Cochrane Library databases, and regional databases including SciELO, Dimensions, and CNKI. In addition, we also searched grey literature sources, ClinicalTrials.gov, and PROSPERO. Furthermore, there are also Google Scholar and Baidu Scholar. The literature search was current through July 2025 and used a narrative synthesis method to comprehensively evaluate the case characteristics, clinical manifestations, imaging characteristics, treatment methods, and follow-up results.

A total of 28 patients with PA of the epiglottis were included. The mean age at diagnosis was 58.8 ± 14.3 years (range: 25-83 years), with the following age distribution: 25-35 years (n = 1, 3.6%), 36-45 years (n = 5, 17.9%), 46-55 years (n = 9, 32.1%), 56-65 years (n = 4, 14.3%), 66-75 years (n = 6, 21.4%), and 76-85 years (n = 3, 10.7%). The cohort comprised 19 males (67.9%) and 9 females (32.1%). The predominant clinical manifestations included pharyngeal foreign body sensation, dyspnea, and dysphagia. Tumors were localized to the laryngeal surface of the epiglottis in 13 cases (46.4%) and the tongue surface in 8 cases (28.6%). Tumor dimensions ranged from a maximum of 6.0 × 5.0 cm to a minimum of 1.3 × 1.0 cm. A complete capsule was identified in 13 cases (46.4%), while absence of an intact capsule was noted in 1 case (3.6%); capsule status was not documented in the remaining 14 cases (n = 50.0%). Twenty-seven patients underwent surgical resection, including open surgery and other operative methods; open surgery was performed in 14 cases (50%). No instances of recurrence, malignant transformation, or distant metastasis were observed during follow-up.

This study represents the first systematic review to comprehensively evaluate the characteristics of PA of the epiglottis. The patient exhibits no typical laryngeal symptoms, and surgical resection serves as the primary therapeutic approach. Given the potential for recurrence and malignant transformation, long-term postoperative follow-up is required.