Large cyst formation in pleomorphic adenoma

The aim of this study was to examine about the etiology of large cyst formation in pleomorphic adenoma from the histopathological standpoint by examining four cases of our own as well as previously reported ones. In the first of our cases, a large cyst wall lined with keratinized squamous epithelium was observed. In the second, a large cyst containing mucinous material was lined with a single cell layer of squamous epithelium-like cells. The third case was a carcinoma in pleomorphic adenoma with some large cysts lined with multiple layers of atypical epithelial cells. In the fourth case, a hemorrhagic portion were seen on a large cyst wall without a lining of epithelial cells. From these histopathological observations and the suggestions of previous authors, we surmised that the large cyst formation in pleomorphic adenoma might originate from the squamous metaplasia of tumor cells and the enlargement of duct-like structures by outstanding secretion from tumor cells or salivary gland tissues, hemorrhagic portions, or necrosis in the malignant tumor.